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SW In Congress

The Association of Veterans Affairs (AVASW) has taken a position opposing The Making Community Care Work for Veterans Act (Tester) which is being actively negotiated among Senate and House committees of Veterans’ Affairs leaders. Below is a copy of the AVASW letter sent to these Senate and House leaders stating our position. The bill will expand eligibility of Veterans to the Veterans Community Care Program (VCCP). We are deeply concerned about two provisions of this bill.

First, it would allow Veterans to bypass the VA and seek VCCP care for their eyes or ears even when it is available at the VA in a timely and convenient manner. If enacted, this would abolish the VA structure for obtaining outside care that utilizes access standards and VA pre-authorization. This could set a dangerous precedent that may allow a myriad of various other physical conditions to be exempt from current processes.

The Second issue is a new allowance for residential mental health and substance use disorder care. It would increase Veteran’s access to VCCP residential care without a single expectation that contract providers be licensed, have subject matter training, deliver evidence-based practices, have emergency medical backup, or report outcomes. It sets no limits on per diem charges.

These two provisions will drastically harm veterans by causing large amounts of funds to be diverted from VA facilities to the private sector. This likely will force more reductions of VA staff and closures of programs, inpatient units, and emergency rooms. This bill will turn the VA from being a healthcare system with its current primary role as provider of healthcare into a payer for private sector care. This type of ‘choice’ for healthcare options will diminish the care available for Veterans. It will ultimately lead to the Veteran having less choice and not more choice.

November 17, 2023

Dear Representative/Senator:

On behalf of the Association of Veterans Affairs Social Workers (AVASW), I am writing to you about the ‘Making Community Care Work for Veterans Act’. AVASW serves as an independent voice supporting the highest quality healthcare and services to Veteran, their families, and caregivers.

The Making Community Care Work for Veterans Act is now being negotiated by leaders in both the Senate and House Committees on Veterans’ Affairs. We are concerned that, as written, the proposed Act would be devastating to the Veterans it purports to help.  

The Act will open eligibility for obtaining eye and ear care in the community without a VA referral, even when it is available at the VA in a timely and convenient manner. This provision will allow substantial amounts of funds to be diverted from the VA to the private sector. The VA will begin the process of transforming itself from being a system that provides healthcare to one that pays for private healthcare at significantly higher costs.

Another concern is not holding the private sector to the same quality standards as VA clinicians which will lead to poorer outcomes.

We urge you to oppose provisions in this bill that will abolish eligibility or that ignore the imperative of establishing quality standards.


Stanley G.  Remer, LCSW

Legislative and Congressional Liaison

Association of Veterans Affairs Social Workers

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