Latest news with #DougCollins
The Guardian
4 days ago
- Politics
- The Guardian
‘Profound alarm': US veterans agency roiled by fight over anti-discrimination provisions
The US Department of Veterans Affairs has enthusiastically joined Donald Trump's war on DEI – demanding that staffers report colleagues who engage in diversity initiatives, banning LGBTQ+ pride flags from VA hospitals and shuttering an office investigating why Black veterans are more likely to have their mental health disability claims rejected. Last week, the VA secretary, Doug Collins, tweeted that 'VA is now squarely focused on Veterans – not out-of-touch, woke causes such as DEI and gender dysphoria treatments.' Collins's pronouncement comes as he faces tough questions from US Senate and House members in the wake of a Guardian report that the agency had quietly removed language from its hospital bylaws that explicitly barred discrimination based on patients' marital status or political views. Seventy House members wrote to express 'profound alarm' that doctors and other VA medical providers 'will now be able to refuse treatment' based on veterans' political views or whether they are unmarried, widowed or part of a same-sex couple. Collins and his agency have pushed back with a series of puzzling statements, saying the bylaw changes were merely a 'formality' and were required by a Trump anti-transgender executive order banning 'gender ideology extremism' – even though the Trump order says nothing about marital status or political affiliations. Especially novel – given the VA and the Trump administration's adamant anti-DEI stance – was the agency's argument that the bylaw changes did not matter because unmarried or politically active patients would still be protected by a 2013 Obama administration DEI directive. Kayla Williams, an Iraq war veteran who is a former VA assistant secretary for public and nongovernmental affairs and former director of the VA's Center for Women Veterans, said the agency's explanation 'doesn't make any sense'. 'If this change isn't going to lead to any of the things we're worried about, why would they make it?' she asked. 'They're talking out of both sides of their mouth. You know they don't like Obama policies.' The VA told the Guardian the directive 'remains in effect' and that 'under no circumstances whatsoever would VA ever allow any employee to refuse to provide appropriate care to any eligible veteran'. The VA declined requests to make Collins available for an interview. On Tuesday, the Guardian sent the agency a five-page email that included 19 questions and details of the issues examined in this story. The VA press secretary, Peter Kasperowicz, responded with a 126-word statement that ignored nearly all of the Guardian's questions. The statement said the Guardian and the story's author 'are purveyors of disinformation with a history of maliciously false reporting on Veterans issues. Nothing they say can be trusted. 'Here is the truth: Under Secretary Collins, VA doesn't tolerate discrimination against Veterans or VA employees on any grounds, and multiple federal laws and VA policies prohibit discrimination,' the statement added. It cited federal code sections that address discrimination in employment and cover overall healthcare eligibility and enrollment practices at VA, but are silent on the subject of discrimination involving veterans who are patients. The statement also cites the VA's Obama era anti-discrimination directive. The protections for veterans included in the directive include language that forbids discrimination based on 'gender identity and transgender status'. But advocates say the agency is actively discriminating against transgender veterans under Trump by denying them many healthcare services. In the same document that ordered changes to the medical bylaws, VA leadership also required hospital directors to 'remove' education and outreach materials 'that provide information about gender identity, gender diversity or gender inclusivity'. Physical items like posters and brochures 'may be discarded', according to the document. Archived and inactive digital material 'may be automatically restricted', the document says, as part of efforts by the VA's technology unit to 'identify and hide documents'. The Guardian asked the VA about the directive to remove and restrict records. The VA did not respond. Doron Dorfman, a law professor at Seton Hall who specializes in healthcare discrimination, said the medical bylaw changes were especially concerning because – unlike protections for race, sex, age, national origin and disability, which are enumerated in federal law – the Trump administration can wipe away rights for equal medical treatment on the basis of marital status and politics by rescinding the 2013 directive. The nearly 100 members of Congress who have signed letters complaining about the changes indicated they were not satisfied with the agency's assurances. Senators led by Richard Blumenthal of Connecticut, the ranking Democrat on the Senate veterans affairs committee, and the Senate minority leader, Chuck Schumer of New York, called the revisions 'deeply dangerous and pernicious in practice and principle'. Under questioning from Senator Patty Murray during a 24 June public hearing, Collins reiterated his position that the bylaw changes were meaningless. 'Nothing was changed that actually affected' protections for veterans, he said. 'When you take words out, people hear them,' Murray, a Democrat from Washington state, pressed. 'Therefore, I'm asking why don't you put them back in?' Collins refused. 'No,' he said. 'I can't believe we're still talking about this … No one is being discriminated against at VA.' After the hearing, they continued the argument over social media – with Collins accusing Murray of 'lying' and Murray replying: 'Did you or did you not explicitly REMOVE language requiring health care professionals to care for veterans regardless of their politics & marital status?' Collins's social media comment about DEI being an 'out-of-touch, woke cause' came in a separate exchange with Representative Ilhan Omar, in response to the Minnesota Democrat's charge that the agency's plans to cut 30,000 staffers will 'devastate veterans who depend on timely care and benefits'. Collins touted the rollback of diversity, equity and inclusion programs as one of the 'commonsense reforms' that were allowing the agency to better serve veterans. Collins has also pushed back against the Guardian – appearing on the conservative outlets Fox News, Newsmax and Barstool Sports to denounce the news organization's reporting on the bylaw changes. He called the story 'fabricated', 'ridiculous' and 'false and unbelievable'. Both the VA and White House demanded a retraction. The Guardian amended the story with additional context provided by the VA after publication, but did not retract it. VA officials took a similar tack in March when the Advocate, a national LGBTQ+ publication, revealed the Trump administration had 'quietly reversed' an agency policy ensuring gender-affirming care for transgender veterans. The agency's press secretary, Kasperowicz, demanded a retraction. 