Sunday, April 29, 2012

Who's ripping off veterans?


Saturday, President Barack Obama wanted to talk about protecting veterans in his weekly address.  "The sad truth is that there are people out there who are less interested in helping our men and women in uniform get ahead and more interested in making a buck."

He might as well have been speaking about the VA.

Certainly, initial results of the Madigan Army Medical scandal don't appear to refute the accusations that fear of financial costs led to over 300 service members with PTSD being told they didn't have PTSD.  But that's only one of the many VA scandals.

The one we're talking about is the scandal where veterans seek treatment but can't get it because the VA lies and lies repeatedly, claiming to have enough staff, claiming to use community providers when they're overwhelmed, claiming to have reduced VA wait time to 14 days.

Iraq and Afghanistan Veterans of America released a statement  last Wednesday which included:

 Today, Iraq and Afghanistan Veterans of America (IAVA), the nation’s first and largest nonpartisan, nonprofit organization representing veterans of the wars in Iraq and Afghanistan, released the following statement expressing outrage over an alarming new report from the Department of Veterans Affairs’ Inspector General. The report concluded that veterans’ wait times for mental health care far exceed that which the VA has previously reported and the VA’s mandates. According to the Inspector General’s findings, for veterans who did not receive evaluations within 14 days, the average wait for a first evaluation was 50 days -- nearly two months. Additionally, 71% of frontline mental health staffers said in an informal VHA survey that in their opinion their facilities did not have adequate mental health staff to meet current demand for care.

The VA lies and they lie again.  Let's drop back to a November 30th Senate Veterans Affairs Committee hearing:

Chair Patty Murray:  Dr. Zeiss, I wanted to ask you, when you testified before a hearing for this Committee May 25th, I asked you whether VA had enough resources to meet OEF OIF veterans needs for health care and you said the resources weren't the problem.  In light of what you've learned from last May, especially from your own providers do you stand by that statement from me?

Antonette Zeiss: I believe that we have unprecedented resources and that we have gotten them out to the field and that we have hired an enormous amount of staff. And at the time, I believed that they were adequate if used in the most effective ways possible. We continue to have an increasing number of mental health patients. We have looked at the FY'11 data and the numbers have again jumped from FY'10 and we are proactively predicting what kinds of increases there will be in FY 12 and we're working with the Office of Policy and Planning to ensure that those projection are embedded into the actuary model that drives the budget predictions so that I can say that we will be aggressively following all the data that we have available to ensure that we can make effective predictions at the policy level about what level of funding and level of staffing will be essential and we will be partnering very closely with Dr. Schohn's office who are responsible for ensuring that those resources are are used most effectively are used in the field to deliver the kinds of care that we have.

Chair Patty Murray:  So you still today do not believe that it's resources that's the issue?

Antonette Zeiss: I believe that we're at a juncture where we need to be looking absolutely at resources because of the greatly increased number of mental health patients that we are serving.  And some of that is because of very aggressive efforts we've made to outreach and ensure that people are aware of the care that VA can provide.  The more we succeed in getting that word across [. . .]

Zeiss continues babbling but any thinking person can grasp that the reality is she's avoiding answering basic questions.  When Committee Chair Murray asks her if the VA has enough resources, that is a yes-or-a-no question.  Zeiss can babble away all she wants but no one paying attention is going to be misled by all those words and think she bothered to provide an answer -- straight or bent.

And that's true of every VA witness that has appeared before the Committee.

On Wednesday, the Senate Veterans Affairs Committee held another hearing on this issue. 

Chair Patty Murray:  At each of the previous hearings, the Committee heard from the VA how accessible mental health care services were.  This was inconsistent with what we heard from veterans and the VA mental health care providers.  So last year, following the July hearing, I asked the Department to survey its own health care providers to get a better assessment of the situation.  The results as we all now know were less than satisfactory.  Among the findings, we learned that nearly 40% of the providers surveyed could not schedule an appointment in their own clinic for a new patient within the 14 days. Over 40% could not schedule an established patient within 14 days of their desired appointment.  And 70% reported inadequate staffing or space to meet the mental health care needs.  The second hearing, held in November, looked at the discrepancy between what the VA was telling us and what the providers were saying.  We heard from a VA provider and other experts about the critical importance of access to the right type of care delivered timely by qualified mental health professionals.  At last November's hearing, I announced that I would be asking VA's Office of Inspector General to investigate the true availability of mental health care services at VA facilities. I want to thank the IG for their tremendous efforts in addressing such an enormous request.  

 While the VA's Office of Inspector General did their job, they appear to be the only section of the VA that is functioning at present.

Senator Scott Brown filled in for Senator Richard Burr as Ranking Member in Wednesday's hearing and he questioned the VA's William Schoenhard.  On issue such as how many people needed to be hired and why the VA isn't using the referral process to send veterans to community providers when the VA's backlog means the veterans will not get an appointment in a timely fashion.

As Schoenhard refused to tell the truth, Brown composed a new song called "But they're not."  In fact, the song just has that one line.

Schoenhard claimed that they were referring (only 2% were referred last year -- despite Schoenhard's claims) and Brown replied, "But they're not."  Schoenhard insisted that veterans were getting immediate care.  Brown replied, "But they're not." Schoenhard insisted that the VA had an obligation and was meeting it and Brown replied . . . "But they're not."

At other points, Schonehard would admit to problems but dismiss them as being issues over "metrics" (measurements).  It was appalling.

Equally appalling was learning that while veterans wait and wait and wait for appointments, VA management is handing out bonuses, handing out $194 million in bonuses just last year.   While the VA is at best dysfunctional, how does management excuse giving itself $194 million in bonuses in 2011?

Committee Chair Murray noted a basic fundamental in the hearing, "As you well know, it's hard enough to get veterans in the VA system to receive mental health care. Once a veteran does take a step to reach out for help, we need to knock down every potential barrier to care. "  It's a real shame that Congress has to impart these fundamentals to a department that should already be following them.

Saturday, the president wanted to mount a high horse about diploma mills ripping off veterans but the VA's repeatedly been ripping off veterans throughout his term as president.  At what point does Barack Obama demand some action with regards to the VA, at what point does he exercise oversight?


All facts and quotes on Wednesday's hearings come from the reporting done by Kat in  "Fire everyone at the VA,"    Ava  in "Scott Brown: It's clearly not working (Ava),"  Wally in  "VA paid out nearly $200 million in bonuses last year (Wally)"and  C.I. in the Wednesday's snapshot. and Friday snapshot.

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