Affect of understaffing, facility closures and ready instances has been “dire” underneath Trump’s second time period, medical staff say.
By Marcus Baram for Capital & Fundamental
“Our staffing in the ER is beyond dire now,” mentioned Heather Fallon, a nurse within the emergency division on the Captain James A. Lovell Federal Well being Care Heart in North Chicago who had lengthy been dreading the arrival of Sept. 30, the day the fiscal 12 months got here to an finish.
That was the day she says she misplaced two nurses — and the power misplaced 9 staffers in whole — whose contracts ended, placing additional pressure on her group, which has seen a rise in sufferers this 12 months. Veteran Affairs Secretary Doug Collins had vowed to have lowered the dimensions of the company by 30,000 positions by that date with out impacting well being companies for veterans.
“We are understaffed,” Fallon mentioned. “We don’t have all of the services that we would have had on a regular basis.”
Secretary of Veterans Affairs Doug Collins testifies at a Senate subcommittee listening to on June 24.
In the meantime, wait instances have elevated for sufferers, mentioned Florence Uzuegbunam, a nurse practitioner who works in main care at a VA hospital exterior of Atlanta. She additionally mentioned that the staffing scarcity has elevated since Sept. 30 and that a rise in sufferers has lowered the time out there for outpatients from the really useful one-hour go to to half-hour. “You can’t do much in 30 minutes.”
She added that in lots of areas of the hospital — together with the ladies’s wellness clinic — there may be lowered staffing.“I am assigned the duties of two people. Many of my co-workers told me they are putting an average of four hours unpaid daily just to keep up with the workload.”
Each Fallon and Uzuegbunam are talking out as members of Nationwide Nurses United, the most important union of registered nurses within the nation, whose contract with the VA was terminated in early August. (Disclosure: NNU is a monetary supporter of Capital & Fundamental.)
The attrition of the VA workforce within the final 9 months has put a pressure on understaffed hospitals and clinics, damage morale and sped up the transition to personal care, nurses and veterans advocates informed Capital & Fundamental.
Collins’ choice in June to scrap a plan for large layoffs and his promise to offer faster companies to veterans introduced a sigh of reduction to many and generated optimistic headlines.
However the upheaval attributable to the Trump administration’s earlier firings of probationary staff who have been then rehired months later, the closing of some VA amenities and the cancellation of medical analysis trials have had a significant impression, say nurses who work at VA amenities, staffers on the division and veterans advocates. Morale is low, say nurses and staffers at VA amenities, who requested to not be recognized out of concern of retaliation, noting that this 12 months the VA determined to not conduct its annual workers satisfaction survey — which has been carried out yearly since 2006 — citing prices. The VA confirmed that the survey was not carried out this 12 months.
Collins has repeatedly vowed that chopping 30,000 positions received’t immediately impression well being care or advantages for veterans offered by the Veterans Well being Administration, the healthcare department of the VA. The VHA, which is the nation’s largest built-in healthcare system, serves 9.1 million enrolled vets every year, offering care at 1,380 well being care amenities.
But, between December 2024 and August 2025, the VA reported a web lack of hundreds of well being care positions — together with 875 physicians, 2,403 registered nurses, 511 licensed sensible nurses, 335 nurse assistants, 649 social staff, 287 psychologists and 906 medical help assistants, based on the division’s workforce dashboards, first highlighted by The American Prospect. The whole variety of these in mission-critical occupations — which “reflect the primary mission of the organization without which mission-critical work cannot be completed” — dropped by 4,214. For comparability, through the Biden administration, the variety of these in mission-critical occupations elevated from December 2023 to August 2024 by 2,806.
A poster depicting Uncle Sam greets shoppers in a pharmacy ready room on the Fayetteville Veterans Affairs Medical Heart in Fayetteville, N.C.
Whereas the entire variety of U.S. veterans has been steadily declining in latest many years, the inhabitants of ageing veterans is rising, with greater than one-quarter of veterans now 75 and over, dealing with larger well being dangers. About 1.3 million veterans are 85 and older, a inhabitants that’s anticipated to extend to 1.7 million in 2034.
The staffing reductions and coverage adjustments on the VA have prompted tons of of present and former VA medical doctors, nurses and different caregivers to write a letter to Collins, warning in regards to the detrimental impacts. “We write to raise urgent concerns about proposed policies which, in addition to ones already enacted, will undermine VA’s healthcare system, overwhelm VA’s budget, and negatively affect the lives of all veterans.”
Peter Kasperowicz, a spokesperson for the company, vigorously pushed again on the claims, stating that “the only staff reductions at VA have been voluntary through resignations and retirements, and these departures had no impact on VA health care, benefits or services.”
He additionally famous that the nurses who left the Lovell facility in North Chicago have been “temporarily hired under a contract to assist with deployment of the electronic health care system at Lovell” and that they have been now not wanted, including that the power’s nursing workers has grown since final 12 months. Kasperowicz additionally mentioned that “the Atlanta VA Health Care System has not implemented any system-wide reduction of routine outpatient visit lengths.” He added that although the power’s ladies’s wellness middle has one much less Affected person Aligned Care Group than it did final 12 months, it’s “actively hiring to fill out” a further group.