'No such policy change has been made,' he said. Three days later, the VA publicly announced that it had reversed the policy and declared that it was ending gender-affirming medical care for transgender veterans. 'All eligible veterans – including trans-identified Veterans – will always be welcome at VA and will always receive the benefits and services they've earned under the law,' Collins said. 'But if veterans want to attempt to change their sex, they can do so on their own dime.' The agency said the move was required by Trump's 20 January executive order titled 'Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government' – the same order that the agency is now citing to justify the hospital bylaw changes. Trump's executive order declares that there are 'two sexes, male and female' that are 'not changeable and are grounded in fundamental and incontrovertible reality'. A lawsuit filed on 9 June by a transgender veteran with the backing of the Yale Law School's Veterans Legal Services Clinic alleged that her hormone treatments had been wrongly discontinued. Four days after being sued, the VA reversed itself, and agreed to resume the veteran's hormone therapy. The veteran then dropped her suit before the court of appeals for veterans claims – leaving the underlying legal issues unresolved. 'It should not require a federal lawsuit for VA to fulfill its obligation to provide healthcare for veterans injured during service,' law clinic member Hillary Browning said. She said the VA 'should reassess any decisions terminating or denying gender-affirming care for other transgender veterans'. Representative Maxine Dexter, a Democrat from Oregon, and a physician who worked for eight years at VA hospitals, said she saw the changes in the medical bylaws and the removal of protections for trans veterans as part of a larger plan to politicize the VA. 'As doctors we're supposed to treat the patient in front of us, whoever they are,' she said. Legal experts say the recent changes to the VA's medical bylaws created a murky situation where individual medical officers and patients will be left to themselves to interpret what is legal and what is not. Dr Ken Kizer, the former head of the VA healthcare system, said the changes opened up the possibility that doctors could refuse to treat veterans based on their 'reason for seeking care – including allegations of rape and sexual assault – current or past political party affiliation or political activity, and personal behavior such as alcohol or marijuana use'. The legal experts and veterans advocates said the impact of the revisions would probably fall hardest on female veterans, LGBTQ+ veterans and those who live in rural areas where there are fewer doctors. After the bylaw changes were publicly reported, veterans in multiple states told the Guardian that they worried whether their own recent problems accessing care were linked to the rollback of explicit anti-discrimination protections. Air force veteran Domonic Medley, 43, who is gay and lives in Dothan, Alabama, said he had to drive four hours roundtrip to Montgomery to receive routine injections of prophylactic HIV medication after staff at his local clinic said they were 'unable' to administer the jab. He suspects discrimination. 'I'm not asking to undergo open heart surgery in my small, community-based clinic,' he said. 'I'm asking to receive a very simple injection, which just happens to be most commonly prescribed to gay men.' After the Guardian's story was published in June, Medley complained to an infectious disease specialist at the VA in Montgomery. The doctor tried to set Medley at ease, saying the prescribed medication might be 'unfamiliar' to clinic staff, but added that he 'was never made aware of any reason why the dose could not be given'. The doctor also told Medley she had since been notified that the 'medication could be given locally by the nursing staff at the Dothan clinic with some pre-planning'. In April, Carrie Sutton, a 13-year navy veteran, received a call from a wellness coach from the Department of Veterans Affairs' 'whole health' team. The coach asked her: 'What do you want your health for? What brings you joy and happiness?' Sutton, a former cryptologist who served a tour combating pirates off the coast of Somalia, told the coach she wanted her family and community to feel safe, but she added that she was upset by the plans to lay off tens of thousands of VA workers. Sutton wanted 'to not have the VA gutted, to be able to have VA care and that VA employees feel safe', her medical record shows. Soon after, Sutton's appointment with a neurologist near her home town of Conesville, New York, was cancelled. She could still receive treatment for service-connected migraines and fibromyalgia, the agency said, but her permission to get treatment in her community had expired and would not be renewed. Sutton, a survivor of military sexual trauma, would now have to drive more than two hours roundtrip to a major VA medical center to see a doctor. Sutton believes she was punished for speaking out. 'I have to think it was what I said,' she said. 'I can see no other reason why.' She filed a complaint with the patient advocate at her VA medical center. The VA declined to comment on Medley and Sutton's experiences, despite signed releases from both veterans. 