The US Department of Veterans Affairs (VA) has eliminated frontline jobs for staffers who provide direct care to veterans, despite previous assurances from agency leaders that such positions would largely be protected from cuts. This move comes as the agency faces a budget shortfall and seeks to reduce its workforce by 10,000 positions, according to a CNN review of documents and interviews with more than 20 VA employees and job applicants.
Positions for psychologists, clinical social workers, and other healthcare providers have been cut, and some job offers have been rescinded. This is happening at a time when veterans continue to experience long wait times for services, and suicides among veterans remain disproportionately high.
The cuts have caused significant discontent among VA employees, especially given the department’s recent scandal involving the improper awarding of about $11 million in bonuses to senior VA executives last year. VA Secretary Denis McDonough has stated that the bonuses were canceled and efforts to recoup the funds have begun.
Following a surge in hiring last year to accommodate the increased number of veterans seeking care, the VA now faces the challenge of balancing budget constraints with the need to provide adequate care. This has led to job eliminations, which some insiders fear will undermine the health system’s ability to serve veterans.
Lawmakers have requested information about the VA’s job reduction strategy after hearing reports that frontline positions were being targeted. VA Under Secretary for Health Dr. Shereef Elnahal issued internal memos in late May directing managers to continue hiring for roles essential to patient safety and care quality, and to fill key positions in areas such as suicide prevention, homelessness, and women’s health. However, administrative roles and certain clinical positions that could be covered by other employees were slated for cuts.
The impact of these cuts remains uncertain, particularly whether any frontline positions will be reinstated and if rescinded job offers will be reissued. VA spokesperson Terrence Hayes stated that the VA continues to strategically hire in critical areas like mental health and locations with increased demand for care, maintaining the staffing levels needed to serve veterans nationwide.
Local VA managers have also been warning about the strain on services due to the hiring initiative. Dr. Mark Kadowaki, chief of staff for the VA medical center in Iron Mountain, Michigan, highlighted the strain on both clinical and non-clinical services in a May email to staff. Despite this, Hayes noted that the Iron Mountain facility has seen a net increase in employees this year, including the addition of specialty providers.
The staff reductions have also sparked backlash on Capitol Hill. In April, leading senators on the Senate Committee on Veterans’ Affairs criticized the staff reduction plan, and a separate group of senators called for more transparency on employee vacancies and cuts.
Dr. Harold Kudler, a psychiatrist with decades of experience at the VA, expressed concerns about the cuts, particularly in mental health care. A Government Accountability Office report in February noted that veterans face a disproportionately high suicide rate, with nearly 18 veterans dying by suicide daily in 2021, a rate significantly higher than the general adult population.
The VA’s plan to downsize follows a hiring spree last year driven by the PACT Act, which expanded health benefits for veterans exposed to toxic substances. The VA hired over 60,000 employees in fiscal year 2023, bringing its total workforce to over 400,000. However, budget constraints have now led to reductions. Elnahal stated in March that up to 10,000 positions could be eliminated through attrition and voluntary separation, focusing mainly on non-direct care roles.
VA sources, however, have criticized the implementation of these reductions, accusing the department of slow-walking hires for critical positions. Tiffany Roman, a VA nurse and vice president of a local American Federation of Government Employees union chapter, asserted that direct-care staff are being eliminated, contradicting the official narrative.
Some job applicants have experienced rescinded offers due to budgetary issues. For instance, William Hazel, who applied for a social worker position in Guam, had his offer rescinded after receiving a tentative offer last September. Similarly, other applicants for roles in mental health and suicide prevention had their offers rescinded, leading to questions about the VA’s commitment to prioritizing mental healthcare.
VA Secretary McDonough acknowledged the difficult choices imposed by the federal budget during a Senate hearing in May but emphasized the department’s high retention rates and improved staffing levels. The VA has reported increased trust among veterans and slightly reduced wait times for new patient appointments. However, a recent Government Accountability Office report highlighted ongoing challenges in providing timely care, especially for mental health appointments in the private sector.
Union leaders and veterans’ advocates warn that the staffing cuts could undermine the progress made in improving VA care. Jeff Shapiro, president of the VA council for the National Federation of Federal Employees union, emphasized the risks posed by reduced staffing and called it a managerial problem.
The ongoing reductions in frontline VA health jobs highlight the complex challenges of balancing budgetary constraints with the need to provide essential care to veterans, raising concerns about the long-term impact on veterans’ health services.
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