As VA updates its motto, Secretary Denis McDonough’s biggest challenge remains inspiring VA’s 400,000 employees to deliver quality care.
The U.S. Department of Veterans Affairs is engraving an updated motto on their buildings: “To fulfill President Lincoln’s promise to care for those who have served in our nation’s military and for their families, caregivers, and survivors.”
The change came after Veterans organizations, such as Iraq and Afghanistan Veterans of America (IAVA), advocated for greater recognition of the number of women veterans served by VA. Until the recent change, VA’s motto long referred to “him who shall have borne the battle, and for his widow, and his orphan.”
“Calling for a change to the VA’s motto was also always about more than words,” said Iraqi War Veteran and IAVA CEO Allison Jaslow. “It was about the need for culture change at the VA and setting the right tone from the top. We must be relentless until the culture at the VA makes every veteran, and their loved ones, feel like they’re supported fully.”
After the Department of Defense, VA is the nation’s largest federal bureaucracy, with taxpayers funding nearly 400,000 government employees working at hundreds of VA medical facilities, clinics, and benefits offices nationwide.
VA’s own data found women veterans felt unwelcome and even unsafe at VA health centers. As a result, many delayed or refused to seek care. According to IAVA, “calls to change the motto were about inclusion, but also a call to action to improve the overall culture at the VA to ensure all veterans are able to utilize the healthcare they’ve earned and deserve.”
Veteran concerns about the quality of care they receive from VA have received significant Congressional attention. As a result, while Congress has increased funding for veteran care, legislation has also required much of that funding be redirected to community-based partnerships and health providers that may be better able to improve veteran care. The challenge, advocates said, has been that many of the same bureaucrats who were responsible for VA’s failed services and care to veterans in the past remain in positions to influence, and even undermine, critical partnerships, care and services in the present.
“There can be a tension, a disconnect, between the intent of Congress, VA’s Secretary, and the actions of individual bureaucrats within VA,” a veteran advocate said.
“VA is making progress ensuring those responsible for care are laser focused on how their actions impact veterans,” said Seth Eisenberg, Chairman and CEO of Purpose Built Families Foundation and a leading provider of programs to disrupt veteran homelessness and prevent suicide. “Experiences people have with VA can still be dramatically influenced by individual employees, for better or worse,” Eisenberg said. “VA still has a long way to go ensuring the actions of every employee are consistent with the department’s mission, vision, and values.”
Veteran advocates are urging VA to adopt additional improvements.
Former VA Under Secretary Dr. Paul E. Lawrence, responsible for leading more than 20,000 employees at the Veteran Benefits Administration during the Trump Administration, said the most important word in VA’s motto is “care”.
To provide world class care, VA should strengthen how the agency measures care, Dr. Lawrence said.
“How long does it take to get appointments and are the medical outcomes achieved? How timely and accurate are your benefits? Are you satisfied with the memorial services?”
Dr. Lawrence stressed improving VA requires measuring performance. “Compare how the actual care is delivered with the very best service providers in the country and improve as we come up short.”
He encouraged VA to report results “regularly and publicly … talk about how you’re delivering care; be radically transparent reporting both good results and disappointing results” he said.
Eisenberg agreed, stressing “radical transparency” should include VA publishing funded grants, contracts and regularly reporting detailed impact and veteran satisfaction results. “That kind of transparency can help veterans and the public hold VA and the programs it funds accountable for delivering promised results,” he said. “Transparency can also make it less likely individual bureaucrats will act arbitrarily and capriciously to the detriment of veteran care,” Eisenberg said.
As Secretary Denis McDonough walks past VA’s updated motto each day, he’d do well to remember his greatest challenge is inspiring 400,000 VA employees to uphold that motto and the values it represents.