TOM UDALL a hited States Senare formers ee WASHINGTON, DC 20610 RULES ANO ADMINISTRATION Mareh 23, 2017 ‘The Honorable David Shulkin Seoretary USS, Department of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420 Dear Secretary Shulkin: Congratulations on your nomination and confirmation as United States Secretary of Veterans Affairs. Your service as Undersecretary for Health was commendable, and I look forward to working with you in your new capacity as Secretary to continue to improve access and care for our nation’s veterans. I write to express concerns regarding a number of troubling developments and long term problems within the New Mexico Veterans Affairs Health Care System (NMVAHCS). I request that you review and respond to these concems and provide details on how the VA plans to remedy the problems. First, the Raymond G. Murphy Veterans Affairs Medical Center (VA Hospital) in Albuquerque continues to face staffing shortages that significantly impact veterans’ access to timely care within the VA health care system, Based on reports I received in February, only three out of ten emergency physician positions were filled. | understand that in order to compensate for the shortage, the VA Hospital must redirect any veterans requiring a trauma unit to a public hospital, primarily the University of New Mexico Hospital ‘which contributes to overcrowding and long wait times. I am told that all neurology cases are similarly being sent to the University of New Mexico Hospital, and radiology scans for strokes are sent to be read in Minnesota. Turnaround time is such that some stroke victims are not treated in a timely fashion. Furthermore, constituents have reported that there are similarly detrimental shortages within the inpatient, Community Living Center, Ambulatory Care, Medical Intensive Care, and Compensation and Pension units, Second, access to mental health services in NMVAHCS has become increasingly difficult for many New Mexico veterans. Time is always critical in connecting veterans to mental health treatment options, and veterans are at their most vulnerable when they seek treatment for substance use issues, homelessness, criminal court involvement, or suicide. The closure of the Gallup Psychosocial Residential Rehabilitation Program has increased the number of veterans seeking inpatient care in Albuquerque. Furthermore, constituents have informed me that there are significant gaps in access to essential care for New Mexico veterans with substance abuse issues. Lastly, mounting difficulties between management and staff within NMVAHCS have contributed to staffing shortages and declining morale. Federal employees at the VA Hospital have expressed their ‘concerns to me that inadequate training and mismanagement make it difficult for them to succeed in their mission, [ understand that the number of equal employment opportunity investigations is increasing, ‘which may be a sign thatthe labor-management relationship is becoming more strained. I was also informed that partnership council meetings to comply with guidance from the VA’s National Partnership Council are often delayed or cancelled. sunrafe ofa tab Sour Foun ‘Aurvavenove, NM B7ie2 no, NM 88220 maa00 Ponraise,NM 98120 Sana Fe, NITEIn response to these eoncems, I ask that you provide me with the following information. ‘© How many physician positions are currently open and unfilled in the NMVAHCS? How many emergency physicians specifically? How do these shortages impact the workload for other ‘members of health care teams and how many positions remain open and unfilled for support roles such as physician assistants, nurses, pharmacists, technicians, therapists, etc.? © What are the impediments to filling these positions? What changes in policy, funding, or law would be necessary to attract qualified candidates and fill these positions within twelve months? ‘+ Does the requirement to send radiology scans out of state negatively impact outcomes for stroke patients? Is it possible to increase capacity at the Albuquerque VA Hospital so that neurology patients are treated in-house? © Does the January 23, 2017 Presidential Memorandum Regarding the Hiring Freeze apply to non- ‘medical support staff such as administrative and scheduling positions? Do you have the authority to fully exempt these positions and ensure that they are not subjected to additional and unnecessary levels of bureaucratic review before they can be filled? ‘+ NMVAHCS must do more to ensure timely access to services seeking help for substance abuse issues, homelessness, and suicide. What is the current capacity at the Gallup Community Based Outpatient Clinic (CBOC) to provide these services? Also, how many spaces are available in the Albuquerque facility for inpatient treatment for mental health. and substance abuse problems? What is the average occupancy rate? What is the average wait time for a patient to be admitted? ‘© When was the last partnership council meeting held within the NMVAHCS? According to VA policy, how often should these meetings take place, and are there penalties for cancelling or rescheduling meetings on short notice? request that you review these concerns and take steps within your agency’s rules and regulations to correct the problems. We share the same goal of ensuring that our veterans receive the quality, timely care that they have earned. My requests for relevant written VA Hospital policies are part of that shared tion and transpareney and will help restore New Mexico veterans’ confidence in the VA's ability to provide cre ‘Tom Udall United States Senator