Lisa Murkowski Asks VA Secretary Doug Collins About Expanding Access For Veterans In Rural Communities

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During a Senate Appropriations Committee hearing last month, Sen. Lisa Murkowski (R-AK) spoke about VA care in rural communities.

Transcript

00:00To follow on Senator Collins' comments about our rural veterans,

00:07you kind of pointed out that Alaska is in that same bucket.

00:10I'm just going to say we're bigger, we're badder, we're just more complicated, as you know.

00:18And we're very proud to host more veterans per capita in Alaska than anywhere else out there.

00:23And so how we do outreach to our rural veterans has long been a challenge.

00:30You and I have had an opportunity to talk about that.

00:34But it's everything from traveling the long distances.

00:37We're not going to be able to put that veteran in a car, more likely than not.

00:41It's going to be travel that requires flying.

00:46It may be trying to access them through telehealth,

00:51but when you have limited broadband, that's a problem.

00:54Then we have shortages of local health care providers.

00:57So it's complicated in many ways.

01:00But all of our veterans deserve this care, and I think we recognize that.

01:03So know that I, along with Senator Collins,

01:06am very interested in any strategies that you are looking to advance

01:12to maintain and expand services in our rural communities.

01:15I have talked about establishing an outreach program that would send teams to rural areas

01:24that are off-the-road system to just kind of let them know about their benefits,

01:28about the services that are made available.

01:30We can't necessarily do everything, but we can at least let you know this is what your VA can do for you.

01:37And I would hope that you'd work with us to support that kind of an event.

01:42I definitely wouldn't, if you'd allow me to expand just a minute on that.

01:44I think this is one of the issues that I've – I want us to break out of the model in many ways,

01:50and I say this in a very generic fashion.

01:53I want us to break out of the model that everything has to be the way we've always done it.

01:57We have to go to a brick and mortar.

01:58We have to go to this as a clinic.

02:01We have – one of the things, and it just highlighted recently,

02:04we had to close our ambulatory clinic.

02:06And this is not a rural issue, but it sort of plays to the issue.

02:10We had to close our ambulatory clinic in L.A.

02:12because of the riots and other things going on in L.A.

02:16We interrupted almost 1,800 appointments, and some were telehealth, some we were able to move to others.

02:23But for the most part, we had folks who aren't getting care.

02:26Very familiar if you were in the middle of a rural state or Alaska or anywhere else, you're not getting.

02:30So we were already beginning to see how could we bring in mobile clinics and others,

02:35even in that area, in a safe area where our appointments could be kept.

02:39So for me, if we have those kind of resources, can we do those in states such as Alaska and others,

02:45is instead of always just defaulting to something, as you said, like a telehealth model or a visiting doctor,

02:53maybe have regular roundabouts like we have that have our health teams go out with these mobile vehicles

03:03that could actually do and provide primary care and others.

03:05And, of course, they need to go elsewhere.

03:06We could do that.

03:07I think that's a – I'm willing to think outside the box to do that.

03:10It could work in a very rural state.

03:11It could work in a state like, you know, New York, Georgia, anywhere else.

03:14The other thing –

03:15It's just – if I can interrupt on that.

03:16Just – you've kind of picked my brain.

03:20We provide – or there are some nonprofits and some for-profits that provide mobile mammography units

03:27that go out to put them on a barge, you go up the river.

03:30It has provided access to women in rural parts of the state that would never be able to get this kind of screening.

03:37You can do that kind of teaming, but you do have to be willing to think outside the box a little bit.

03:44And I appreciate that you're looking into that.

03:47Let me ask you here about the tribal health side.

03:54I'm pleased that IHS and VA have entered into a reimbursement agreement

04:00as we're trying to figure out how we access some of the unique challenges in VA services.

04:10Office of Tribal Government Relations.

04:12This is – this is an office that has proven to be important.

04:19I would like to know if you think that that Government Relations Office will continue.

04:26And then the VA Advisory Committee on Tribal and Indian Affairs.

04:30This is another VA advisory body.

04:34This is under review.

04:36Know that the committee really does play a vital role in ensuring that Native voices are represented

04:44when VA policies are developed.

04:47We think that it's good.

04:49It helps to advance culturally competent care, strengthens tribal consultation,

04:53and helps the VA fulfill its commitment.

04:56So I don't know if you can give me an update on the current status of this committee

05:00and whether its work will continue uninterrupted.

05:04And then if you can share with me whether or not you think the Office of Tribal Government Relations will continue.

05:10Yes.

05:11That's an yes to both.

05:13They're both going to be continuing.

05:14And also, yeah, we're continuing to outreach as well.

05:17And we're – as I said earlier, we're making sure our intergovernmental offices

05:22and working with different organizations is strengthening.

05:25We brought in our caseload to make sure that we're reaching out to states, tribes, and others,

05:31that that is being a part of what we do.

05:32So they're both increasing.

05:34And also, I'm looking forward to being, I think, if my schedule is – if they've told me correctly,

05:39I'll be up there in October, I think, around some of these issues that will be going on with the tribes.

05:43Great.

05:43I think hopefully you're coinciding – or you're scheduling that trip to coincide with the Alaska Federation of a Native Conference in October.

05:51I believe it is, yes.

05:52That's great.

05:53Mr. Chairman, I've got a couple of questions that I'm going to submit for the record.

05:56One is on the roof of the Palmer Pioneer Home.

05:59I can't let a hearing go by without mentioning that, as well as the electronic health record rollout.

06:06As you know, the Alaska VA system is going to get the rollout of this technology in 2026.

06:11There's a lot of people anxious about that because previous rollouts have not exactly been fun.

06:16So you will see those questions submitted for the record.

06:19I look forward to that, and maybe later on, you know, we'll discuss that, and I'll look forward –

06:22That'd be excellent.

06:22The electronic health record is very important.

06:24Yes, it sure is.

06:25Thank you, Mr. Chairman.

06:27Senator Baldwin.

06:28Thank you, Mr. Chairman.

06:29Thank you, Mr. Chairman.

06:30Thank you, Mr. Chairman.

06:31Thank you, Mr. Chairman.

06:32Thank you, Mr. Chairman.

06:33Thank you, Mr. Chairman.

06:34Thank you, Mr. Chairman.

06:35Thank you, Mr. Chairman.

06:36Thank you, Mr. Chairman.

06:37Thank you, Mr. Chairman.

06:38Thank you, Mr. Chairman.

06:39Thank you, Mr. Chairman.

06:40Thank you, Mr. Chairman.

06:41Thank you, Mr. Chairman.

06:42Thank you, Mr. Chairman.

06:43Thank you, Mr. Chairman.

06:44Thank you, Mr. Chairman.

06:45Thank you, Mr. Chairman.

06:46Thank you, Mr. Chairman.

06:47Thank you, Mr. Chairman.

06:48Thank you, Mr. Chairman.

06:49Thank you, Mr. Chairman.

06:50Thank you, Mr. Chairman.

06:51Thank you, Mr. Chairman.

06:52Thank you, Mr. Chairman.

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