'I'm not really surprised they didn't actually address the issue,' Sutton said. It 'seems to be the current trend in the country right now. There is no transparency.' Lois Weithorn, a professor at the University of California San Francisco School of Law, said denials of care might ultimately have to be addressed through litigation, but that the changes to the medical bylaws 'could cause substantial delays in the provision of care to veterans, and create difficult obstacles for sick veterans who must challenge denials of care'. The VA runs the nation's largest integrated healthcare system, serving 9 million veterans a year across 170 hospitals and more than 1,000 clinics. Like any large hospital system, the VA has long struggled to ensure benefits are provided equitably. A 232-page report, published by the agency in 2022, found that Black and Native American veterans received significantly lower quality healthcare than non-Hispanic white veterans, while female veterans over 65 years old faced 'large gaps in quality' compared with male veterans in the same age group. The report also found 'female veterans of reproductive age' reported far worse patient experiences than male veterans of the same age group, while Black, Asian and Hispanic veterans reported worse experiences than whites. Disparities have also been endemic when it comes to the provision of benefits. A 2023 report by the Government Accountability Office, the investigative arm of Congress, found the VA was far more likely to deny disability claims filed by Black veterans than white veterans. Under President Joe Biden, the VA worked to confront these problems, including deploying a team within the VA's Office of Equity Assurance to address the disability benefits issues for Black veterans. In March, the VA 'liquidated' the office of equity assurance, placing staff on administrative leave, according to the investigative news outlet ProPublica. The VA said the office was being liquidated because there was no longer discrimination at the VA. Under Collins's leadership, press secretary Kasperowicz told ProPublica, the VA 'treats all veterans and beneficiaries fairly and equally, so the Office of Equity Assurance is no longer needed'. Richard Brookshire, a former US army combat medic and co-founder of the Black Veterans Project, called that statement 'laughable'. Brookshire, an Afghanistan war veteran, noted that during the first Trump administration, the VA produced an internal report that found just 43% of Black veterans' post-traumatic stress disorder claims were approved compared with 57% for non-Hispanic white veterans. The report provided a detailed analysis of where disparities were greatest based on a long list of factors, accounting for the veterans' income, age, education, the state where the veteran lived and the war where the veteran served. 'They know this is happening,' Brookshire said. 'They just don't want to do anything about it.' Veterans and VA employees said the Trump administration's clampdown on diversity efforts had created a chilling effect with far-reaching consequences. In Seattle, Iraq war veteran and former army intelligence sergeant Selena Coppa said she spent almost half of a recent therapy session talking to her therapist 'about their own fear of getting fired because they had participated in various forms of political activity'. Staffers' concerns rose two days into Trump's second term, when then acting VA secretary, Todd Hunter, sent an all staff email that asked VA workers to report colleagues who are 'using coded or imprecise language' to 'disguise' diversity efforts. 'Failure to report this information within 10 days may have adverse consequences,' the email said. In the months that followed, Coppa said, posters and pamphlets providing information on sexual health, disease transmission and suicide prevention disappeared from the women's clinic in Seattle. Rainbow flags have also been removed and some of the most caring clinicians have quit, Coppa said. 'What's going to be left and who's going to be left?' she said. 'It's like a grim horror movie' that also affects the healthcare available to straight veterans. The women's health medical director at another VA hospital, in California, said basic information about women's healthcare – including posters and pamphlets – was also removed from her hospital. Half of the staff of the women's clinic had either resigned or are looking for work, she said. 'You can't erase the word 'gender' without impacting women,' she said, requesting anonymity to avoid being publicly attacked. The Guardian asked the VA about reports of disappearing pamphlets, loss of staff and low morale at VA women's clinics. The agency did not answer. Experts say the lack of gender-affirming care will have a major impact on trans veterans' mental health, experts say. VA researchers have found elevated rates of suicide among lesbian, gay, bisexual and transgender veterans – with trans veterans dying by suicide at more than twice the rate of cisgender veterans. The VA did not answer a question from the Guardian about the mental health impacts of ending gender-affirming care. In Pittsburgh, transgender navy veteran Rayven Greer lost her therapist, when he resigned. The therapist, a licensed clinical social worker, said he could not ethically continue to treat Greer because he had been instructed that, consistent with Trump's executive order, he had to refer to his patient by her birth name and gender in his clinical notes. The therapist spoke on condition of anonymity because he feared online attacks and unwanted political attention to his new employer. Greer, a survivor of military sexual trauma who suffers from post-traumatic stress disorder, said she is now struggling to create a relationship with a new therapist in an atmosphere where her identity as a trans woman is being held in question. 'I get 'sirred' all the time,' she said. 'It's very obvious that I look like Rayven. I use she/her pronouns, but they refuse to follow that.' The VA's updated clinical practice guidelines for treating trans veterans direct staff to address veterans by their preferred name and pronoun, saying that doing so 'demonstrates respect', but Greer said that hadn't been her experience. VA clinicians regularly refer to her as a 'MALE' in her VA medical record. The VA did not respond to questions about Greer's care, despite a signed release from the veteran. Harold Kudler, a psychiatrist who served as a top VA mental health official under Obama and the first Trump administration, said the changes at the VA were not small matters. 'A psychotherapist who can neither be present nor genuine with patients is seriously compromised,' Kudler said. 'By creating an environment in which neither veteran nor clinician feels safe in speaking frankly and honestly, there can be no new understanding, no growth, and no healing.'
