Thursday, April 26, 2012

The VA hearing

Mark Thompson (Time) highlights the followning from Iraq War veteran Nicholas Tolentino's testimony yesterday explaining why he left the VA:

I could detail other instances of unethical practice at the Manchester VAMC that contributed to my decision to resign, but the final straw occurred when the medical center failed to take meaningful action in response to the discovery that a VA clinical psychopharmacologist was intoxicated while providing patient care. On October 31st, 2011 the Mental Health Service Line Manager discovered that a psychopharmacologist at our facility was noticeably intoxicated and slurring his speech. The Service Line Manager became aware of this situation when a veteran reported that the clinician had failed to appear for an appointment. Looking into the matter, I discovered that he had written numerous prescriptions during that day, presumably during the period of his intoxication. The very next day, while the clinician was again treating patients, a water bottle was found hidden in that clinician’s personal office refrigerator that was filled with a brown fluid clearly smelling of alcohol.  An internal panel was convened, but the panel seemed to be more of a formality than an actual investigatory board. I was disturbed to learn that the incident did not lead to the clinician’s removal, and instead he was simply transferred to work in the pharmacy. To make matters worse, the service line manager’s response to my protest regarding the lack of action was to imply that, as a combat veteran, I was likely also vulnerable to substance abuse.
That implication, notwithstanding my impeccable employment history, was not only personally insulting, but unfathomable coming from a psychiatrist responsible for the facility’s mental health service. A similar attempt to imply that my combat veteran status is a personal liability was made after my resignation, when I provided voluntary testimony to an internal investigative board. The board attempted to discredit my testimony by stating that my responses to incidents I’d reported were simply magnified by my combat experiences and resulting emotional instability.

Tolentino was appearing before the Senate Veterans Affairs Committee yesterday. The hearing was called after a report from the VA's office of the Inspector General documented that the VA had repeatedly misled and lied about wait time.  As the Washington Post notes:

Contrary to a VA claim that 95 percent of first-time patients seeking mental-health care in 2011 received an evaluation within the department's goal of 14 days, just less than half were seen in that time frame, the report found. A majority waited about 50 days on average for a full evaluation.
A similar claim that 95 percent of new patients in 2011 got appointments to begin treatment within 14 days of their desired date was also far off the mark. The report from the VA Office of Inspector General estimated 64 percent of patients did; the rest waited on average 40 days.

The New York Times editorial board uses their space to bash Republicans -- which tends to happen when you can't afford to have a full-time Congressional correspondent. When you do it on the cheap, it shows. I have no position on the voucher program for homeless veterans. However, I am aware of the abuse by the VA. They use that program and they misuse it. Among other things, it has allowed them to hide the true number of homeless veterans. Again, I've got no position on the issue. But, unlike the editorial board of the New York Times, I do know why some Republicans and some Democrats on the House Veterans Affairs Committee are bothered by the program.

By going off into a partisan detour, they trivialize the non-partisan issues yesterday's hearing addressed and the entire process.  Everything is not about getting a party into the White House or keeping one in there.  When not ranting and raving like a host on The View  (and exposing ignorance -- but I believe we covered that with "like a host on The View"), a breath is taken long enough to note:

 On Monday, the department’s inspector general released a report showing that veterans are waiting far longer for mental health care than the department has been willing to admit. A new applicant for mental health services is supposed to receive an evaluation within two weeks, a standard the department says it meets more than 95 percent of the time. But the inspector general said that fewer than half of veterans received evaluations within 14 days. The rest waited an average of 50 days. This sounds distressingly familiar. Last year, the United States Court of Appeals for the Ninth Circuit, in San Francisco, accused the V.A. of “unchecked incompetence” in delaying treatment and ordered it to overhaul mental health care for troubled veterans, who are killing themselves by the thousands each year.

Did the VA's Office of Inspector General just decide to do an investiagtion?  Did they get an anonymous tip or something?

Again, the ignorance is appalling.

Senator Patty Murray is the Chair of the Senate Veterans Affaris Committeee.  She is the one who called for the investigation.

Why did she do so?

As we noted in yesterday's snapshot, she explained that at the top of the hearing:

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.  The findings of this first phase of the investigation are at once substantial and troubling.  We have heard frequently about how long it takes for veterans to get into treatment and I'm glad the IG has brought those concerns to light.

