President Trump touted reforms at the Department of Veterans Affairs in a speech Tuesday at the Veterans of Foreign Wars’ annual convention in Kansas City. He pointed to a new hotline for veterans at the White House, expanded private medical options and, most especially, increased accountability within the department.

“We’ve enacted some of the largest VA reforms in the history of the VA,” Trump said to the veterans group.

Reforming the agency -- which has been beset by scandals and inefficiencies -- was among the president’s top priorities when he took office. He vowed to tackle the problem in two ways: by providing more private health care options for veterans and addressing bureaucratic issues within the department.

The administration first took on the task of holding VA employees accountable through the VA Accountability and Whistleblower Act, which aims to increase transparency at the agency and weed out employees who underperform.

“Now, when a bad person -- maybe a federal employee in this case, but somebody bad -- mistreats, or neglects, or abuses our great veterans in their time of need, we can turn to them, look at them in the eye and say, ‘You’re fired. Get out,’” said Trump. “We’ve gotten rid of a lot of people over the past year — only the bad ones. The good ones we cherish.”

An agency spokesman said the change has helped the department become more productive. “During this administration, VA has had its most productive year-and-a-half in decades. We have made groundbreaking progress, particularly in the areas of accountability, transparency and efficiency across the department,” said Curt Cashour.

The press secretary provided numbers showing that 2,537 people were fired last year compared to 2,001 people in 2016. The VA is also the first federal agency to publicly post information on employee disciplinary actions.

“These personnel moves are what’s required to ensure VA is performing at its best. Under President Trump, VA won’t wait to take necessary action when it comes to improving the department and its service to Veterans,” Cashour said in a statement.

The issue of inefficiencies and problematic personnel first came to light in 2014 with press reports that veterans were dying while waiting to get medical care at Veterans Health Administration hospitals. Several investigations showed widespread failures in the medical system and falsified wait times for patients to receive care.

The VA says that under Trump’s leadership, wait times have improved and are comparable to those in the private sector, based on a 2017 Merritt Hawkins survey of large and mid-size markets. But despite recent reforms, problems remain in the department. A Government Accountability Office report in June found that the Veterans Choice Program — instituted under former President Obama to expand private health care options and reduce wait times — was not meeting its requirements. Under the program – part of the Veterans Access, Choice and Accountability Act -- veterans are supposed to wait no more than 30 days for care. The GAO found some are waiting up to 70 days.

“Without designing appointment scheduling processes that are consistent with this requirement, VA lacks assurance that veterans will receive Choice Program care in a timely manner,” concluded the report.

In May, Congress passed legislation to do just that. The VA MISSION Act, which stands for Maintaining Internal Systems and Strengthening Integrated Outside Networks, was a bipartisan measure drafted by Sens. Jon Tester, D-Mont., and Johnny Isakson, R-Ga. Trump enthusiastically signed the bill into law last month.



“You fulfilled your duty to our nation with tremendous loyalty and courage. And with the signing of this veterans choice legislation, we take one more crucial step in fulfilling our duty to you,” he said at the signing ceremony.

Leaders from major veterans organizations, including the American Legion and the VFW, had put their support behind the bill, saying it was necessary to streamline the process for veterans seeking medical care. The law provides $5.2 billion in mandatory funding for the VA Choice Program until the new system is ready next year. It also outlines a system for consolidating community care into one entity, and providing more modernized care to reach those in “underserved” areas. Now the fight turns to funding as Congress gears up for another budget battle in the fall. The White House wants the funds to come within existing budget allocations, while many lawmakers want to increase spending caps each year to pay for the bill.

An official at one veterans group sees tangible, necessary changes coming from the Trump administration in a way not seen under Obama. He said that the president is on the same page as Congress and the leadership at the VA when it comes to creating a culture of accountability.

“I don’t think the Obama administration was interested in substantially reshaping the VA. I think they wanted to make changes on the margin and blow them up into bigger reforms than they actually were,” said Dan Caldwell, executive director of Concerned Veterans for America.

Amid all these new changes comes a change in leadership as well. Newly confirmed VA Secretary Robert Wilkie officially takes the helm this week after months serving as acting secretary. He will not only oversee the implementation of the new MISSION Act but also begin the $15.8 billion project of replacing the VA’s electronic health care records so it can work with the system at the Department of Defense, as well as those at private facilities. Wilkie spearheaded the deal made with an IT health company in May.

“We really do need the new secretary to hit the ground running,” Sen. Jerry Moran, R-Kan., told Fox News after the president’s speech Tuesday. He said the Choice program has left veterans feeling discouraged about health care, and changes are needed soon. Moran sits on the Senate Veterans Affairs Committee.

One veterans group said it would like to see the agency begin to fill some vacant positions within the department, especially amid these massive changes.

Joseph Plenzler, a spokesman for the American Legion, expressed concern about the more than 33,000 job vacancies at the Veterans Health Administration, which he said represents a staffing deficit of almost 10 percent of the workforce. “This is having a negative effect on VA's capacity to deliver healthcare to veterans and forcing more vets out of the VA system to seek community care at greater expense to the American taxpayer,” he said in an email.