The Guardian
4 days ago
- Politics
- The Guardian
‘Profound alarm': US veterans agency roiled by fight over anti-discrimination provisions
The US Department of Veterans Affairs has enthusiastically joined Donald Trump's war on DEI – demanding that staffers report colleagues who engage in diversity initiatives, banning LGBTQ+ pride flags from VA hospitals and shuttering an office investigating why Black veterans are more likely to have their mental health disability claims rejected. Last week, VA secretary Doug Collins tweeted that 'VA is now squarely focused on Veterans – not out-of-touch, woke causes such as DEI and gender dysphoria treatments.' Collins' pronouncement comes as he faces tough questions from US Senate and House members in the wake of a Guardian report that the agency had quietly removed language from its hospital bylaws that explicitly barred discrimination based on patients' marital status or political views. Seventy House members wrote to express 'profound alarm' that doctors and other VA medical providers 'will now be able to refuse treatment' based on veterans' political views or whether they are unmarried, widowed or part of a same-sex couple. Collins and his agency have pushed back with a series of puzzling statements, saying the bylaw changes were merely a 'formality' and were required by a Trump anti-transgender executive order banning 'gender ideology extremism' – even though the Trump order says nothing about marital status or political affiliations. Especially novel – given the VA and the Trump administration's adamant anti-DEI stance – was the agency's argument that the bylaw changes did not matter because unmarried or politically active patients would still be protected by a 2013 Obama administration DEI directive. Kayla Williams, an Iraq war veteran who is a former VA assistant secretary for public and nongovernmental affairs and former director of the VA's Center for Women Veterans, said the agency's explanation 'doesn't make any sense'. 'If this change isn't going to lead to any of the things we're worried about, why would they make it?' she asked. 'They're talking out of both sides of their mouth. You know they don't like Obama policies.' The VA told the Guardian the directive 'remains in effect' and that 'under no circumstances whatsoever would VA ever allow any employee to refuse to provide appropriate care to any eligible veteran'. The VA declined requests to make Collins available for an interview. On Tuesday, the Guardian sent the agency a five-page email that included 19 questions and details of the issues examined in this story. The VA press secretary, Peter Kasperowicz, responded with a 126-word statement that ignored nearly all of the Guardian's questions. The statement said the Guardian and the story's author 'are purveyors of disinformation with a history of maliciously false reporting on Veterans issues. Nothing they say can be trusted.' 'Here is the truth: Under Secretary Collins, VA doesn't tolerate discrimination against Veterans or VA employees on any grounds, and multiple federal laws and VA policies prohibit discrimination,' the statement added. It cited federal code sections that address discrimination in employment and cover overall healthcare eligibility and enrollment practices at VA, but are silent on the subject of discrimination involving veterans who are patients. The statement also cites the VA's Obama era anti-discrimination directive. The protections for veterans included in the directive include language that forbids discrimination based on 'gender identity and transgender status'. But advocates say the agency is actively discriminating against transgender veterans under Trump by denying them many healthcare services. In the same document that ordered changes to the medical bylaws, VA leadership also required hospital directors to 'remove' education and outreach materials 'that provide information about gender identity, gender diversity or gender inclusivity'. Physical items like posters and brochures 'may be discarded', according to the document. Archived and inactive digital material 'may be automatically restricted', the document says, as part of efforts by the VA's technology unit to 'identify and hide documents'. The Guardian asked the VA about the directive to remove and restrict records. The VA did not respond. Doron Dorfman, a law professor at Seton Hall who specializes in healthcare discrimination, said the medical bylaw changes were especially concerning because – unlike protections for race, sex, age, national origin and disability, which are enumerated in federal law – the Trump administration can wipe away rights for equal medical treatment on the basis of marital status and politics by rescinding the 2013 directive. The nearly 100 members of Congress who have signed letters complaining about the changes indicated they are not satisfied with the agency's assurances. Senators led by Richard Blumenthal of Connecticut, the ranking Democrat on the Senate veterans affairs committee, and Senate minority leader Chuck Schumer of New York, called the revisions 'deeply dangerous and pernicious in practice and principle'. Under questioning from Senator Patty Murray during a 24 June public hearing, Collins reiterated his position that the bylaw changes were meaningless. 'Nothing was changed that actually affected' protections for veterans, he said. 'When you take words out, people hear them,' Murray, a Democrat from Washington state, pressed. 'Therefore, I'm asking why don't you put them back in?' Collins refused. 'No,' he said. 'I can't believe we're still talking about this … No one is being discriminated against at VA.' After the hearing, they continued the argument over social media – with Collins accusing Murray of 'lying' and Murray replying: 'Did you or did you not explicitly REMOVE language requiring health care professionals to care for veterans regardless of their politics & marital status?' Collins' social media comment about DEI being an 'out-of-touch, woke cause' came in a separate exchange with Representative Ilhan Omar, in response to the Minnesota Democrat's charge that the agency's plans to cut 30,000 staffers will 'devastate veterans who depend on timely care and benefits'. Collins touted the rollback of diversity, equity and inclusion programs as one of the 'commonsense reforms' that are allowing the agency to better serve veterans. Collins has also pushed back against the Guardian – appearing on conservative outlets Fox News, Newsmax and Barstool Sports to denounce the news organization's reporting on the bylaw changes. He called the story 'fabricated', 'ridiculous' and 'false and unbelievable'. Both the VA and White House demanded a retraction. The Guardian amended the story with additional context provided by the VA after publication, but did not retract it. VA officials took a similar tack in March when the Advocate, a national LGBTQ+ publication, revealed the Trump administration had 'quietly reversed' an agency policy ensuring gender affirming care for transgender veterans. The agency's press secretary, Kasperowicz, demanded a retraction. 