Monday, April 23, 2012

The uninformed press and Robert Petzel

Gretchen Gavett (PBS' Frontline) writes:

Good news arrived this week from the Department of Veterans Affairs: It plans to hire 1,900 mental health workers, consisting of of 1,600 clinicians and 300 support staff, adding to its current roster of 20,600 mental health employees.
"The mental health of America's veterans not only touches those of us at VA and the Department of Defense, but also families, friends, co-workers, and people in our communities," said VA Undersecretary for Health Dr. Robert Petzel in a press release. "We ask that you urge veterans in your communities to reach out and connect with VA services."
In 2011, the VA provided mental health services to about 1.3 million veterans.
Dr. Petzel's remarks touch on some of the major issues facing American servicemembers -- and those who support them -- as the long wars in Iraq and Afghanistan slowly come to a close. 

"Writes" and not "reports"?  Sorry, I'm just not in the mood to call that crap "reports." 

The VA is responding now only because of Senator Patty Murray (Chair of the Senate Veterans Affairs Committee).  From a Thursday press release:

Today, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee, made the following statement after the VA announced that it would be moving to hire 1,600 mental health care professionals.  The announcement comes just days before the findings of a major VA Inspector General report that Senator Murray requested on long wait times for VA mental health care are expected to be announced.  VA's action is welcome news to Senator Murray who has held multiple hearings over the past year on overcoming barriers to VA mental health care.  Murray will hold a third hearing on this subject in order to hear the Inspector General's findings on Wednesday, April 25th.

We'll again note the entire press release at the end of this entry.  Right now we're staying focused on what passed for 'reporting.'

In addition to failure to know the prompting incident, there's the Petzel issues.  Robert Petzel is the sort of moron that leaves you praying for a sex scandal.  That's because, these days, that's about the only thing that gets you fired.  Incompetence and inability to do your job do not get you fired, as Petzel's continued employment attests.  You have to wonder if things would be different if there was anyone -- other than the AP and some veterans news outlets -- covering veterans issues regularly, attending those hearings and reporting on them?  Right now, reviewing back mentally to 2009, I'm counting 18 members of Congress who have strongly called Petzel out for misleading the Congress and for poor management.   I'll give one example only, we're not writing a book here.  The House Veterans Affairs Committee held a hearing May 3, 2011 about the VA infecting veterans who came in to be treated.  This was a very serious issue.  We're noting this exchange between Petzel and Ranking Member Bob Filner:

