Thread by @AbbieRBennett

Today at 10 a.m., @SenateVA @SVACDems holds a hearing on @DeptVetAffairs and the pandemic. Also at 10 a.m., @VetAffairsDems @HouseVetAffairs holds a hearing on toxic exposures and VA presumptive service connection.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs VHA Executive Dr. Richard Stone is among those testifying in the Senate today.

Former SecVA @DavidShulkin is testifying on the second panel of the House hearing.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin Chairman @JerryMoran says he's looking to hear from VA about its progress on broadband agreements to support rural veterans and telehealth during the pandemic.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran Moran also notes that VA did not have the authority to suspend community care/Mission at the beginning of the pandemic.
More on that here: radio.com/connectingvets…

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran Moran says VA argued community care providers weren't seeing patients, but providers told Senators in October that wasn't true.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran Moran says, unsurprisingly, he wants to hear more from VA about plans for vaccine distribution. We got a first look at some of those plans yesterday. More here: radio.com/connectingvets…

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran Moran mentioning several groups who may be especially vulnerable during the pandemic, including homeless or housing insecure vets, unemployed vets, toxic exposures, etc.

More on toxic exposure risks here: radio.com/connectingvets…

and here: radio.com/connectingvets…

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran Ranking member @SenatorTester says his concerns echo many of @JerryMoran's and that there are "bipartisan concerns" about VA and veterans during the pandemic.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester FDA meets tomorrow to discuss Pfizer vaccine and distribution could begin within 24 hours.

Tester says he's concerned VA has yet to release its full distribution plan, and he specifically wants to know how VA plans to reach its staff and veterans in rural areas.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester As Congress weighs VA's position during the pandemic here's where the department stands:
- 16,239 active cases, up 164% from Nov. 1 and 388% from Oct. 1
- 422 patient deaths recorded in Dec. so far, about 1,200 since this time last month.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester Dr. Stone mentions VA's first pandemic response report. More on that here: radio.com/connectingvets…

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester Lawrence says the C&P backlog stands at about 350,000 and is normally about 140,000.
Says VBA expects backlog to be reduced back down to those levels by July and the claims backlog to be reduced by the end of the fiscal year.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester On issues of quality of contractor versus VA C&P exams, Lawrence says veteran surveys show contractors are rated slightly higher, and VA is working to expand their capacity.
92% of veterans have positive experiences with contracted exams, he says.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester Stone says VA's vaccine plan is with the CDC and that's why it hasn't been released publicly though Tester argues other federal agencies and states have already released theirs. "Why can't we be more transparent?"

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester Stone says VA has 37 sites chosen for initial distribution and placed an order for 73,000 doses distributed after emergency use authorization is approved.

Tester asks if those 37 sites have been made public. Stone says yes. I haven't seen that anywhere yet.

@SenateVA @SVACDems @DeptVetAffairs @VetAffairsDems @HouseVetAffairs @DavidShulkin @JerryMoran @SenatorTester VA will also potentially receive the Moderna vaccine, which is easier to transport, Stone says.

So that's Pfizer and Moderna for VA, potentially and pending approval, of course.

Reminder that these vaccines typically require 2 doses.

73,000 of Pfizer and 120,000 of Moderna is "not enough" Stone says, with at least 7 million veterans expected to get the vaccine (of the roughly 9M VA treats) and nearly 400,000 VA staff.

"It is not an adequate amount, and this will be a long process to reach all 7 million veterans who we believe will want a vaccine from us, as well as all 400,000 VA employees," Stone says.

VA is not part of the Immunization Information System through CDC which helps track vaccinations, @SenBillCassidy says.
Stone says VA will connect with the system if needed.

@SenBillCassidy Cassidy asks Stone if it's unions standing in the way of VA inspecting state veterans homes. Stone said that's "absolutely incorrect information" and VA has been inspecting those facilities, though more limited during the pandemic, and with a major contract recently expired.

@SenBillCassidy .@SenBlumenthal expresses condolences for the death of 2 in a steam pipe explosion at a Connecticut VA Medical Center. OSHA is completing that investigation, Stone says.
Background: radio.com/connectingvets…

@SenBillCassidy @SenBlumenthal "We are the safety net to this system," Stone says of American healthcare, especially in rural and remote areas where private hospitals are going out of business and veterans need care -- along with non-veterans during emergencies like pandemics.

@SenBillCassidy @SenBlumenthal Senators are concerned that since several of these vaccines require low temps and special refrigeration/freezing, how VA will deliver them to rural areas. Stone says VA is aware of those issues and working on them.

@SenBillCassidy @SenBlumenthal That includes flying doses of vaccines into rural areas directly, Stone said.
"I believe we're going to need that kind of creativity and innovation to deliver this effectively and quickly."
Says VA has 37 freezers in hub locations ready and ordered 36 more.

@SenBillCassidy @SenBlumenthal A total of 188 VA facilities are prepared to accept/administer the Moderna vaccine, Stone said. 122,000 doses ordered.
37 sites for the Pfizer vaccine. 73,000 doses ordered.

@SenBillCassidy @SenBlumenthal "I don't think it's going to cover the entire nation in the way that it should," Stone says of the VA vaccine sites identified so far.

@SenBillCassidy @SenBlumenthal Cold storage is clearly going to be one of the most significant challenges VA and other providers will face in getting these vaccines out across the country. Hope our supplies of dry ice is in good shape. (Stone said VA expanded its contracts for just that recently.)

@SenBillCassidy @SenBlumenthal The Pfizer vaccine requires colder storage than the Moderna vaccine, which could make it key for delivering to more remote areas.

"I'm going to need the Moderna vaccine in order to reach the rural veteran," Stone said.

This looks like it will be a key challenge for VA.

@SenBillCassidy @SenBlumenthal Though VA received nearly $20 billion more for pandemic response in March (radio.com/connectingvets…), Stone says VA will need more money for vaccine distribution and for care costs. Says he believes VA is weeks away from another peak in active COVID-19 cases.

@SenBillCassidy @SenBlumenthal A reminder that VA has been sending out more and more reminders to veterans about this every day: The department delayed collection of copays/debts during the pandemic, but those bills are coming due very soon:

radio.com/connectingvets…

@SenBillCassidy @SenBlumenthal Story from this hearing so far: radio.com/connectingvets…

@SenBillCassidy @SenBlumenthal .@DeptVetAffairs released its latest COVID-19 report showing that once again, hospitalizations are up.
As of Dec. 1-7, 1,206 VA patients were hospitalized because of the coronavirus, up from 1,055 the week prior.
Also: VA has administered 1,065,712 COVID tests so far.