“Struggling to Keep Up With Patient Load”
Understaffing is a persistent grievance amongst veterans. U.S. Military veteran Jose Vasquez, who’s the chief director of Widespread Protection, an advocacy group for veterans, was not too long ago identified with pancreatic most cancers. He credit New York’s Manhattan VA (now the Margaret Cochran Corbin VA Campus) with saving his life.
“I mean, full stop, they figured out what was going on with me, got me quickly through the diagnostic processes and got me referred to surgical oncology.”
However he mentioned that when he was an inpatient, earlier than and after surgical procedure, “It was clear to me that the nursing staff was struggling to keep up with the patient load.”
Vasquez mentioned that he has heard from different veterans with most cancers who’re receiving chemotherapy via the VA that “some appointments have been either delayed or cancelled.” Most cancers remedy delays have been an ongoing situation on the company for many years. The VA mentioned it couldn’t touch upon such nameless anecdotes with out having particular particulars on the circumstances.
CNN not too long ago reported that some VA hospitals had elevated their enforcement of a coverage that limits the variety of long-term remedy periods out there to veterans and to “broadly reduce the number of patients who get this long-term care — without consideration for whether this is clinically appropriate,” based on psychological well being suppliers and VA sufferers. Kasperowicz, a spokesperson for the company, informed CNN that there aren’t any limits on the variety of VA appointments that sufferers can have in psychological well being and different areas.
The seal is seen on the Division of Veterans Affairs constructing in Washington, D.C.
In September, veterans with amyotrophic lateral sclerosis, often called Lou Gehrig’s illness, testified earlier than the Senate Veterans’ Affairs Committee about delays they mentioned they’ve skilled in getting medical care and provides, in addition to prolonged wait instances for companies at VA clinics and hospitals.
“For a person with my condition, this is not just an inconvenience — it’s a grave threat,” Navy veteran Shelly Hoover — who was identified with the illness in 2013 — informed the committee. The testimony prompted Sen. Richard Blumenthal (D-Conn.) to request an unbiased audit by the Authorities Accountability Workplace of the VA’s spinal twine accidents and issues program.
As well as, the VA’s hiring freeze of medical analysis staffers has slowed entry to medical trials, together with these geared toward stopping dementia and coronary heart illness and learning superior cancers, based on Sen. Patty Murray (D-Wash.), senior member of the Senate Committee on Veterans’ Affairs. She and different senators despatched a letter to Collins on July 22, demanding the rehiring of “wrongly terminated researchers” and the restoration of grants revoked from VA researchers. Her workers mentioned that Collins has not responded to her letter.
Within the final a number of months, a number of researchers informed Capital & Fundamental that they’ve been rehired by the VA and are persevering with their research. They declined to talk on the file about their experiences, citing fears that they’d face retribution.
Kasperowicz, the VA spokesperson, informed Capital & Fundamental that its department-wide emptiness charges for medical doctors and nurses are 13.7% and 10%, respectively — decrease than the emptiness charges through the Biden administration. However veteran advocacy teams mentioned they don’t belief these numbers as a result of the VA is chopping positions, leading to an artificially low emptiness fee. “If you take the position off the organizational chart as a [full-time employee], it looks like you don’t have a vacancy,” mentioned Suzanne Gordon, the co-founder of the Veterans Healthcare Coverage Institute.
The decline within the VA’s workforce leaves it incapable of dealing with the rise in ageing vets, veterans well being advocates mentioned. “The fact is that the veteran population is older and sicker and poorer,” Gordon mentioned. “So even if the population demand declines a small bit, the need doesn’t decline because you have these people now who are older — in addition to their military-related service conditions, they now have health conditions connected to aging.”
Jan Ruhman, a Marine Corps veteran who did two excursions in Vietnam, is 78 and has had his share of medical procedures — eye surgical procedure, Mohs surgical procedure for pores and skin most cancers and a triple bypass operation in 2015 after a coronary heart assault that 12 months. He lives in San Diego and goes to the La Jolla VA, the place he’s skilled “longer waiting times and people are a little more rushed.”
He mentioned that the VA has come a good distance from 1970 — he distinctly remembers the filthy circumstances of the Lengthy Seashore VA hospital; he not too long ago visited a buddy there and, he mentioned, it now has “first-class facilities.”
However he’s frightened in regards to the impression of workers cutbacks — “Every single person at that VA health care system is a critical worker” — and mentioned, “My fear is that they’re going to take a system that became world class from being one of the worst in the world and they’re going to take it apart, piece by piece.”
Throughout a latest go to to the Fayetteville VA Medical Heart in North Carolina, Secretary Collins toured an expanded emergency division and dental clinic and informed reporters: “For those who came to this area and said we’re cutting and slashing … We’re actually putting the money where it needs to be.” He added: “We’re also making sure we’re organized in such a way that we’re spending the money in a proper and efficient way.”
Storm clouds roll over the Fayetteville Veterans Affairs Medical Heart in Fayetteville, N.C.