Ranking Member Bob Filner: Dr. Petzel, you're here as the representative of the VA.  We've gone through this before, sir. It seems to me your job here should have been -- and we have Congress people from all the districts that have been effected -- was to begin to restore some trust and confidence in your institution. I'd hate to take a poll.  If I did, and I said, "How many people now have confidence everything is fine in your VA hospital?," I doubt if anyone would raise their hand. You said everything is fine.  It's not true.  Simply not true. You talk about all of these transparent procedures and these-these Journal -- New England Journal best practices, and yet every time something happens, we have  disaster.  We don't have a way of communicating. We don't have a way of dealing with   the personal concerns.  We don't have any knowledge that anybody's been reprimanded.  Now you've got three.  We've been going over this for years and now we've got three.  And we still -- You have never told this committee those figures before as far as I know. But,   Dr. Petzel, we've gone through this before. We've raised concerns in our opening statements.  You read your opening statement as if we never said anything.  So you    never addressed issues of accountability, you never addressed issues of      communication -- whether within your agency or with veterans or with this Committee.  I-I-I-I've gone through the time lines with almost every one of these [Congress] members here and their hospitals.  You say panels get together to decide "should we disclose, what should we disclose, who should we --?"  It looks to many of us like they get together to decide "What do we keep secret from our" -- You know, you keep shaking your head "no."  But why did it take 8 weeks at St. Louis -- where Mr. Carnahan will raise the issues -- why did it take 8 weeks for that panel to decide, we're going to tell people that we have almost 2,000 people infected -- possibly infected with HIV?  It took two months before you guys decided that.  I would have -- And the Secretary [of the VA, Eric Shinseki] wasn't notified, as far as I know, in  his words to me, in that whole period of time.  So it sounds like you're sitting there deciding, "What's the minimal amount of information that we can give out so people don't get upset with us?"  Rather than the maximum.  I would have -- that first day -- I would have had the Secretary had a press conference that said, you know, "We have a possibly of X-hundred or thousands of people, we're going to get to you right away, we want to make sure this is happening."  And put pressure on yourselves to become public.  Because there's no pressure for you to do anything. We didn't know anything.  The Secretary didn't know anything. I don't know if you knew anything.  Because these guys are going, "How do we keep this secret for as long as possible? Maybe we don't have to disclose at all?"  Because your question was: "Should we disclose?"  Not how to do it.  And then, as I said, your whole disclosure process is as if everybody knows all your acronyms and your-your initials for everything, all these SPDs and RMEs, as if the patients know what's going on.  They get a letter.  I've seen these letters. It says basically -- it's not this bald, but almost -- "You may have HIV."  They get a letter.  It may have even gone to a wrong address. For 1500 people, as I said to you earlier at a hearing, you should have had 1500 of your 250,000 employees, assigned each one to somebody, call them, call them, go visit them, find out where can they come back, when can they get their blood tests, treat them as if they may have HIV.  And they're scared to death they're going to die and you send them a letter.  And there's no one there necessarily to answer a phone call when they call back cause you don't have people working this like case managers and one person to five people.  I think you should do one-on-one.  But what you described as this open, transparent process does not come through.  And everyone of these people [points to members of Congress] has constituents  which I bet confirm what I just said.  And even if it's perception and not reality, that, that's just as bad.  That you took forever, you weren't very personal in your notification, you weren't very clear about what it is that they might have, you didn't follow up in a way that was very quick and then we don't know anything about accountability.  We know nothing from basically what you said today.  And you guys have got to develop a new system.  Whether it's talk -- You know, we just killed Osama bin Laden and they notified 8 members of Congress and the Committee and they kept that.  Well maybe you should notify all the Chair and Ranking Member of the Veterans Committees about what you're doing about your personnel.  But there is no sense that you have done anything.  And we don't know -- Nobody in Dayton, nobody in St. Louis, nobody in Miami,  nobody in New Jersey, nobody in Tennessee knows anything about that accountability.  And I doubt anybody in the system knows anything about it, so they don't think there's any accountability. So I wish you would address these issues.  We've gone over them for several years.  You and I have gone over these exact issues several times in hearings and you do the exact same thing. You give me a prepared statement.  'Everything's fine.'  You move the discussion into these arcane things about SPDs and RMEs and you neglect the basic issues of communications and accountability that are at the heart of the confidence that our people have in your system. You may comment in any way you want.

Dr. Robert Petzel: Uh, thank you, Mr. Filner. The, uhm . . . What I want to do is, uh, first talk about our, uh, notification process.  The, uh, the process by which we determine who ought to be notified or who might be at risk, as I said before, is an industry standard.  I will stand by that process under any circumstance. It takes some time but it is transparent and it is weighted heavily in the favor of --

Ranking Member Bob Filner: Nobody knew about St. Louis for 8 weeks.

Dr. Robert Petzel: I'm --

Ranking Member Bob Filner: Eight weeks.

Robert Petzel:  Sir.

Ranking Member Bob Filner:  And I'm if that's industry standard, we shouldn't be following industry standard.

Dr. Robert Petzel:  Sir, I'm not talking about the communication, I'm talking about the process that we go through. It is very thorough and it's weighted on the side of being abundantly cautious to be sure that we take into account every possible risk.  The process by which we disclose to patients involves letters, phone calls and case managers.  Particularly in the instance of St. Louis, every single individual that was effected was called, they were offered a case manager, there was a case manager that involved -- in fact, in some instances, the leadership of the medical center.  I will admit that we've learned figuratively since --

Ranking Member Bob Filner: Sir, that conflicts exactly with what you said to me at St. Louis. The Chairman was there, Mr. Carnahan was there, Mr. Lacy -- Clay [US House Rep William Lacy Clay] was there, sorry, sir. Mr. [John] Shimkus was there.  You never mentioned the word case manager, you never mentioned mentioned that they were called.  Is that right, Russ? [Carnahan nods his head in agreement.]  We-we went through this discussion with you.  The first word I said to you was case manager.  I said to you, "Why don't you have case managers?"  You said, "Yeah, we'll look at that." We're both going to review your testimony in St. Louis because it's contrary to what you just said now.

