“It is the proper duty of
a representative body to look diligently into every affair of government and to
talk much about what it sees. It is meant to be the eyes and the voice,
and to embody the wisdom and will of its constituents.…”
— Woodrow Wilson
Congress has the
Constitutional responsibility to perform oversight of the Executive Branch and
matters of public interest. This report summarizes highlights from each
week’s Senate oversight hearings.
Tuesday,
November 6, 2007: Senate Committee on Veterans Affairs
“Hiring Practices
and Quality Control in VA Medical Facilities”
·Senators and witnesses
discussed the concerns about the hiring practices and quality controls at Veterans
Affairs clinics across the country that have been
raised by the tragic events at the Marion,
Illinois VA Medical Center.
·The witness from the
Illinois Department of Veterans Affairs discussed the importance of ensuring
first-rate standards at veterans’ care facilities in order to meet the growing
needs of incoming Iraq and Afghanistan
veterans.
·The witness from the
Illinois Department of Veterans Affairs discussed the problems created by the
lack of consistency in enforcement of national Veterans Administration policies
at individual medical centers.
Tuesday,
November 6, 2007: Senate Committee on Energy and Natural Resources
“To Receive Testimony on the Domestic
Energy Industry”
·Witnesses discussed
coordination between the Department of Energy, the Department of Education, and
the Department of Labor’s programs designed to train people to work in new
energy industries.
·Senators and witnesses discussed
the need to address the gap between existing workforce skill sets and those
needed for emerging energy industries.
·Senators and witnesses
discussed the workforce needs in biofuels, as well as
solar and wind power.
Senators and witnesses
discussed the concerns about the hiring practices and quality controls at Veterans
Affairs clinics across the country that have been raised by the tragic events
at the Marion, Illinois VA Medical Center.
SEN.
AKAKA: Dr. Cross, there are two issues at the heart of the situation at Marion. One, did V.A. [Veterns Administration] do all it could to ensure that
physicians practicing there were appropriate hires? And two, when deaths and
botched surgeries started to arise, did hospital management take appropriate
action? Are you confident that V.A. did everything possible to verify the
credentials of physicians? And are you, at this point, able to say with
certainty that hospital management responded appropriately when they were told
about problems with the surgeon?
…
Dr.
Cross and Ms. Enchelmayer, timing clearly poses a
problem in the process of background checks. Because medical administrators
cannot discuss open disciplinary investigations, prospective employees may not
be aware of serious issues surrounding potential hires. The question is how can
the background check process be improved to ensure timely and accurate
reporting?
GERALD
CROSS, PRINCIPAL DEPUTY UNDERSECRETARY, HEALTH, DEPARTMENT OF VETERANS AFFAIRS:
Sir, what I can assure you of is that we have taken dramatic, swift, definitive
action based on the information we have at this time, and that we had in
August. I’m not going to be confident to tell you that I have the complete
picture until the investigations are complete. That does include the medical
inspector investigation and the IG [Inspector General] investigation.
But
we found that we had enough concerns early on in August that we took rather
definitive action in removing, by detailing out the medical center director. We
detailed out the medical center Chief of Staff, and subsequently detailed out
the Chief of Surgery and an anesthesiologist. As our investigation has
continued, we have taken further action, which I have listed in my oral
statement elsewhere, and some of that just occurring within the past few days.
KATHRYN
ENCHELMAYER, DIRECTOR, QUALITY STANDARDS, OFFICE OF QUALITY PERFORMANCE, VETERANS HEALTH ADMINISTRATION: I think that I can honestly
say that we have a credentialing system in V.A. that is an envy of most of the
health care industry. We collect a great deal of information on our health care
practitioners at this time.
The
application process using the VetPro system as an
electronic system that actually requires practitioners to answer the questions
that Dr. Cross alluded to in the opening statement about actions in their past;
voluntary, you know, surrenders, because they have moved from states; as well
as disciplinary actions. And they attest to the accuracy of that information as
they submit their information to us.
…
When
practitioners submit their information, they actually attest to the
completeness and accuracy of that information. So it is a legal attestation and
a legal signature that can be used later if the information is not complete.
And then, as Dr. Cross said, all information is primary source verified. And we
receive all the information that we can possibly receive.
You
asked how it could be helped. The health care industry as a whole could be
helped, because we get the same information every other hospital and health
care entity gets. And that’s public information. So we would have to go beyond
what all of health care industry gets at this time.
The witness from the
Illinois Department of Veterans Affairs discussed the importance of ensuring
first-rate standards at veterans’ care facilities in order to meet the growing
needs of incoming Iraq and Afghanistan
veterans.