That features opening new clinics and shutting others, typically forcing veterans to journey removed from their properties to get medical companies. The residential substance abuse middle at New York’s Brooklyn VA Medical Heart “paused” admissions on Might 30 attributable to “loss of critical staff needed to maintain a safe and effective program,” per a memo despatched to staffers.
In some circumstances, that has compelled some veterans looking for substance use remedy to be admitted to psychiatric amenities to get care, mentioned a staffer on the Brooklyn middle who requested to not be recognized out of concern of retaliation. “Now when you’re trying to rehab from drugs, you don’t really need the person next to you eating his toenails,” mentioned the staffer. “It’s not conducive to the rehab process. It’s an awful situation.”
The Brooklyn middle not too long ago reopened although it had bother filling prime slots, mentioned Ketsia Glemaud, a psychological well being care nurse talking as a member of Nationwide Nurses United who labored on the facility till Might when it was shut down.
Glemaud mentioned the scenario is dire in New York Metropolis, claiming that there are usually not sufficient substance abuse clinics to satisfy the wants of veterans attributable to closures within the wake of the pandemic and price range cuts during the last eight years. She says that those that confirmed up on the doorways of the Brooklyn facility in latest months have been turned away and informed to go to VA amenities in New Jersey and Westchester County, no less than an hour’s drive from New York Metropolis.
“The closure of these programs has been heartbreaking for the veterans,” Glemaud mentioned. “That’s a really difficult thing to experience, especially if you’re a veteran who’s been through hell and back and now you’re dealing with health issues or addiction. You feel abandoned.”
The VA’s Kasperowicz mentioned that well being care wait instances and advantages backlogs “were worse under President Joe Biden and are getting better under President Donald Trump.” He added that the VA has opened 16 new well being care clinics since January and that the backlog of veterans ready for VA advantages elevated 24% underneath Biden and is down greater than 37% through the second Trump administration.
As well as, Kasperowicz mentioned the backlog of veterans ready for VA advantages is down 49% since Jan. 20, 2025, after it elevated 24% through the Biden Administration; that the company is processing file numbers of incapacity claims, “reaching an all-time fiscal-year high of three million claims”; that it has provided veterans greater than 1.4 million appointments exterior of regular working hours since Trump took workplace; and that it’s spending a further $800 million on infrastructure enhancements “to ensure department facilities provide safe and effective patient care.”
Pushing Sufferers Into the Non-public Sector
Ruhman, the Marine Corp veteran, mentioned he’s additionally involved in regards to the VA’s transfer to push extra veterans into personal care via a program referred to as Neighborhood Care, which permits vets to get reimbursed for care at non-VA medical amenities. He mentioned that his expertise with this system didn’t give him confidence — claiming he needed to wait 5 weeks to get a referral for rehab companies after his triple bypass surgical procedure. “You wait too long — and they’re not prepared to deal with veterans — and that has been the experience of many people.”
The rationale for this system is universally supported — particularly for vets who require specialised care or dwell removed from VA clinics — but it surely has been criticized for lack of oversight, its rising value and issues that it doubtlessly weakens the VA’s personal companies.
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Obligatory spending for Neighborhood Care is projected to extend from $6.74 billion in fiscal 12 months 2024 to $9.77 billion in fiscal 12 months 2025, although “the evidence does not bear out Community Care as a meaningful replacement for VA direct care,” mentioned Dr. Kyleanne Hunter, a former Marine Corps fight helicopter pilot who now runs Iraq and Afghanistan Veterans of America (IAVA). In testimony earlier than the Home Veterans Affairs Subcommittee on Well being final month, she famous that solely 31% of IAVA members felt that Neighborhood Care suppliers understood their medical wants and said that direct care obtained on the VA has “markedly better patient outcomes” when in comparison with Neighborhood Care at non-VA amenities.
“The VA system was built with the veteran as its heart. Private sector medical care has been built on a system of profit maximization. These two systems may be at odds when it comes to veteran outcomes; their philosophies and models of care are that different,” Hunter mentioned. “This is born out in the evidence. Recent studies found that Community Care providers frequently administered high-cost and medically unnecessary procedures to veterans in order to maximize the money received from the government.”
As well as, a latest research funded by the VA of 62,911 veterans with psychological well being circumstances confirmed “significantly lower ratings of experiences” with Neighborhood Care when it got here to general satisfaction, clinician ranking, ready instances and billing.
Veterans say that Neighborhood Care might be an necessary part of well being companies, but it surely must be improved and never weaken the VA. “If you don’t fund the VA direct care system, Community Care could cause it to collapse and we are very close to that,” mentioned Ruhman.
Kasperowicz mentioned that the second Trump administration “has already made a number of improvements to Community Care capabilities,” together with extending the size of latest VA Neighborhood Care authorizations to 1 12 months for 30 standardized forms of care and eradicating secondary approval necessities for veterans to entry non-VA care.
That second provision has been criticized by veterans advocates, who declare that it removes an necessary oversight perform. “That’s the reason why the private sector loves the VA and the Community Care program, because there’s no effective utilization review,” mentioned Gordon, the co-founder of the Veterans Healthcare Coverage Institute. “That’s unheard of in the private insurance market or even Medicare.”