We covered the hearing in yesterday's snapshot.    Ava covered it at  Trina's site with "Scott Brown: It's clearly not working (Ava),"  Wally covered it at  Rebecca's site with "VA paid out nearly $200 million in bonuses last year (Wally)" and Kat offered her take and conclusions in "Fire everyone at the VA."  There were a number of issues to cover in the hearing and somehow the New York Times misses everyone.  But, again, it's not like the increasingly cheap paper has correspondents to cover Congress and it's not like anyone at the paper has the brains to think, "When you're pretending to write about a Senate hearing, you might want to actually write about it."

There were many, many issues in yesterday's hearing.  All four of us could again report on it today and we still probably wouldn't be able to cover it all.  Silly us, thinking you cover a hearing and what was discussed.  As the New York Times demonstrates, you just go intoa fugue state and riff freely about various unrelated topics and hope and pray that someone says, "I really loved that free-form editorial you did 'on' the hearing."

If only we'd all known that was 'the way' to do it, we could have saved a great deal of time last night.

The following community sites -- plus NPR, World Can't Wait, IVAW, Adam Kokesh, Bat Segundo and Diane Rehm  -- updated last night and this morning:

If you haven't noticed, Blogger/Blogspot went Beta or some other nonsense.  It's a pain in the ass and you'll note a slightly different look at most Blogger/Blogsite sites.  This happened last Friday -- where everyone was forced into it (prior to that you had a choice of whether you wanted to use the new nonsense or not).  It's a pain in the butt especially if you use HTML which is what I prefer.  (You can do your posts using their software meaning you type and use buttons or you can use HTML and write your own code in the entries to tell the entry when to italicize or when to bold or when to paragraph break, etc.)  HTML is a nightmare in the upgrade.  Everything runs together and it's pure nonsense.  A number of Third readers are confused, for example, why there are four or so paragraphs in Ava and my "TV: Why Revenge resonates" that have a White background instead of a green one like the rest of the piece.  We moved those paragraphs in the editing.  When we moved them -- simple copy and paste -- that different background popped up on them.  I have no idea, I hate the upgrade.  I offer that long winded nonsense to explain the different things that are popping up at all the sites and to explain that this excert we're closing with is good enough the wa it is. I'm not in the mood to try to spend 30 minutes trying to figure out how to fix the spacing on it.  This is from Sherwood Ross'  review of Michel Chossudovsky's new book Towards a World War III Scenario: The Dangers of Nuclear War:

plans to attack Iran with a mix of nuclear and conventional weapons have been in
readiness since June, 2005, according to Michel Chossudovsky. a distinguished
authority on international affairs.

by military documents as well as official statements, both the U.S. and Israel
contemplate the use of nuclear weapons directed against Iran," writes professor
Chossudovsky, Director of the Centre for Research on Globalization in

plans were formulated in 2004. The previous year, Congress gave the Pentagon the
green light to use thermo-nuclear weapons in conventional war theaters in the
Middle East and Central Asia, allocating $6 billion in 2004 alone to create the
new generation of "defensive" tactical nuclear weapons or

"In 2005, Vice President Dick Cheney ordered
USSTRATCOM (Strategic Command) to draft a 'contingency plan' that included "a
large-scale air assault on Iran employing both conventional and tactical nuclear
weapons," Chossudovsky writes.

plan went beyond the terms of reference outlined in the Pentagon’s 2001 Nuclear
Posture Review (NPR), which called for a "preemptive" "first strike use" of
nuclear weapons against Russia and China as well as Iran and North

2005 plan identified more than 450 strategic
targets in
Iran, including numerous alleged nuclear-weapons-program development sites. The
plan, incredibly, was rationalized on a second 9/11 type attack on the US that
Cheney believed Iran would allegedly support!

Obama has largely endorsed the doctrine of pre-emptive use of nuclear weapons
formulated by the previous administration," Chossudovsky writes in his new book,
a World War III Scenario: The Dangers of Nuclear War
(Global Research, 2012). His Administration "has also intimated it will use
nukes in the event of an Iran response to an Israeli attack on

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