'No such policy change has been made,' he said. Three days later, the VA publicly announced that it had reversed the policy and declared that it was ending gender-affirming medical care for transgender veterans. 'All eligible Veterans – including trans-identified Veterans – will always be welcome at VA and will always receive the benefits and services they've earned under the law,' Collins said. 'But if Veterans want to attempt to change their sex, they can do so on their own dime.' The agency said the move was required by Trump's 20 January executive order titled 'Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government' – the same order that the agency is now citing to justify the hospital bylaw changes. Trump's executive order declares that there are 'two sexes, male and female' that are 'not changeable and are grounded in fundamental and incontrovertible reality'. A lawsuit filed on 9 June by a transgender veteran with the backing of the Yale Law School's Veterans Legal Services Clinic alleged that her hormone treatments had been wrongly discontinued. Four days after being sued, the VA reversed itself, and agreed to resume the veteran's hormone therapy. The veteran then dropped her suit before the court of appeals for veterans claims – leaving the underlying legal issues unresolved. 'It should not require a federal lawsuit for VA to fulfill its obligation to provide healthcare for veterans injured during service,' law clinic member Hillary Browning said. She said the VA 'should reassess any decisions terminating or denying gender-affirming care for other transgender veterans'. Representative Maxine Dexter, a Democrat from Oregon, and a physician who worked for eight years at VA hospitals, said she saw the changes in the medical bylaws and the removal of protections for trans veterans as part of a larger plan to politicize the VA. 'As doctors we're supposed to treat the patient in front of us, whoever they are,' she said. Legal experts say the recent changes to the VA's medical bylaws created a murky situation where individual medical officers and patients will be left to themselves to interpret what is legal and what is not. Dr Ken Kizer, the former head of the VA healthcare system, said the changes open up the possibility that doctors could refuse to treat veterans based on their 'reason for seeking care – including allegations of rape and sexual assault – current or past political party affiliation or political activity, and personal behavior such as alcohol or marijuana use'. The legal experts and veterans advocates said the impact of the revisions would probably fall hardest on female veterans, LGBTQ+ veterans and those who live in rural areas where there are fewer doctors. After the bylaw changes were publicly reported, veterans in multiple states told the Guardian that they worried whether their own recent problems accessing care were linked to the rollback of explicit anti-discrimination protections. Air force veteran Domonic Medley, 43, who is gay and lives in Dothan, Alabama, said he had to drive four hours roundtrip to Montgomery to receive routine injections of prophylactic HIV medication after staff at his local clinic said they were 'unable' to administer the jab. He suspects discrimination. 'I'm not asking to undergo open heart surgery in my small, community based clinic,' he said. 'I'm asking to receive a very simple injection, which just happens to be most commonly prescribed to gay men.' After the Guardian's story was published in June, Medley complained to an infectious disease specialist at the VA in Montgomery. The doctor tried to set Medley at ease, saying the prescribed medication might be 'unfamiliar' to clinic staff, but added that he 'was never made aware of any reason why the dose could not be given'. The doctor also told Medley she had since been notified that the 'medication could be given locally by the nursing staff at the Dothan clinic with some pre-planning'. In April, Carrie Sutton, a 13-year Navy veteran, received a call from a wellness coach from the Department of Veterans Affairs' 'whole health' team. The coach asked her: 'What do you want your health for? What brings you joy and happiness?' Sutton, a former cryptologist who served a tour combating pirates off the coast of Somalia, told the coach she wanted her family and community to feel safe, but she added that she was upset by the plans to lay off tens of thousands of VA workers. Sutton wanted 'to not have the VA gutted, to be able to have VA care and that VA employees feel safe', her medical record shows. Soon after, Sutton's appointment with a neurologist near her hometown of Conesville, New York, was cancelled. She could still receive treatment for service-connected migraines and fibromyalgia, the agency said, but her permission to get treatment in her community had expired and would not be renewed. Sutton, a survivor of military sexual trauma, would now have to drive more than two hours roundtrip to a major VA medical center to see a doctor. Sutton believes she was punished for speaking out. 'I have to think it was what I said,' she said. 'I can see no other reason why.' She filed a complaint with the patient advocate at her VA medical center. The VA declined to comment on Medley and Sutton's experiences, despite signed releases from both veterans. 'I'm not really surprised they didn't actually address the issue,' Sutton said. It 'seems to be the current trend in the country right now. There is no transparency.' Lois Weithorn, a professor at the University of California San Francisco School of Law, said denials of care might ultimately have to be addressed through litigation, but that the changes to the medical bylaws 'could cause substantial delays in the provision of care to veterans, and create difficult obstacles for sick veterans who must challenge denials of care'. The VA runs the nation's largest integrated healthcare system, serving 9 million veterans a year across 170 hospitals and more than 1,000 clinics. Like any large hospital system, the VA has long struggled to ensure benefits are provided equitably. A 232-page report, published by the agency in 2022, found that Black and Native American veterans received significantly lower quality healthcare than non-Hispanic white veterans, while women veterans over 65 years old faced 'large gaps in quality' compared with male veterans in the same age group. The report also found 'female veterans of reproductive age' reported far worse patient experiences than male veterans of the same age group, while Black, Asian and Hispanic veterans reported worse experiences than whites. Disparities have also been endemic when it comes to the provision of benefits. A 2023 report by the Government Accountability Office, the investigative arm of Congress, found the VA was far more likely to deny disability claims filed by Black veterans than white veterans. Under President Joe Biden, the VA worked to confront these problems, including deploying a team within the VA's Office of Equity Assurance to address the disability benefits issues for Black veterans. In March, the VA 'liquidated' the office of equity assurance, placing staff on administrative leave, according to the investigative news outlet ProPublica. The VA said the office was being liquidated because there is no longer discrimination at the VA. Under Collins' leadership, press secretary Kasperowicz told ProPublica, the VA 'treats all veterans and beneficiaries fairly and equally, so the Office of Equity Assurance is no longer needed'. Richard Brookshire, a former US army combat medic and co-founder of the Black Veterans Project, called that statement 'laughable'. Brookshire, an Afghanistan war veteran, noted that during the first Trump administration, the VA produced an internal report that found just 43% of Black veterans' post traumatic stress disorder claims were approved compared to 57% for non-Hispanic white veterans. The report provided a detailed analysis of where disparities were greatest based on a long list of factors, accounting for the veterans' income, age, education, the state where the veteran lived and the war where the veteran served. 