Frontline VA health jobs cut despite officials saying they’d largely be protected

By Curt Devine and Audrey Ash, CNN

(CNN) — US Department of Veterans Affairs officials have eliminated frontline jobs for staffers who provide care to veterans, even though agency leaders previously declared such positions would largely be protected from cuts, according to a CNN review of documents and interviews with more than 20 VA employees and job applicants.

Positions for psychologists, clinical social workers and others have been cut, and some job offers have been rescinded in recent weeks and months as the agency seeks to address a budgetary shortfall and shave its workforce by 10,000 positions.

The job reductions come at a time when some veterans continue to face extended wait times for service and as suicides among veterans remain disproportionately high.

The cuts have rankled rank-and-file VA employees as their department has been embroiled in a scandal for improperly awarding about $11 million in bonuses to senior VA executives last year, as detailed in a May inspector general report. VA Secretary Denis McDonough said the VA canceled the bonuses and began recouping them after realizing the error.

The eliminations follow a surge in VA hiring. The agency added tens of thousands of staffers to its ranks last year to keep pace with an increase in veterans seeking care, but VA insiders now fear the job eliminations — especially those involving frontline positions — could undercut their health system.

In recent weeks, lawmakers have requested information from the VA about its job reduction strategy after hearing reports that jobs that provide direct care for veterans have been targeted. CNN has confirmed with VA staffers and prospective hires that offers for such positions have been rescinded.

VA Under Secretary for Health Dr. Shereef Elnahal issued internal memos in late May directing managers to continue hiring for roles vital to patient safety and to quality and timeliness of care. He also said certain key positions geared toward suicide prevention, homelessness and women’s health that had been frozen should be reactivated and filled.

Elnahal did, however, say administrative roles and certain clinical positions — such as those that could be accomplished by other employees — could be cut.

It remains unclear how many frontline positions that were on the chopping block could be reinstated following Elnahal’s updated guidance, and whether applicants who had offers rescinded would be offered the jobs again. VA spokesperson Terrence Hayes told CNN in a statement that while the VA continues to strategically hire in key areas, such as mental health and in locations with spikes in veterans seeking care, the agency has “the nationwide staffing total we need to deliver for our nation’s Veterans.”

Hayes said that local VA leaders have authority to make decisions about the staff they hire. “There are no plans for an enterprise-wide hiring freeze or layoffs,” he said, noting that the VA has onboarded thousands of mental health professionals over the last three years.

Recently, local VA managers have been issuing internal warnings about hiring.

“The recent VA strategic hiring initiative has placed considerable strain on all our services and disciplines across our facility, both clinical and non-clinical,” wrote Dr. Mark Kadowaki, the chief of staff for the VA medical center in Iron Mountain, Michigan, in a May email to staff obtained by CNN. VA spokesperson Hayes said the Iron Mountain medical center has had a net increase in employees this year and has added specialty providers.

The staffing shakeup has also triggered backlash on Capitol Hill. In April, the top two senators on the Senate Committee on Veterans’ Affairs called the staff reduction plan a “mess.” A separate group of senators requested language in a bill that would direct the VA to share details on employee vacancies, positions cut, and how those could affect care. “Inconsistent staffing patterns put veterans’ healthcare quality and accessibility at risk,” the senators wrote in a letter.

Dr. Harold Kudler, a psychiatrist and associate professor at Duke University who has four decades of experience serving veterans through the VA, questioned the decision to rescind offers for frontline positions and said, “It’s very simple. If you remove access to expert care — if you remove access to the largest suicide prevention program in the country, if not the world — then that’s not good for veterans.”

Kudler and others expressed particular concern about cuts involving mental health care. A Government Accountability Office report in February noted that veterans suffer a disproportionately high rate of suicide, with an average of almost 18 veterans dying daily by suicide in 2021, about 72% greater than the general adult population.

Job offers axed

The plan to downsize comes after the VA went on a hiring spree last year amid an increase in veterans seeking care. In 2022, President Joe Biden signed into law the PACT Act, which expanded health care benefits for veterans exposed to various toxic substances. More veterans enrolled for VA care and the department’s health administration hired more than 60,000 employees in fiscal year 2023, which swelled the VA’s ranks to more than 400,000 total staffers.  

