“VHA evolved from the first federal soldiers’ facility established for Civil War Veterans of the Union Army. On March 3, 1865—a month before the Civil War ended and the day before his second inauguration—President Abraham Lincoln signed a law to establish a national soldiers and sailors asylum. Renamed as the National Home for Disabled Volunteer Soldiers in 1873, it was the first-ever government institution created specifically for honorably discharged volunteer soldiers. The first national home opened November 1, 1866, near Augusta, Maine. The national homes were often called “soldiers’ homes” or “military homes,” and only soldiers who fought for the Union Army—including U.S. Colored Troops—were eligible for admittance. These sprawling campuses became the template for succeeding generations of federal Veterans’ hospitals.
By 1929, the federal system of national homes had grown to 11 institutions that spanned the country and accepted Veterans of all American wars.
But it was World War I that brought about the establishment of the second largest system of Veterans’ hospitals. In 1918, Congress tasked two Treasury agencies — the Bureau of War Risk Insurance and Public Health Service –with operating hospitals specifically for returning World War I Veterans. They leased hundreds of private hospitals and hotels for the rush of returning injured war Veterans and began a program of building new hospitals.
Today’s VHA–the largest of the three administrations that comprise VA–continues to meet Veterans’ changing medical, surgical and quality-of-life needs. New programs provide treatment for traumatic brain injuries, post-traumatic stress, suicide prevention, women Veterans and more. VA has opened outpatient clinics, and established telemedicine and other services to accommodate a diverse Veteran population, and continues to cultivate ongoing medical research and innovation to improve the lives of America’s patriots.
VHA operates one of the largest health care systems in the world and provides training for a majority of America’s medical, nursing and allied health professionals. Roughly 60 percent of all medical residents obtain a portion of their training at VA hospitals; and VA medical research programs benefit society at-large.
The VA health care system has grown from 54 hospitals in 1930 to 1,600 health care facilities today, including 144 VA Medical Centers and 1,232 outpatient sites of care of varying complexity.” History – VA History – About VA
With all of that information, it kind of provides some brevity to what the Veterans Health Administration goes through to continue operating. But of course, there is so much more to be done.
One of the biggest triumphs has been the Deborah Sampson Act finally passing. This act has been morphed into many different things since its birth many years ago. IAVA Celebrates Final Congressional Passage of Deborah Sampson Act Following Years-Long Campaign – IAVA
GAO designated VA health care as a high-risk area in 2015 due to five areas of concern regarding VA’s ability to provide timely access to safe, high-quality health care for veterans: (1) ambiguous policies and inconsistent processes; (2) inadequate oversight and accountability; (3) IT challenges; (4) inadequate staff training; and (5) unclear resource needs and allocation priorities. In 2017, GAO reported that while VA had taken some actions to address these issues, little progress had actually been made.
Since GAO’s 2017 High-Risk Report, VA has worked to address each of these areas, but still has not made sufficient progress to address the concerns. GAO has found, for example:
- VA medical center officials did not always document or conduct required reviews of providers in a timely manner when allegations were made against them. As a result, VA medical center officials may have lacked the information they needed to ensure that VA providers were competent to provide safe, high-quality care to veterans.
- VA lacked complete, reliable data to systematically monitor the timeliness of veterans’ access to care through the Veterans Choice Program. For example, veterans that were referred to this program for routine care could potentially wait up to 70 calendar days for care (as allowed by VA’s policies), rather than the 30 days required by law.
- VA’s data on employee misconduct and disciplinary actions were unreliable and could not be accurately analyzed. VA also did not consistently ensure that allegations of misconduct involving senior officials were reviewed according to VA’s investigative standards, or ensure that these officials were held accountable.
- VA’s suicide prevention media outreach activities declined in recent years due to leadership turnover and reorganization. Additionally, VHA did not assign key leadership responsibilities or establish clear lines of reporting for its suicide prevention media outreach campaign, which hindered its ability to oversee the campaign. As a result, VA may not be maximizing its reach with suicide media content to veterans, especially those who are at risk.
U.S. GAO – Key Issues: Managing Risks and Improving VA Health Care