First person

I have been battling this issue with the Veterans Administration for 11 years.

After two years and eight ACHC customers being denied access to vendor contracts with VA medical centers, in June 2000, I wrote the under secretary for health for the VA, Dr. John Garthwaith. The responses from his chief quality director, Dr. Perlin, and general counsel clearly state that there is no system-wide policy or requirement to only use JCAHO for vendor contracts.  Some ACHC-accredited customers were then able to get VA contracts.

In 2002, I met Dr. Tom Edes, chief of home and community based programs, at a conference. He asked ACHC to put together a crosswalk comparing ACHC, JCAHO and CHAP. The crosswalk was forwarded to an accreditation workgroup that he organized to compare the standards of the three companies. All three were determined to be equal.

 Dr. Edes then invited Terry Duncomb from CHAP and me to sit on a panel with Mary Ann Popovich from JCAHO to educate VA nurses and physicians about their programs at the 2003 VA National Home Care Conference in New Orleans.

 During the same period, I again asked Dr. Edes if there was any reason that a VA medical center should deny ACHC or CHAP customers a vendor contract. His response: No.

However, in 2006, we had a couple of ACHC customers again hear these words from VA contracting officers saying, "The VA only accepts JCAHO accredited companies for contracts." ACHC certainly understands that the VA system is very large and communications can break down, but we decided that we needed something definitive from the top of the VA to clear up the matter again. Under Secretary for Health Dr. Michael Kussman was contacted by one of our consultants. He did not agree with this exclusionary practice and had Deputy Under Secretary William Feeley issue a memo. Feeley's memo specifically mentions ACHC in the text and warns of inappropriate restriction of trade.

We still occasionally run into some resistance from a contracting VA officer. When that happens, we show the responses I cited above and hopefully open the way for our customers to compete for the VA contract. hme

Tom Cesar is president/CEO of ACHC.