TAMMY
DUCKWORTH, DIRECTOR, ILLINOIS DEPARTMENT OF VETERANS’ AFFAIRS: So I’d
like to just summarize my testimony by saying that some of the suggested
solutions are that the USDVA [United States Department of Veterans Affairs]
needs to either open more V.A. clinics and vet centers, or they need to start
certifying private practitioners to provide medical services and give the
veteran this option to access care outside of the V.A. clinic, the V.A.
hospital themselves.
We
need to ensure, however, that there is no drop in standard of care for our
veterans. We also need to identify major civilian medical facilities, such as
university teaching hospitals or other large networks, where the physicians who
have privileges at the V.A. hospital should be required to also have privileges
-- surgical privileges, practice privileges -- at these outside facilities to
provide a cross-check, as it were, not only at their V.A. system that is being
implemented by the local V.A. hospital administrator;
But if that physician is required to have a licensing
requirement in the state where he’s practicing, as well as privileges at an
outside hospital. I hope that that
will help to reinforce and provide a backup.
There
simply is just not enough time for the USDVA to try to recruit enough
physicians to meet the current need. And I think that it’s time to think a
little outside the box.
The
witness from the Illinois Department of Veterans Affairs discussed the problems
created by the lack of consistency in enforcement of national Veterans
Administration policies at individual medical centers.
MS.
DUCKWORTH: My biggest concern, sir, is that there is a lack of consistency
across the nation when it comes to the local level for implementing many of the
V.A.’s national programs. And I am seeing this in our
rural communities especially, specifically not -- Danville V.A. and Marion
V.A., both are in central and southern Illinois.
The
problem that we have is that, whether it’s the policy of allowing veterans to
access outside physicians, or whether it’s this credentialing issue, there is a
national policy. But it selectively enforced at the individual medical center level.
I’ll give you an example with Danville V.A.
Many
of the patients at Danville V.A. actually have to travel upwards of three to
four days just to get a simple chest x-ray, while there are doctors and
physicians near their home towns where they can actually get these procedures
completed without having to spend multiple overnights. The Danville V.A. is
very reluctant to allow the patients in its community to access their outside
health care, even though a procedure already exists for them to do so in the
federal V.A. system.
So
while there is great national policy and procedures written someplace in a
manual, oftentimes it is the local hospital administrators who interpret those
policies who don’t actually administer them.
Tuesday, November 6,
2007: Senate Committee on Energy and Natural Resources
"To Receive Testimony on the
Domestic Energy Industry"
Witnesses discussed the coordination between the Department of Energy, the
Department of Education, and the Department of Labor’s programs designed to
train people to work in new energy industries.
EMILY DEROCCO, ASSISTANT SECRETARY OF LABOR,
EMPLOYMENT AND TRAINING ADMINISTRATION, UNITED STATES
DEPARTMENT OF LABOR: Coordination among federal agencies engaged in education
and job training in any sector, but particularly in energy, in the past, has
not been well coordinated. We have not known what each other has focused on.
Our WIRED initiative has offered us the opportunity
to build a partnership among 12 federal agencies engaged in supporting the
development of talent in sectors of the economy that are creating jobs and
assuring economic prosperity.
In that engagement, we have found that there, yes, is
duplication of effort and it’s critically important for us to institutionalize
some ways in which the investments across the Department of Labor, the
Department of Education, in the case of energy, the Department of Energy, the
National Science Foundation, interestingly, the Department of Defense.
All of us are engaged in some level of investment and
encouragement of STEM [science, technology, engineering, and math] education,
workforce development and technology skills development across multiple sectors
in our economy.
...
There
currently is a group of 12 federal agencies engaged through this specific
initiative, the WIRED initiative, that is working in
39 regional economies across the country.
But from an institutional basis, there is no current
institutionalized engagement across the agencies for, for example, the energy
sector when it’s not specific to a regional economy.
We
need to do that. There is an example underway in the aerospace industry, which,
by law, Congress called for an interagency task force on the future of the
aerospace workforce, which has engaged agencies that are developing the talent
to support the aerospace industry in a very formal way.
Now,
in the energy arena, we are partnering in an informal way.
PATRICIA
A. HOFFMAN, DEPUTY DIRECTOR OF RESEARCH AND DEVELOPMENT AND ACTING CHIEF
OPERATING OFFICER, OFFICE OF ELECTRICITY DELIVERY AND ENERGY RELIABILITY, DEPARTMENT OF ENERGY: I would agree that we need to have
better coordination among the federal agencies. Within the Department of
Energy, our activities focus on research and university level educational
programs to continue to sustain long-term funding for faculty development, as
well as student development.
