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In a hearing with the House Committee on Veterans’ Affairs today, Rep. Celeste Maloy (UT-02) questioned Hillary Peabody – Acting Assistant Under Secretary for Health for Integrated Veteran Care (IVC) – on the VA’s bureaucratic rulemaking that prevents rural veterans from receiving eyeglass fittings outside of VA facilities. 

Rep. Maloy: Thank you, Madam Chair. H.R. 1002, the See Act came about because I had a constituent in rural southern Utah who couldn't get to Salt Lake City to get his glasses. It was a 500-mile round trip. So, he can see a local eye doctor to get an eye exam, but he can't get his glasses fitted in southern Utah. So, in order to actually get his glasses, the VA will pay for mileage for him to drive to Salt Lake. They'll pay for a room for him to stay in Salt Lake, but they won't pay for him to go to a local eye doctor, get his glasses. It doesn't make a whole lot of sense. And my concern is that people in my district, most of which is very rural, are just going to not get eyeglasses because of bureaucratic rules that might make sense in a manual or on paper, but they don't make sense for veterans who need eyeglasses to be able to see. And I see from my notes here that the VA doesn't support this bill. So, I would ask you to reconsider that and to work with my team. And let's find ways to give good service to the people who've served our country. We owe them good health care. They want good health care, but they don't all live in Salt Lake City or in urban areas close to a VA hospital. I just want to maybe pile on what Mr. Rosendale has been saying, but I introduced the SEE Act to try to help veterans in rural areas get their eyeglasses, and the way it's working right now isn't convenient for the veterans. It's also not saving tax dollars. It seems like we should have one or the other, but it's more expensive to send someone from a rural area to an urban area to get their glasses, and it's also less convenient for the veteran. Then the notes I got back from the VA on this are that the VA doesn't support this bill because it's not necessary for the intended outcome, and the VA could do this under the current authority, but the VA hasn't done it under the current authority. And then later on, it says VA's contracts don't include fittings for eyeglasses. But they could. But they don't. And I've heard in the time I've been sitting here that you all want flexibility. You don't want Congress to tell you how to do this, because we're not flexible and you want to have flexibility. But I'm not seeing flexibility. What I'm saying is defensiveness of the way it's already done. And what we're asking for is better service for our veterans. I'll give you a second to respond. And then I've got another question.

Ms. Peabody: Thank you. Thank you for raising that. And thank you to, I think a few committee members had raised that that issue was happening to us. So, the reason why we don't support the legislation as written is that for us to be able to resolve long term, what I think the issue is that you've raised, it's a contractual matter. It's not a matter of it needing to be codified as a, as a medical service. And we absolutely do consider eyeglass fittings as part of the veterans benefits package. Now, the specific issue that I think you're raising, which is that we did have veterans that were having to drive significant distances, particularly in places like Utah, to be able to get their fittings. We're committed to being able to provide low cost or no cost eyecare to veterans. And so the way this process has worked historically is a veteran would get their eye exam through a vision provider within VA. Or if they're eligible for community care, they would get that through the community. But we have a very competitively priced contract or set of contracts that allows us to procure the actual glasses. We do that part in VA. So they've created a gap on the part at the end, which is where they get the fitting. We have addressed this in the short term and are working on the long term fix to that. There's a few different ways we can do that. In the short term, we've made a modification to our standardized episode of care. There's a few of them for vision care, so that we are now able to pay for that through our Community Care Network contracts. In the long term, it could make sense to do that through those contracts. It could also make sense to bundle it with the glasses through a different contract. So, we're carefully weighing that right now.

Rep. Maloy: Okay. So, I'm going to point out one more thing that was in the VA's response to this. One of the things we asked for in the bill is, report back from the VA within 180 days of what you're doing to respond to this. And it says VA would likely have nothing to report within 180 days of enactment because it would still be engaged in the rulemaking process, which could easily take longer than two years to complete. So, I just want to point out one more time the irony that you're sitting here saying, don't legislate how we do things because we're flexible and we want to have that flexibility. But you're also saying we can't report back in 180 days because it takes us two years to go through a rulemaking process. Work with me, work with my staff. I want a solution to this problem more than I want to have a fight with the VA. But we've got to do better for our veterans. We’ve got to design this in a way that veterans are getting the care they need, instead of opting out of care, because it's so inconvenient and so expensive for them to get it. Thank you. With that, I yield back.