Public Service Health Care Workers Are Critical—Let’s Treat Them as Such

Public servants have a vital role in confronting the COVID-19 pandemic. Epidemiologists, public health experts, engineers, and health care providers working for local, state, and federal government are all pitching in on tasks as varied as contact tracing, expanding hospital capacity, data analysis, and direct patient care.

As a member of the Army Nurse Corps for over 31 years, I am familiar with the health care systems operated by the federal government, which are responsible for military service members, retirees, and their families; for veterans; for certain tribal members; and for prisoners. Along with military health care professionals who deploy at home and abroad, the 6,500 members of the U.S. Public Health Service Commissioned Corps are uniformed health care providers who deploy anywhere in the country to help with the response. And the Veterans Health Administration provides care for nine million veterans each year—while also serving as a backup for the private-sector health care system during a crisis.

As public servants work tirelessly to halt the spread of the coronavirus, their personnel systems don’t always provide them the backup they need to maintain and expand capacity. On average, federal agencies take three times as long to hire an employee as the private sector. The challenges are especially significant at the VA health care system, which has almost 43,000 vacancies—more than half of which are for health care providers. In addition, unfilled positions for administrators, human resources specialists, and financial analysts also inhibit operations. These vacancies slow the process needed to recruit, hire, and onboard health care providers.

Currently, I serve on the National Commission on Military, National, and Public Service, which was formed by Congress to review the military selective service process and propose ways to increase participation of Americans in all forms of service. As part of our research, the Commission met with Veterans Health Administration staff who shared that their medical center struggled to retain housekeepers—critical to ensuring patient safety for their role in cleaning and disinfecting hospital facilities. Their pay was not only uncompetitive with private-sector hospitals, but also lower than hotel housekeeping.

After more than two and half years of research, the Commission recently published its final report, Inspired to Serve, which includes recommendations to modernize federal personnel systems and attract new generations to public service. Our report proposes many ways to streamline and improve federal hiring, including replacing the three cumbersome personnel systems at the Veterans Health Administration with a single, streamlined system with competitive pay. We also propose modifications to direct-hire authority and more flexibility for temporary and term appointments to help agencies respond to this public health crisis and future challenges. Further, while licensed Defense Department civilian health care providers may practice within the scope of their federal duties in any state, other agencies face more restrictions. The Commission’s recommendations would permanently extend this licensure portability to all federal agency health care workers, increasing flexibility and resilience in an emergency.

Policymakers are already taking action. As part of the CARES Act, Congress authorized a new ready reserve for the Public Health Service. The Office of Personnel Management recently offered agencies increased hiring flexibility to fill positions to respond to the crisis. Some of these remedies are temporary, but it should not take a crisis to make forward progress. All of them are a good start.

But to be truly prepared for the next crisis, and to better deliver vital services to the American people every day, action is needed on the Commission’s recommendations to improve federal personnel systems and attract and retain talented Americans—especially health care workers—to public service.

Jeanette James serves as a Commissioner on the National Commission on Military, National, and Public Service. She retired after 13 years as a professional staff member on the House Armed Services Committee and 31 years in the Army as a Nurse Corps officer.