But a budgetary shortfall has led the department to make reductions, officials say. Elnahal said at a news conference in March that he believed the VA could eliminate up to 10,000 positions through “attrition and voluntary separation,” without compromising care for veterans. He said such cuts would primarily focus on positions that were “more managerial, programmatic individuals, supervisory roles that aren’t necessarily over the point of care directly.”

But multiple VA sources told CNN that reductions have seemed less strategic than Elnahal promised. And they have accused the department of slow-walking hires for positions they called critical.

“It’s actually direct-care staff that’s being eliminated,” said Tiffany Roman of Pueblo, Colorado, a VA nurse who works as the vice president of a local chapter of the American Federation of Government Employees union.

In an April email shared by another source, a VA manager in Central Texas, Stacy Ritz, told local staffers that 22 vacant positions related to mental health and behavioral medicine had been “abolished,” meaning the jobs were no longer “on the books.” Ritz wrote that her team could “ask for them back when the financial situation is more optimistic,” though she described the losses as “painful.”

VA spokesperson Hayes said those abolished positions had been vacant for half a year and that local leadership can refill them if needed. He said the Central Texas VA has increased mental health staffing in the last three years.

Some VA staffers have questioned the logic behind many of the cuts.

“It doesn’t seem like they are assessing clinical needs,” said Chris Mapps, president of a local AFGE union chapter in Michigan and a VA advanced medical support assistant. “It seems to be based on them telling the facilities, ‘These are your numbers you got to hit.’”

William Hazel, a clinical social worker who has worked for the federal government for years, experienced one of the cuts.

Hazel said that he applied last year for a VA social worker position based in the US territory of Guam, which he said lacks many of the mental healthcare resources available in parts of the US mainland. He hoped to help veterans overcome substance abuse and other challenges.

After receiving a tentative job offer in September, Hazel said, he continued moving through the agency’s onboarding process. In March, the government notified him that although he was an “exceptional candidate,” the offer had been rescinded due to “budgetary issues the Agency is experiencing and other unforeseen circumstances,” according to an email he shared with CNN.

Hazel told CNN he was disappointed.

“They say that mental health is a critical element to them, yet we were cut,” he said. “The motto of the VA is to care for him who has borne the battle. Are they doing that? I respectfully submit, no.”

“I feel like I have been betrayed and left out to dry,” said another applicant who received a tentative job offer for a VA position researching suicide prevention that was rescinded in March after the applicant had moved to the state where the job was located. He spoke on the condition of anonymity because he still wants to work for the VA.

Yet another applicant who had a tentative offer for a VA staff psychologist position rescinded in March — also “due to unforeseen circumstances,” according to a government email — said the experience made her question the extent to which the VA truly prioritizes mental healthcare. She also spoke anonymously due to plans to reapply for VA jobs.

Asked about the staffing cuts at a Senate hearing in May, VA Secretary McDonough said that the federal budget “does force some choices” on his department, though he said the agency’s retention of employees had been at “historic highs” and that it is “better sourced with clinicians” due to spikes in hiring in recent years. He also said the VA could continue to strategically fill positions based on clinical need.

The VA has been touting in news releases that department surveys show trust in the VA has increased among veterans and that wait times for new patient appointments in primary and mental healthcare slightly decreased in April.

Still, a Government Accountability Office report published this month found challenges with the VA’s ability to provide timely care and noted that many VA facilities last year took more than two weeks to even schedule mental health appointments in the private sector, an option used when veterans have to wait too long or travel too far for VA care. The VA said in response to the report that it was seeking to improve the timely scheduling of such appointments.

Some warn any momentum in improving VA care could be undercut by decisions to trim health workers.

“Any time you impact staffing, any time you lower the potential for one-on-one care, any time you lower the areas of need — mental health, primary care, surgeries — that always poses a risk,” said Jeff Shapiro, the president of the VA council for the National Federation of Federal Employees union. “It’s a managerial problem.”

CNN’s Allison Gordon and Kyung Lah contributed to this report.

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