Let's stay with that hearing to note US House Rep Phil Roe who is also (medical) Doctor Roe.  This is part of what he had to say in that hearing:

US House Rep Phil Roe: One of the things that we have to sell in medicine is trust.  Our patients need to trust us. They need to trust the VA that that's where the quality of care and transparency, Mr. Filner is absolutely 100% correct.  I can assure you that when I had a problem go wrong in my shop when I practiced medicine, not the clerk that answered the phone made the call to the patient, I made the call to the patient. I called them up.  I explained to them.  I had them come in and tell them what was going on. And I can tell you, with 1500 people, that could have been in a large institution with multiple people, I would have had the highest level people contacting someone when they think they have HIV or a potential life threatening condition. 

Do you not get how poorly Petzel handled that?  Were he working for a major hospital and not the government, he would be the subject multiple lawsuits as a result.   And yet he retains his job.  There's no excuse for PBS serving up crap and calling it news.  I'm sorry they're too lazy to do the work necessary, I'm sorry they're too ignorant to know the record of the man they're supposedly reporting on.  I'd say that's "their problem" but, of course, PBS receives US tax dollars, so I guess it's "our problem."

Again, pray for a sex scandal.  That's apparently the only thing that will finally lead the government to firing someone whose job performance should have resulted in termination long, long ago.

Mike Vizena (Director of Michigan Association of Community Mental Health Boards) wrote a Saturday column for the Battle Creek Enquirer Saturday which included ,  "According to, 18 veterans commit suicide each day, and a CBS News investigation uncovered that the suicide rate for veterans is twice that of other Americans. These numbers are far too high, and we as a community should come together and strengthen the safety net of support for our veterans in need of treatment."

And the numbers aren't really going down.  At some point, department heads are going to need to tie in accountability.  They're going to need to set goals and they're going to need to fire those -- at the top the deputies -- who cannot meet those goals because the American people are sick of this across the board.  In fact, if Barack Obama or anyone else wanted a winning talking point, that's what they could propose.  It would probably work better for a Mitt Romney, Jill Stein or Ron Paul or anyone else who hasn't been president for the last four years,  but it would work for Barack as well.

On this week's Law and Disorder Radio -- a weekly hour long program that airs Monday mornings at 9:00 a.m. EST on WBAI and around the country throughout the week, hosted by attorneys Heidi Boghosian, Michael S. Smith and Michael Ratner (Center for Constitutional Rights), topics explored include CISPA, the film Herman's House, attorney and professor Alexandra Natapoff about her new book Snitching: Criminal Informants and the Erosion of American Justice and historian Paul Buhle about Wisconsin.

Here's the press release from Senator Patty Murray's office:

Thursday, April 19, 2012
Contact:  Murray Press Office
(202) 224-2834
Senator Murray's Statement on VA Hiring Announcement

(Washington, D.C.) -- Today, U.S. Senator Patty Murray, Chairman of the Senate Veterans' Affairs Committee, made the following statement after the VA announced that it would be moving to hire 1,600 mental health care professionals.  The announcement comes just days before the findings of a major VA Inspector General report that Senator Murray requested on long wait times for VA mental health care are expected to be announced.  VA's action is welcome news to Senator Murray who has held multiple hearings over the past year on overcoming barriers to VA mental health care.  Murray will hold a third hearing on this subject in order to hear the Inspector General's findings on Wednesday, April 25th.
"I am pleased that the VA has taken this desperately needed step toward providing timely access to mental health care.  Too often we have seen staff vacancies, scheduling delays, and red tape leave those veterans who have been brave enough to seek help in the first place left with nowhere to turn. With suicide rates that continue to be high and an influx of new veterans into the system these barriers to mental health care are completely unacceptable.  I look forward to fighting for the resources needed to meet this staffing request as it is clearly a cost of the decade of war that has taken such a toll on our veterans and their families."
Matt McAlvanah
Communications Director
U.S. Senator Patty Murray
202-224-2834 - press office
202--224-0228 - direct

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