RACHEL MARTIN, HOST:
The new secretary of Veterans Affairs is a man named David Shulkin, and he has his work cut out for him. The aging VA system is struggling to meet extraordinary demand. Wait times to get care are as long as they were before they became a scandal. And a program called Veterans Choice that allows some veterans to go outside the system to get care is set to expire this August. Secretary Shulkin is working with Congress to renew that program. Shulkin is also trying to get enough doctors and nurses to do the work. I asked him how the VA ended up with 45,000 vacant jobs.
DAVID SHULKIN: Well, we have about 360,000 employees in the VA health care system. It's the largest health care system in the country. And the negative attention that's been put on VA has hurt the morale of our workforce. And so what we're trying to do is to get people to understand that we're doing great work every day. It's a way to serve your country, and we want people to come and join us.
MARTIN: The Choice Act channeled roughly $2.5 billion to the VA to hire more medical staff, doctors, nurses. Yet, you still have this high number of vacancies. I mean, people will hear that and think $2.5 billion - what did you get for that?
SHULKIN: Well, we got a lot. We actually have about 13,000 net new health care professionals who were on board because of the Choice Act, so that program worked exactly as it was intended. The issue is is that we're seeing more and more veterans coming to us for care. The demand for our services is considerable. We are seeing that more veterans actually are choosing to get their care within the VA health care system.
MARTIN: An investigation that was done by our team here at NPR actually found that the Choice Act money wasn't given to those hospitals with the most egregious wait times. Why didn't that happen?
SHULKIN: Well, we're talking about now something back almost three years ago, and when Congress authorized this program, it was done with urgency. And they asked the VA to get an entire national program up in 90 days. That's really never been asked of any agency or any private company ever before. So in the end, I think that we ended up hiring where the wait times were the longest, but it wasn't done in the most thoughtful way because of the time that we had to stand this program up.
MARTIN: I want to ask about the president's hiring freeze. This is something he's put in place for the entire federal government. Does that affect all these vacancies you're trying to fill?
SHULKIN: Well, the hiring freeze does apply to all aspects of federal government except for defense and except for those that involve the safety and health of our citizens. So of the 45,000 positions that we talked about that we are looking to hire, we now have 41,000 that are exempt from the hiring freeze.
MARTIN: So is the solution about more money?
SHULKIN: No, I don't believe that the problems in the VA are necessarily about money. When I look back over the problems of the VA over the past decade, this is fundamentally a system that hasn't kept up with modernization in the way that the rest of health care in the private sector has.
MARTIN: For a long time, we've been talking about the suicide rate among veterans in this country. And since 2001, the suicide rate for veterans has surged 35 percent. For female veterans, that rate has gone up by 85 percent. How do you get a grip on what appears to be an epidemic?
SHULKIN: There is no doubt that suicide is my number one clinical priority. We are a system where I can tell you that nobody is doing more for behavioral health care in this country than the VA. We have extremely comprehensive systems. I have 1,000 professionals who do nothing but suicide prevention every single day. The problem is that we're responsible for the 22 million veterans in this country, and of the 20 veterans that take their life every day through suicide, just six are getting care in the VA health care system. So we have to work with community groups, with families and others to identify the 14 that aren't getting care that we're very, very concerned about.
MARTIN: Last week, the VA inspector general reported about ongoing problems at the veterans suicide crisis hotline. What's happening there?
SHULKIN: Well, the suicide crisis hotline was one of those situations where the demand for our services was outpacing our ability to keep up with it. About four months ago, I made the decision to bring on an additional 200 Veterans Crisis Line responders. And now today, I'm pleased to say that while we were not able to get to about 30 percent of the calls three or four months ago, really in the past six weeks we're getting to more than 99 percent of those calls.
MARTIN: Secretary Shulkin, thank you so much for coming into our studios.
SHULKIN: Thank you very much.
MARTIN: That was Secretary of Veterans Affairs David Shulkin.
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