'They know this is happening,' Brookshire said. 'They just don't want to do anything about it.' Veterans and VA employees said the Trump administration's clampdown on diversity efforts has created a chilling effect with far reaching consequences. In Seattle, Iraq war veteran and former army intelligence sergeant Selena Coppa said she spent almost half of a recent therapy session talking to her therapist 'about their own fear of getting fired because they had participated in various forms of political activity'. Staffers' concerns rose two days into Trump's second term, when then acting VA secretary Todd Hunter sent an all staff email that asked VA workers to report colleagues who are 'using coded or imprecise language' to 'disguise' diversity efforts. 'Failure to report this information within 10 days may have adverse consequences,' the email said. In the months that followed, Coppa said, posters and pamphlets providing information on sexual health, disease transmission and suicide prevention disappeared from the women's clinic in Seattle. Rainbow flags have also been removed and some of the most caring clinicians have quit, Coppa said. 'What's going to be left and who's going to be left?' she said. 'It's like a grim horror movie' that also impacts the healthcare available to straight veterans. The women's health medical director at another VA hospital, in California, said basic information about women's healthcare – including posters and pamphlets – was also removed from her hospital. Half of the staff of the women's clinic have either resigned or are looking for work, she said. 'You can't erase the word 'gender' without impacting women,' she said, requesting anonymity to avoid being publicly attacked. The Guardian asked the VA about reports of disappearing pamphlets, loss of staff and low morale at VA women's clinics. The agency did not answer. Experts say the lack of gender affirming care will have a major impact on trans veterans' mental health, experts say. VA researchers have found elevated rates of suicide among lesbian, gay, bisexual and transgender veterans – with trans veterans dying by suicide at more than twice the rate of cisgender veterans. The VA did not answer a question from the Guardian about the mental health impacts of ending gender affirming care. In Pittsburgh, transgender Navy veteran Rayven Greer lost her therapist, when he resigned. The therapist, a licensed clinical social worker, said he could not ethically continue to treat Greer because he had been instructed that, consistent with Trump's executive order, he had to refer to his patient by her birth name and gender in his clinical notes. The therapist spoke on condition of anonymity because he feared online attacks and unwanted political attention to his new employer. Greer, a survivor of military sexual trauma who suffers from post traumatic stress disorder, said she is now struggling to create a relationship with a new therapist in an atmosphere where her identity as a trans woman is being held in question. 'I get 'sirred' all the time,' she said. 'It's very obvious that I look like Rayven. I use she/her pronouns, but they refuse to follow that.' The VA's updated clinical practice guidelines for treating trans veterans direct staff to address veterans by their preferred name and pronoun, saying that doing so 'demonstrates respect', but Greer said that hasn't been her experience. VA clinicians regularly refer to her as a 'MALE' in her VA medical record. The VA did not respond to questions about Greer's care, despite a signed release from the veteran. Harold Kudler, a psychiatrist who served as a top VA mental health official under Obama and the first Trump administration, said the changes at the VA are not small matters. 'A psychotherapist who can neither be present nor genuine with patients is seriously compromised,' Kudler said. 'By creating an environment in which neither veteran nor clinician feels safe in speaking frankly and honestly, there can be no new understanding, no growth, and no healing.'
Yahoo
4 days ago
- Business
- Yahoo
VA expects 30K voluntary job cuts by October, erasing need for layoffs
Voluntary retirements and resignations are expected to trim 30,000 Veterans Affairs workforce positions by the end of September, forgoing plans for potential forced resignations this fiscal year to meet administration goals to reduce the size of government, department leaders announced Monday. Already, about 17,000 VA jobs have been vacated since Jan. 1 through a combination of deferred resignations, retirements, normal attrition and department hiring freezes, officials said. Another 12,000 posts are expected to be cleared out over the next two and a half months. VA Secretary Doug Collins in a statement said that because of those significant workforce reductions — equalling a 6% decrease in the roughly 484,000 VA workforce last fall — department leaders are no longer discussing the idea of a department Reduction In Force process. 'Since March, we've been conducting a holistic review of the department centered on reducing bureaucracy and improving services to veterans,' Collins said in a statement. 'As a result of our efforts, VA is headed in the right direction — both in terms of staff levels and customer service.' House passes $435 billion spending plan for VA in fiscal 2026 A VA spokesman said the department is not looking to make any additional 'major changes' to staffing levels beyond that 30,000 cut. Previously, officials had said they may eliminate up to 80,000 department jobs in coming months. For the last several months, department leaders and members of President Donald Trump's White House staff have insisted that workforce cuts are needed to trim down the federal bureaucracy to reduce spending and improve efficiency. However, Democratic lawmakers and union leaders have strongly objected to those claims, saying the increased medical and benefits workload of the department mandates more staffing, not less. They have also said that hiring freezes and staff cuts have begun to hurt veterans benefits, particularly in tasks indirectly related to medical care, such as appointment scheduling and medical supply delivery. But Collins and top VA officials have said the department has multiple safeguards in place to ensure that staff reductions do not impact veteran care or benefits, including exempting more than 350,000 positions from the federal hiring freeze. Department officials also pointed to positive trends in benefits processing and medical care in recent months, continuing trends from the last few years. Collins said in his statement Monday that the staff reductions thus far have 'resulted in a host of new ideas for better serving veterans that we will continue to pursue.' Department leaders said they are looking at 'duplicative and costly administrative functions that can be centralized or restructured' for additional workforce savings, as well as reducing some of the 274 separate call centers the department runs. Solve the daily Crossword
