Congress moves on IMPROVE Well-Being for Veterans Act
Lawmakers are piling on to the bill as co-sponsors. But do they really know what it will and won’t do? Here’s a cheat sheet for people with a lot on their plate:
The claim:
The bill will follow a model of issuing grants, like those for homelessness, which are used when outside entities could effectively augment services the VHA cannot provide itself.
The reality:
The bill duplicates services that the VHA offers. Here are the mental health services identified in the bill for grantee entities to offer, all of which the VHA already provides:
- A baseline mental health assessment for risk screening and referral to care.
- Education on suicide risk and prevention to families and communities.
- Direct mental health treatment.
- Medication management.
- Individual and group therapy.
- Case management services.
- Peer support services.
- Substance use reduction programming.
- Family counseling.
- Relationship coaching.
- Outreach to identify veterans at risk of suicide.
The claim:
The entities will connect with veterans who are currently “beyond VHA’s reach,” especially veterans who live in rural areas, where suicide rates are the highest.
The reality:
There is no requirement that grant recipients focus efforts in rural communities. In fact, the entities are allowed to be located close to where VA Medical Centers, Community Based Outpatient Clinics and Vet Centers already exist.
The claim:
The reason most of the 14 of 20 veterans who are not VHA users who die by suicide don’t use VHA is that the services are not accessible.
The reality:
The likely reason most of those 14 veterans don’t use VHA is because they are Enrollment Priority Group 8 with high co-pays. Awarding grants won’t solve that, since entities would presumably use the same care eligibility and co-payment criteria as the VHA. (The bill actually allows entities to have lower co-pays than VHA, thereby undercutting VHA care.) Further, as the National Academies review reported, many veterans don’t know how to apply for VA benefits, are unsure whether they are eligible, are unaware that the VHA offers mental health care or do not perceive a personal need for mental health services whether within or outside of the VHA.
Also, many outside veterans have mental health care options through their private insurance, so grants aren’t needed to offer them care in the community.
Click here to download the full chart and analysis.
Secretary Robert Wilkie's press release on IMPROVE
Click here to read it.
Is Wilkie's VA stonewalling congressional oversight?
What happens to veterans after VA Secretary Robert Wilkie sends them outside the VA to get care from private providers in the Community Care Network? Congress can’t seem to get its foot in the door to find out. An investigation by Suzanne Gordon and Jasper Craven posted at AlterNet:
On June 6, the House Committee on Veterans’ Affairs deployed seven staffers to five veterans’ hospitals across the country. Their goal: to monitor the rollout of a new law set to accelerate the outsourcing of hundreds of thousands of veterans served by the Veterans Health Administration (VHA) to private-sector providers.
But this critical monitoring work was actively undermined by officials inside the Department of Veterans Affairs (VA). According to a House report obtained by the Washington Monthly, Congressional staff faced “coordinated and unprecedented obstruction” by national VA staff in these oversight efforts.
For months, lawmakers had been largely frozen out of efforts to build the programs and write the rules to implement this law, formally called the VA Mission Act, leading to widespread concern among both legislators and veterans’ advocacy groups. But in early June, when the staffers were able to exercise limited oversight to find out what was truly happening, their fears were confirmed. “VA did not adequately prepare facilities, providers, or veterans for the transition,” their report reads.
The VA Mission Act is widely considered the most significant—and ideologically motivated—veterans’ law in a generation. Passed by a GOP-controlled Congress and signed into law by President Donald Trump, it established a sweeping new private sector healthcare program, the Veterans Community Care Program (VCCP) and granted the Veterans Affairs Secretary, Robert Wilkie, with wide latitude to set eligibility criteria that determines when veterans can use private-sector care.
…
In turn, tensions between the VA and the Hill have intensified. Over the last several months, Wilkie has sniped at House Democrats on Twitter, launched a broadside against the department’s public sector union (which was subsequently criticized by more than 100 lawmakers), and skipped an oversight and investigation hearing. In closed door meetings, congressional staff say VA officials have offered conflicting answers over the law’s cost and eligibility standards.
“Very little is being shared,” a congressional staffer told the Monthly. “VA will say one thing one week, and a different thing the next. The whole process is a shit show.”
Hill staffers hoped the committee’s site visits would bring some clarity, but they soon realized that the VA was trying to prevent them from happening all together. Its Office of Congressional and Legislative Affairs issued guidance to medical center staff that “congressional staff ‘shadowing’ medical center leaders or staff is not permitted;’” it required the staffers be escorted by a public affairs officer or other designee at the facilities; and it mandated that all questions be pre-cleared by national staff, or at least referred directly to them.
