The Department of Veterans Affairs (VA) may gain additional pay flexibilities for its health care workforce if a sweeping legislative bill makes its way through Congress. Titled the Sen. Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, the bill was introduced by top lawmakers on the House and Senate committees.

Aside from addressing pay and workforce provisions, the legislative package also puts forth new requirements for the VA to meet before resuming the rollout of its new Electronic Health Record (EHR) system. Currently on hold, the EHR rollout has faced challenges at sites already implementing the new system.

The bill consolidates several pieces of legislation introduced in the current session of Congress, with the aim of enhancing VA health care and benefits delivery. Senate VA Committee Chairman Jon Tester (D-Mont.) described the bill as a "common-sense step towards delivering veterans and their families the kind of support they earned and deserve." House VA Committee Chairman Mike Bost (R-Ill.) stated that the bill reflects extensive feedback gathered from veterans and veterans service organizations to identify gaps in VA services and formulate practical legislation to improve them where possible.

One notable aspect of the bill is its focus on providing the VA with additional pay flexibilities and staffing updates. If passed, the legislation would grant the VA the flexibility to offer pay awards, recruitment bonuses, retention bonuses, and relocation bonuses to its health care workforce. It would also allow the VA to waive pay limitations for up to 300 personnel when deemed necessary for the recruitment or retention of critical health care personnel.

Moreover, the bill would require annual pay evaluations for VA physicians, podiatrists, optometrists, and dentists. The VA would need to submit an annual report to Congress on the outcomes of these pay evaluations along with any resulting market pay adjustments. In addition, the VA would be authorized to provide retroactive compensation to health care employees who exceeded annual pay caps between January 8, 2006, and December 31, 2017. The bill also emphasizes the need for the VA to keep Congress informed about its staffing needs and calls for the development of staffing models for various departments within the VA.

Another important aspect of the bill pertains to the VA's EHR rollout. The legislation introduces new requirements for the VA to resume the deployment of its Oracle-Cerner EHR system. Until the department can demonstrate that all facilities currently using the EHR have recovered to normal operational levels, the VA would be restricted from implementing the system at additional facilities. The bill also sets a two-year deadline for the VA to either certify facilities using the Oracle-Cerner EHR have recovered and that health care quality data shows improvement or end the EHR Modernization Program.

To ensure the quality of care and proper implementation, the bill mandates the VA to establish health care quality metrics for the new EHR within 90 days. This includes certifying that the system is fully built and configured, VA facility staff are ready to use it, and that the EHR meets uptime requirements according to the contract. As the VA is currently in a "reset" phase due to persistent issues at sites already using the system, the department anticipates discussions to exit this phase by the end of the year and resume deployment.

The bill does not include any funding for additional EHR deployment in the VA's 2025 budget request, which seeks $894 million for EHR modernization. However, VA Secretary Denis McDonough reassured lawmakers that prior appropriated funds will be available for deployment once the department exits the "reset" phase.

If this comprehensive legislative bill is enacted, it has the potential to provide the VA with greater flexibility in compensating its health care workforce and ensuring the successful rollout of its new EHR system, thereby improving health care services for veterans.

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