Newsweek
14-07-2025
- Business
- Newsweek
VA Announces Expansion of Benefits
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. The Department of Veterans Affairs (VA) has announced a temporary expansion of burial benefits for certain veterans and their families. Recipients will see a temporary expansion of burial benefits thanks to the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, known as the Dole Act. The department has been contacted via email for comment. Secretary of Veterans Affairs Doug Collins pictured in the Dirksen Senate Office Building on Tuesday, June 24, 2025. Secretary of Veterans Affairs Doug Collins pictured in the Dirksen Senate Office Building on Tuesday, June 24, 2025. Bill Clark/CQ Roll Call via AP Images Why It Matters The VA is the second-largest U.S. government department, employing about 470,000 people, a quarter of whom are veterans. Some 6.2 million veterans in the United States receive disability benefits from the VA. Veterans who received VA healthcare were not always eligible for a VA-covered burial, resulting in families having to cover the costs after their deaths. This benefit from the Dole Act will mean eligible veterans will have their full burial costs covered. This temporary expansion of burial benefits comes as the department reduces its headcount as part of the Trump administration's program to downsize the federal government - although by much less than originally planned. The VA had planned to reduce its workforce to 400,000, but after much criticism last week announced it would shed fewer than 30,000 jobs this year. Some 12,000 staff will leave their roles by the end of September, after 17,000 job cuts were made between January and June. The department says it has "multiple safeguards in place to ensure these staff reductions do not impact veteran care or benefits." What To Know "The new law specifies eligible Veterans are those who are discharged from VA-provided medical or nursing care to receive VA-provided hospice care at their home and who pass away between July 1, 2025, and Oct. 1, 2026," said the VA in a statement. "Previously, Veterans who died at home under VA hospice care after discharge from VA-provided medical or nursing care were not always eligible for a full VA burial allowance. The Dole Act addresses that gap." The Dole Act was signed into law in January 2025 by then-President Joe Biden. Following its passage, Chairman of the House Committee on Veterans' Affairs, Republican Illinois Representative Mike Bost said: "The men and women who have served have earned access to a VA that puts them – not government bureaucracy – at the center of its operations. The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act will do exactly that." The act includes several increases and changes to veterans' benefits, including changing the definition of "surviving spouse" to "someone who lived continuously with the veteran until their death and who has not remarried," and requiring the VA to create a plan for creating transitional housing grants for homeless veterans. Trump administration changes to the VA include barring transgender veterans from getting their fertility treatment covered by the VA, and increasing the VA budget by $83 billion through the recent budget. What People Are Saying VA Secretary Doug Collins said in a press release: "VA is working hard to fully implement the many provisions of the Dole Act. We're excited to offer this expanded benefit, which better supports Veterans who choose to spend their final days at home, surrounded by their loved ones." What Happens Next Families and caregivers are encouraged to contact their local VA office to determine eligibility and to apply for the expanded burial benefits. Additional details are available on the VA burial benefits website or by calling 800-827-1000.
UPI
14-07-2025
- Health
- UPI
VA shifts layoff plans, but questions persist over veterans' care
1 of 3 | Department of Veterans Affairs Secretary Doug Collins prays with 72-year-old Vietnam-era Army veteran Brenda Sue Jordan at the Lexington, Ky., VA Health Care System's Bowling Campus in February. Photo by Candace Hull-Simon/Department of Veterans Affairs WASHINGTON, July 14 (UPI) -- Despite an apparent reversal on mass layoffs, the Department of Veterans Affairs is quietly advancing a large-scale workforce reduction, prompting legal challenges, staff unrest and warnings from frontline nurses who say the cuts will harm the very veterans the VA is meant to serve. The VA initially signaled it would not move forward with mass layoffs, but recent developments show the agency is still on track to eliminate tens of thousands of jobs by the end of 2025. Internal contracts and legal challenges suggest broader restructuring efforts are underway, yet the scope and restructuring framework is unclear, raising concerns among lawmakers, unions and frontline workers about their potential impact on veteran care and employee rights. In a VA press release last week, the agency secretary, Doug Collins said the "VA is headed in the right direction," thanks to departmental reviews conducted since March. "A department-wide [reduction in force] is off the table, but that doesn't mean we're done improving VA. Our review has resulted in a host of new ideas for better serving veterans that we will continue to pursue," Collins said. 30,000 employees to be cut The VA, which employs over 467,000 medical professionals, administrative staff and others, also announced the press release that it's on track to reduce its workforce by nearly 30,000 employees by the end of fiscal year 2025 through retirements, resignations and attrition. The department says this voluntary path eliminates the need for a formal reduction in force. However, that conflicts with a $726,000 contract signed by the VA and the U.S. Office of Personnel Management to prepare for a mass layoff. The contract was prepared because the VA said it lacks the internal expertise for such a wide-scale restructuring and requires OPM to supply seasoned human relations specialists to guide layoffs. Neither the VA nor OPM responded to multiple phone and email requests for comment on the status of the contract. And, so, the VA's actual plan remains mired in lack of information and confusion for employees, veterans and congressional representatives. Of the 83,000 VA positions Collins previously set as a goal to cut, according to the department's latest update, the agency