Wednesday, April 25, 2012

Petzel swore wait time was not an issue

Larry Abramson (NPR's Morning Edition) reports today on how the increasing number of veterans entering the VA system has been accompanied by increased federal funding but that has not resulted in decreased wait times despite VA officials repeatedly telling Congress otherwise. The VA Inspector General report finds what Senator Patty Murray has maintained based on her experience with field hearings and her conversations with veterans: long delays for veterans seeking medical help.

 Let's drop back to the Feb. 28th joint-hearing of the House and Senate Veterans Affairs Committee (see the March 1st snapshot) for this:

Chair Patty Murray:  Mr. Secretary, last year, we talked a lot about mental health care and I think we together uncovered a lot of serious issues best summed up by a veteran that I heard from recently who uses the Ann Arbor Medical Center and had to wait months and months to get into counseling but then he had glowing things to say about his mental health care once he got in.  So in order to address those types of issues, VA has to be certain it has enough resources to not only keep up with the increasing number of veterans seeking mental health care but also bring down that unacceptably long wait time. Over the course of the last fiscal year, the number of Iraq and Afghanistan veterans who are looking for mental health care went up by about 5% and that's about 18,000 every quarter.  So I wanted to ask you this morning if you believe the increase in mental health funding in the budget request is sufficient to accomplish the goals and keep up with this increasing demand?
Secretary Eric Shinseki::  I-I believe that the budget, if you look at the 13 budget request, I think it's adequate for us to meet what we understand our requirements are in 13. Are there issues out there now that we will discover between now and executional budget?  I would say if we do, Madame Chairman, I would be the first to tell you.  Now you asked us to do a survey and we did. It was very hastily done.  Senator Burr referred to some of the output conclusions out of that survey.  Out of 27,000 of our health care -- mental health providers, 319 were surveyed and the results were as described.  My question of VHA was did you go to the places we thought there would be problems?  And the answer was yes, because we were asked to go figure this out. So I would say we got a pretty pure response.  What I think we need to do is make sure --  we're going to take another broader look  -- to make sure we understand across the larger population what our issues are and where there are opportunities for -- reallocation or to hire more people?  I would offer to the Chair, I took a look at what we've done in mental health over the last 4 budgets.  If we look at '12 to '13, it's rather unimpressive.  I mean, it's 5% and it matches the increase in the medical budget but between '9 and '13 our increase is 39%. in mental health.  And if you include the 14 advance appropes [2014 advance appropriations requests] it will go up 45% -- 
Chair Patty Murray: And that is a result of the number of soldiers who are coming home with the invisible wounds of war which is dramatically increasing, correct?
Secretary Eric Shinseki:  Uh, true but we are trying to anticipate that there's going to be a larger requirement in the odd years even if we don't have clarity, we're trying to prepare for that.  We want to do a larger survey here as I indicated and then see -- and then see what the outcomes are.  But let me turn to Dr. Petzel for any details.
Dr. Robert Petzel:  Thank you, Mr. Secretary.  Madame Chairman, as a result of the hearing that we had earlier in the year, we have now done two things that are, I think, important and on point with regards to your question.  One is that we've developed a staffing model.  It is the only staffing model that I know that is available about mental health.  It's in the -- in the beginning stages but it is giving us some information about what the need might be.  But I think more importantly, we're site visiting all 152 of our medical centers to look at the access to mental health services -- both the initial appointment and subsequent appointments, be it for PTSD patient program, a group program or individual psychotherapy.  And what we're finding is that there is -- We do meet the criteria for the first appointment in most every instance. We're having some difficulties in some parts of the country making the next appointment in a timely fashion, getting them -- as you mentioned earlier -- into the specialty services.  This could be the result of three things.  One, is do we have enough staff out there?  Have we given enough positions and enough resources?  Two is: are those positions filled? Are they filling those positions up in a timely fashion.  And then the third is are we getting the appropriate level of productivity out of  each one of those people?  If we do discover, as the Secretary just mentioned, that we do have additional needs that are unmet, I can guarantee you that we will be in communication with the Committee about those needs and in for a discussion.

 Regardless of whether they did the two things Petzel claims, the VA did do one thing he 'forgot' to share in the hearing.  NPR's Abramson reports, "The inspector general's report says, rather than starting the clock from the moment a vet asks for mental health care, the VA has been counting from whenever the first appointment became available. That could add weeks or months to the wait time." So the VA has intentionally lied, has sought to pull the wool over the eyes of vets, members of Congress and America.   And Petzel lies every time he appears before the the Senate or House Veterans Affairs Committee. 

He claims he reviewed "all 152 of our medical centers to look at the access to mental health services -- both the initial appointment and subsequent appointments, be it for PTSD patient program, a group program or individual psychotherapy.  And what we're finding is that there is -- We do meet the criteria for the first appointment in most every instance."

They 'met' it by lying.  They 'met' it by misleading.

If Petzel wasn't lying directly -- he appeared to be lying which is one of the main reasons we included his entire response  in the snapshot reporting on that hearing -- then he can plead incompetence.  Regardless, he's repeatedly demonstrated that he's not qualified and needs to go.

There's a hearing this morning on the above issues.  Information in a moment.  First, the editorial board of the Virginian-Pilot observes:

Too much, far too much, can happen in 50 days to a person who needs mental health care but is unable to get it.
Sadly, that's how long nearly half of America's veterans have to wait to receive help, according to an inspector general's report released Monday.
The backlog is yet another shameful breakdown in our nation's support of the men and women who've risked their lives in the long wars in Afghanistan and Iraq.

The following community sites -- plus KPFK, Jane Fonda and --  updated last night and this morning:

Senator Patty Murray is the Chair of the Senate Veterans Affairs Committee.  Yesterday her office noted a hearing that's taking place this morning:
Tuesday, April 24, 2012
Contact: Murray Press Office
(202) 224-2834
TOMORROW: Murray to Hold Hearing on IG Report Showing Major Delays in VA Mental Health Care
On the heels of report showing that VA is failing to meet its own mandate for timely health care, Murray to hear from report's authors and question top VA officials on necessary changes
* Will be broadcast LIVE on C-SPAN.
(Washington, D.C.) -- Tomorrow, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee, will hold a hearing to examine the results of a report released yesterday by the Department of Veterans Affairs' Inspector General that Senator Murray had requested on the time it takes the VA to provide mental health care appointments for our nation's veterans.  The report concludes, as Senator Murray has repeatedly warned, that the wait times faced by many veterans far exceed that which the VA has previously reported and the time the VA mandates.  At tomorrow's hearing, Senator Murray will question a top VA official and the VA Inspector General on the specifics of the report, and seek answers to the problems it raises.
Who:       U.S. Senator Patty Murray
                Office of Inspector General of the Department of Veternas Affairs
                Senior VA Officilas
What:       Hearing focused on VA mental health care, evaluating access and assessing care
When:      TOMORROW: Wednesday, April 25, 2012
                 9:30 AM ET/ 6:30 AM PST
Where:      Dirksen 138

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