It’s been six months since we first heard about the coronavirus outbreak. The administration’s failure to heed initial warnings from medical professionals and prepare ourselves before the pandemic reached our shores has disastrous consequences. The outbreak and severe shortages of personal protective equipment (PPE) and other life-saving medical equipment have affected everyone in the country, including veterans receiving medical care and other services from the Department of Veterans Affairs.
Now that more and more VA hospitals began to reopen, here are 7 things you need to know about the current situation at the VA:
1. VA medical facilities still do not have enough PPE, medical resources
Contrary to the public assurances made by Secretary of Veterans Affairs Robert Wilkie, VA medical facilities still do not have adequate masks, respirators, gowns, hand sanitizers, testing, and other medical resources essential for the safe treatment of patients and necessary to control the spread of this deadly virus.
In fact, the secretary himself admitted to the House Appropriations Military Construction, Veterans Affairs and Related Agencies Subcommittee on May 28 that each VA facility only has a two-week stockpile of PPE.
2. Staff testing for COVID-19 is still limited
We have heard for over a month from senior VA leadership that any employee who wants a test can get a test, but that is not what we have seen on the ground. Indeed, Dr. Richard Stone, executive in charge of the Veterans Health Administration, recently told the Senate Veterans’ Affairs Committee that the department is “not there yet” and that testing is still limited.
Our members report that testing policies are still very inconsistent and unpredictable. Some have been told that they must get tests from their own outside providers in order to request leave to allow them to isolate themselves after exposure or when they exhibit virus symptoms. In some locations, it appears that testing of employees is far more limited than testing of patients. In addition, employees seeking testing due to exposure to COVID-positive coworkers are finding it more difficult to get testing than those exposed to patients with the virus due to exposure or illness.
It is imperative that the VA provide access to testing to every employee who request it. As restrictions begin to loosen and foot traffic returns to normal at each facility, access to universal testing and contact tracing will be an important tool for facility leadership to make prudent policy decisions.
Congress needs to ensure that ongoing testing is widely available at no cost to employees who are deemed essential and to those who are teleworking before and after they return to their duty station.
3. VA Hospitals are competing for known PPE supplies
The VA’s medical equipment supply chain has been severely weakened by a lack of coordination, transparency, national guidance, and consultation with front-line workers and their labor representatives. PPE acquisitions and distribution have been left largely to each medical center. These medical centers do not have sufficient guidance from the VA Central Office (VACO), recommendations from the Centers for Disease Control (CDC), or the extensive expertise and experience of VA contracting officers and front-line employees who experience firsthand the risks of working during this pandemic without adequate protection.
As a result, local procurement officers are forced to compete for known PPE supplies instead of working together. At the same time, the VA’s outdated inventory system does not allow for the accurate tracking of PPE inventory levels. There is no system in place for facilities to exchange information about best practices and good and bad suppliers, or to ensure reasonable pricing.
4. The PPE needs of critical support personnel are overlooked
Every VA employee who works at a medical facility needs adequate PPE, not just those who work in COVID units and “hot zones.” That’s because every employee can on short notice find himself or herself in a high risk situation even if his or her official duties are not within a “hot zone” because of a reassignment to a short staffed area, or an unexpected medical emergency involving a COVID-positive patient.
The PPE needs of critical support personnel are often overlooked. These include entrance screeners, medical support assistants who do patient check-ins, housekeepers cleaning COVID units, maintenance workers disposing of trash, food service and canteen workers interacting with large numbers of employees and veterans, and logistics warehouse workers frequently interacting with commercial companies making deliveries, all of whom are denied adequate PPE at many facilities or provided none at all.
5. VA hospitals are not prepared to reopen
The VA is pushing to reopen its hospitals, but based on reports from our members, we are doubtful that the department is prepared for facilities to reopen.
This process is already underway in many locations, but the agency is not fully communicating usable plans to workers and their representatives. They have failed to make sure all facilities that will reopen have sufficient PPE inventory, testing, and contact tracing.
6. To increase PPE and medical equipment supply, the Defense Production Act (DPA) needs to be fully utilized
To increase the supply and proper distribution of PPE and other medical equipment, the administration needs to fully utilize the DPA and vastly increase oversight and transparency of DPA activities. The country urgently needs a comprehensive strategy to ensure adequate production and distribution of PPE and other medical equipment necessary to fight COVID-19 for all workers who need them.
We also urge lawmakers to enact the PPE provisions in H.R. 6800, the “HEROES Act,” which has passed the House and awaits the Senate’s actions. The bill would enhance DPA authority, require the President to work with a team of federal agencies to carry out DPA activities, require extensive Congressional oversight, and ensure transparency through public reporting requirements.
A strong federal supply chain is essential to ensuring that every federal and private sector worker who needs PPE and other medical equipment and services receives what he or she needs to do their jobs safely.
7. A few things the VA can do to protect workers
As more and more VA facilities began to open, there are a few things that need to happen if the VA is to succeed in providing care to veterans, preventing the spread of the virus in the hospitals, and protecting the workforce:
As VA employees are required to interact with the public, with individuals who are quarantined, and those who have been diagnosed with COVID-19, there should be a presumption that the employee contracted the virus at work. A workplace presumption of illness will allow federal employees who have contracted the virus on the job to make a workers’ compensation claim without facing a potentially lengthy denial and appeals process, and help these workers receive the care and services they need.
In the VA, the benefits of telework have already been demonstrated at the Veterans Benefits Administration (VBA), where claims are being processed at a higher rate since employees have been required to work at home compared to before the pandemic when the VBA put up restrictions making it more difficult for employees to be granted the ability to telework.
In VHA, the use of telework has not been used to its maximum availability. This is particularly true for administrative work that does not require in person interaction with patients such as third-party collections and Office of Community Care consults.
We applaud the VA for expanding the use of telehealth and telemental health during the pandemic and urge the agency to continue to expand its telehealth capacity. The agency should also continue to provide more tablets and other needed technology to veterans to allow remote access.
One of the simplest steps that the federal government could take to protect workers from the COVID-19 pandemic is to have the Occupational Safety and Health Administration (OSHA) issue an Emergency Temporary Standard (ETS).
If the Secretary of Labor were to issue an ETS, all employers, including the federal government, would be required to meet a federally mandated and enforceable standard to protect employees from the COVID-19 pandemic.
In order to ensure adequate PPE, testing, commonsense leave policies and other policies that ensure safety for veterans and workers going forward, VA leadership should work with employee union representatives to accurately assess PPE and testing needs, identify and properly implement new safety practices and properly distribute staff to areas of need in order to serve both its core and fourth missions.
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