had shed nearly 17,000 positions as of June 1, with another 12,000 departures expected by Sept. 30. "Nobody in their right mind thinks you can cut 80,000 workers and not cut resources to the veteran," said Irma Westmoreland, a registered nurse at VA medical centers in Georgia and chair of the Veterans Affairs division of National Nurses United. Nurses skeptical VA nurses on the front lines remain skeptical that reduced staffing can be carried out without affecting patient care. The VA is the largest integrated health care system in the United States, providing services at 1,380 facilities to more than 9.1 million enrolled veterans each year, according to the agency. "The VA says nurses and doctors won't be affected, but that just means they're cutting all the support staff," Westmoreland said. "That's still going to impact patient care." Westmoreland said the VA has failed to include frontline staff in restructuring discussions, and that the resulting fear and confusion already have caused widespread staffing shortages. That's because many have decided to retire or switching to another health care system. The remaining staff is facing burnout by being assigned additional tasks outside of their role to fill the staffing gaps, Westmoreland said. "People who can retire are retiring. People just hired are leaving. And the rest of us are being stretched thin to do non-nursing work like cleaning, delivering trays, even transporting patients," she said. Although the VA plans the staffing cutbacks, the department is requesting $441.3 billion in fiscal year 2026, according to its budget request released in May. Paradoxically, that is a 10% increase from the 2025 fiscal year budget. Budget approved in House House Republicans approved a $435.3 billion budget on June 25, but the Senate must prepare its version of the spending plan. The Military Times noted that "the plan is unlikely to pass as its own standalone measure, but instead is expected to be approved sometime this fall as part of an all-of-government spending package." The VA said the funding increase, if it happens, would be prioritized toward health care, benefits and national cemeteries. Much of what is coming has not been shared with Congress, and congressional staffers who work for the House Veterans Affairs Committee say they are in the dark about the agency's plan. "VA indicated to the committee in June that they are 'allowed to do planning, but no execution' of a reduction in force," a committee statement said. "They have developed recommendations for an RIF for VA Central Office positions, but that plan has not been signed off on." Requests ignored Staffers also noted that repeated requests for documentation by Democrats on the House Veterans Affairs Committee have been ignored, raising questions of whether veterans will be negatively impacted by the proposed changes. "We continue to have serious concerns about the effects of VA's plan because details remain so limited," said a Democratic staffer who asked that his name not be used because he was not authorized to speak for the committee. "We are conducting an ongoing investigation into VA's workforce reduction efforts." Meanwhile, legal challenges to President Donald Trump's March 2025 executive order to mandate sweeping federal workforce reductions continues to complicate VA's path forward. The order was initially blocked by a federal court, but the Supreme Court lifted that injunction Tuesday, allowing agencies like VA to resume planning for workforce cuts while the legality of the order is still under review. In a separate lawsuit, a federal judge in California issued a preliminary injunction in June against the Trump administration for stripping federal workers of their union rights. Unions file suit Six major unions -- National Nurses United; American Federation of Government Employees; American Federation of State, County, and Municipal Employees; National Association of Government Employees; National Federation of Federal Employees; and Service Employees International Union -- filed that suit. In a June press release from National Nurses United, the unions argued that Trump's order violated the First and Fifth amendments by taking away collective bargaining rights without due process from nearly 1 million federal employees. Westmoreland said the case is critical for protecting care quality and the rights of VA staff. "Collective bargaining rights are critical for union nurses so we can advocate for our veterans and ensure they get the care they deserve," National Nurses United's Westmoreland said. "We will fight for our veterans who put their lives on the line for us." The court has temporarily stopped the administration from stripping federal workers of their union rights. The injunction is still in place while the lawsuit plays out. Representing veterans as president of the American Federation of Government Employees Local 2092, Robert Malosh said the administration's actions have created a culture of fear and uncertainty among staff. Life-threatening gaps Malosh, a veteran, recounted the union's role in addressing life-threatening gaps in emergency care at the main VA hospital in Ann Arbor, Mich. "For almost 30 years, [certified registered nurse anesthetists] were expected to respond to emergency airway calls from home. We identified that risk and bargained for 24-hour on-site coverage," he said. "Just last month, a CRNA told me they saved a life. If they weren't already in the building, that veteran would have died." Malosh said that cases like this spotlight the value of unions in identifying blind spots and advocating for both staff and veterans. He described a troubling case involving podiatric surgeries being delayed due to administrative interpretation of care eligibility rules, potentially placing diabetic veterans at risk of amputation or worse. He also pushed back against a VA back-to-office mandate, calling it a disruptive change that was poorly planned and worsened care delivery. Back to the office According to the VA, it announced its back-to-office mandate Feb. 3, ordering all employees, except those with approved arrangements, to work full-time at their assigned duty stations. The announcement followed Trump's presidential memorandum Jan. 20 for a back-to-office mandate across all agencies and departments in the executive branch, according to the White House. Malosh said a number of issues arose with that mandate: For one, employees strugglied with Wi-Fi issues due to the influx of people connecting, causing disruptions for telehealth medical appointments. Also , mental health professionals who had been working privately from home were moved to shared offices and cubicles, causing veterans to feel uncomfortable due to lack of privacy. Malosh said some veterans saw people in the background of a private call. As the VA moves forward with plans to reduce its workforce, questions remain about the long-term effects on veteran care and employee stability. With ongoing legal challenges, congressional scrutiny and staff uncertainty, the future of the agency's restructuring efforts and their consequences for the nation's largest health care system remain unresolved.