We
do have efforts that work with DHS[Department of
Homeland Security]. DOD [Department of Defense] is definitely an opportunity
for dual use technologies. The National Science Foundation, we have interagency
agreements with them to conduct workshops. In fact, there is a workshop on
November 28 and 29 to look at workforce issues. As well as USDA, there’s a
potential to work with them through the rural electric service.
So I do believe that there is an opportunity that we could do better
coordination.
Senators and
witnesses discussed the need to address the gap between existing workforce
skill sets and those needed for emerging energy industries.
SEN. BINGAMAN: The Energy Information
Administration’s [EIA] annual Energy Outlook projects that energy use in the United States
is going to increase by 31 percent over the next 25 years; that will result in
a very substantial increase of generating capacity for electricity in the
country.
EIA projects an addition of 4,761 miles of new
natural-gas pipeline, up by 50 percent from the 2007 projection that they had
earlier come out with. These large increases in projections by the Energy
Information Administration indicate the nation will require a trained workforce
on hand to design and build this future energy generation, whether that’s from
fossil fuels, from nuclear power, from renewable sources.
RAY STULTS, ASSOCIATE DIRECTOR, NATIONAL
RENEWABLE ENERGY LABORATORY: As you know, we’re a national laboratory and the
primary focus of what we work on is developing new energy technology options
for the future. So in wind, solar, biomass, geothermal, we’re heavily involved
in developing new energy options for the future.
And only recently have we started to address the
workforce issues as we develop these new technologies and we start to build plants.
And so what I would like to do now is to talk a little bit about one example,
and that’s the example in the biofuels area, where
there’s been a tremendous amount of interest in the last several years.
…
If we’re going to produce 20 billion gallons of
ethanol by 2017, we’re going to require developing on the order of 400 new
refineries. The stainless steel requirements will equal eight percent of the
annual U.S.
production of stainless steel to build those refineries and, in some years, the
peak will be more like 30 percent of the development.
We will need 600,000 tons per year of concrete to
build those plants. Once they’re operational, the demands on water are
significant, 80 billion gallons of water per year to do the processing.
Construction labor, this is averaged out over that
ten-year growth period, will be 10,000 person labor years per year and then
once the plants are operating, we will need 12,000 person years of labor each
year to operate the plants.
So I think those numbers are quite staggering and it
sort of goes along with everything we’ve been hearing this morning about the
demand on trained skilled workforce.
The last thing I would like to comment on is
something that we’re seeing at our laboratory and that is the projected
shortage of scientists and engineers in this field. We’re already seeing a
workforce demand. We need additional scientists and engineers in our national
bio energy center, for example.
We
have numerous positions we’re working to fill. It’s going a lot slower than we
would like. And so there is a work labor issue in the science and engineering.
Senators and witnesses discussed the workforce needs in biofuels, as well as solar and wind power.
SEN. WYDEN: My own sense is that the green energy
field is going to be a huge magnet for economic development and for good paying
jobs for our country’s future and my sense is that we’re really lagging behind
in terms of getting good numbers about what’s going on in this area.
And I have appreciated Chairman Bingaman’s leadership
in this area and I know he’s already tasked the Department of Energy to give us
a sense of their assessment of the workforce needs, particularly in solar and biofuels and wind.
…
I just don’t want renewables
and green energy to get the short end of the stick and I very much appreciate
Chairman Bingaman’s leadership on this. I think both the chairman and I think
that there are a great many economic opportunities in this area.
It’s going to be an economic magnet for investors and
we’re just going to need the government to be more proactive as it relates to
the assessment of workforce needs in this area.
MS. HOFFMAN: We don’t have any statistics at this
moment on the workforce needs, but we have expanded EPAct’s
Section 385 and 1830 to include the workforce requirements for renewable
technologies as part of the potential future agreements with the Department of
Labor.
We know that there is a growth in the industry and
there is a huge potential for alternative energy and jobs across the United States
in this area.
MS. DEROCCO: As you can tell, Senator, we’re
partnering on the National Academy of Sciences study that is called for in the
Energy Policy Act and with the expansion to alternative energy, we really have
just begun the study work.
We certainly will look at accelerating the work on
the alternative energy field to see when we can get data to you from that
study.
Also, we have gained some experience with industry
itself, having projections, and we’d be more than glad to very quickly reach
out to provide the industry projections.
I would also just want to add that the National
Renewable Energy Lab in Golden, Colorado has been an exceptional partner, with
nine of the WIRED regions that are focusing on alternative energy to both
determine the talent development requirements, the new competency and skill
requirements, and to be of assistance in assuring those employment centers
around the country are beginning the skills development programs that will be
necessary to support the growth of the industry.
From those three sources, we will try to get you some
preliminary information as quickly as possible and we will focus on this
National Academy of Sciences study, which I believe is a year-long effort.