In the end, the VA blocked congressional staff from speaking to key employees at four of the five hospitals they visited. At one hospital, staff weren’t even allowed to venture beyond the hospital lobby. Read the full article at AlterNet.
Coming up on Capitol Hill
House Committee on Veterans’ Affairs
- Sept. 18 at 2:05 p.m. ET: Full Committee Oversight Hearing: Critical Impact: How Barriers to Hiring at VA Affect Patient Care and Access
- Sept. 19 at 10:30 a.m. ET: Disability Assistance & Memorial Affairs Subcommittee Oversight Hearing: Update on VA Contracted Exams, Quality Review Process, and Service to Rural Veterans
- Sept. 19 at 2 p.m. ET: Oversight and Investigations Subcommittee Oversight Hearing: Preventing Harm to Veterans: Examining VA’s Overpayments and Debt Collection Practices
Tracking veteran health care facility closings
As the VA MISSION Act curbs traditional VA services and outsourcing veterans to the Community Care Network increases, VA facilities will likely become underutilized and close (not to mention the efforts of the COVER Commission). We’ll be tracking these closures as they happen.
- Tennessee: A clinic closed because of “administrative issues,” with no other elaboration. Veterans were directed to non-VA facilities. VHPI is looking into the circumstances around this closing.
2020 Veteran Issues Watch
- Sen. Bernie Sanders: A veteran with Huntington's disease tells Sen. Sanders he is going to end his life because of medical debt
- Sen. Cory Booker: During the third debate, Sen. Booker mentions long waits for gynecological services for women veterans at the VA. One study found that the average wait time for these services in non-VA facilities is 26 days, and the longest average wait is 122 days...which he didn't mention.
- Veteran OpEd: What does the Democratic field offer to veterans? “Nothing.”
Special court set up for veterans
Read more at The Exponent Telegram:
The goal of the court program is to address the unique issues faced by veterans who wind up in the court system for nonviolent crimes and break the cycle that can put them back there over and over again, McCarthy said.
...
The West Virginia Supreme Court of Appeals previously operated a veterans court program, but, in 2017, former Chief Justice Allen Loughry discontinued the program, citing financial constraints, according to Weld.
Many times, the issues veterans face in the court system are not linked to substance use. Instead, they may be linked to behavioral health, anger management or post-traumatic stress disorder from their time in the service. Those issues cannot always be addressed through a drug court, Weld said.
“I’m very lucky. I spent most of 2009 and 2010 in Afghanistan on a deployment, and I saw folks that I was deployed with or that I knew elsewhere in the military that came home and had some issues that were linked to their deployment, their time in service, and they didn’t have the proper network of support when they came home,” Weld said.
The Veterans Justice Outreach Program, founded in 2009, is designed to avoid the incarceration of mentally ill veterans. Every VA Medical Center has a veterans justice outreach specialist who “serves as a liaison with the local criminal justice system.” These specialists “reach out to veterans in jails or the courts and work as case managers trying to engage them in treatment.”
They also assist veterans with eligibility claims and connect veterans to the VA or community services. Specialists also provide training to law enforcement personnel about issues that are specifically relevant to veterans, such as how PTSD or TBI may be connected to their history of legal problems.
These specialists play a critical role in the system of over 220 Veterans Treatment Courts that exist around the United States. While VA plays no role in their administration or operation, these special courts generally aim to place non-violent veteran offenders into VA treatment instead of incarcerating them.
The profit in veterans’ health information?
As Cerner continues moving its $5.5 billion veterans’ electronic health record project, another tech company wants in. They said “If the DOD, VA and CMS can't fulfill this much needed service to the men and women of our armed forces and veterans, ISeeYouCare will.” What can be seen clearly? Veterans’ health information means big money. Read ISeeYouCare’s press release.
Quick Clicks:
- Iron Mountain Daily News: Oscar G. Johnson VA Medical Center will host a veterans health care presentation on October 1
- Sunshine State News: Effort to expand dental benefits to veterans gains steam on Capitol Hill
- Newsweek: Members of Congress face eviction from VA facilities
- MOAA.org: Military officers association objects to DoD’s major cuts to medical personnel
- VAntage Point Blog: VA Medical Center’s Farmers Market stays open all year long
|
|
|
|
|
