Jeff Miller confronts VA

| February 14, 2013 | 13 Comments

In a hearing yesterday, representative Jeff Miller of Florida in a Veterans Affairs Committee hearing asked the Department of Veterans’ Affairs “WTF, over” (my words);

Rep. Jeff Miller, R-Fla., said the extra funding and effort by the Department of Veterans Affairs seems to be going toward more bureaucracy and not better care for veterans. That’s particularly concerning with the wave of Iraq and Afghanistan servicemembers expected to reach the department in coming years.

“The true measure of success with respect to mental health care is not how many people are hired but how many people are helped,” he told VA officials during a hearing Wednesday. “It has become painfully clear to me that the VA is focused more on its process and not its outcomes.”

Of course, the VA came back with it’s usual;

Veterans Health Administration Undersecretary for Health Robert Petzel countered that the department is on the right path, but acknowledged they still have a daunting task ahead.

They’re always on the right path, but they’re not motivated enough to move forward on that path in this electronic age, the same age that has passed by the Post Office is now shooting ahead of the VA, apparently.

Earlier this week, department officials announced they have hired more than 1,280 clinical providers and support staff to new posts in the last five months, part of an effort to add 1,900 new mental health specialists.

They’ve also filled 1,980 vacant mental health positions since last summer, and increased the number of crisis workers and phone lines. In a statement, VA Secretary Eric Shinseki said the moves mean that “we can treat more veterans and provide greater access to our mental health services.”

So you “can” treat more veterans, but I think this question remains unanswered; “why aren’t you treating more veterans?”

Category: Veterans' Affairs Department

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  1. Green Thumb says:

    Here in the great NW we have non-clinical practicioners making clinical decisions and opining in patient’s medical records that are used to determine benefits.

    Unethical, immoral and illegal.

    But the VA looks the other way and then puts pressure on the Vet through unecessary appts, time constraints, etc.

    Gets old.

  2. Just an Old Dog says:

    Package in May 2011, claim date 1 April Already being service connected for same issue, now much worse. I’ve had over 20 VA Appointments and pension physicals all backing my claim, no decision yet in 21 months. Shit I applied for was denied, appealed and got Social Security on my own in 11 months. Yet every VA has employees tripping over each other.

  3. NHSparky says:

    If this was part of a civilian corporation, they’d have had their managers shitcanned and the department dissolved long ago.

  4. Flagwaver says:

    Hey, I received a letter from them on my claim yesterday… It said they need a certified copy of my DD-214 or other separation papers for my periods of service and my service treatment records from the service department. Oh, and it says I need to have them sent by the 17th of this month.

    WTF, over.

    The date on the letter says it was printed on the 17th of last month, but the postmark says it wasn’t mailed until the 9th of this month. Not to mention, I can’t even get through to my state VA. All I get is an automated system that has me leave my name and number saying they will call me back. It hasn’t happened yet.

    So, I have to ask… What the fuck are they spending the money on and who the hell are they actually trying to help? Because it is obvious that the actual Veterans are more of an inconvenience to them.

  5. JBS says:

    The VA is a sore spot for most of us. I’ve had my claim for my son’s dependancy in since 2009. I keep getting letters saying they need more proof. I send it in through the DAV. Now the DAV is saying I need to have patience. The letters I get don’t have any contact info other than an address I can write to (like that helps) and the 800-BUL-SHIT number for the national VA office.

  6. AW1 Tim says:

    Part of the reason that the mental health programs aren’t being used to their full extent is that no one trusts them.

    With the laws that the feds and states have passed, if anyone tells the mental health folks the truth, they are likely to be involuntarily committed, have their firearms confiscated, be tagged with a mental hold and maybe all sorts of other stuff.

    It’s happened before, and it’s happening now. there is NO confidentiality in the VA mental health services, and like to none in the rest of the VA.

    If I am forced to answer questions about my mental health state and/or whether I have or have access to firearms, I always say I’m just ducky and I don’t have any weapons. I’m gonna lie through my teeth, and deal with my problems on my own. I do NOT trust the VA and I do NOT trust this government. It’s a sad state of affairs, but that’s what it has come to.

    And yeah, the last time I applied for a rating exam, it took 6 months to get the appointments, then 13 months to get a decision, which increased my rate by 10%. Social Security rates me at 100% for the same issues. Go figure.

  7. Al T. says:

    “Part of the reason that the mental health programs aren’t being used to their full extent is that no one trusts them.”

    Bingo! We have a winner.

  8. DaveO says:

    Repeat after me: The VA is a Jobs Program, not a Healthcare System. Those people in the white lab coats being addressed as “Doctor” are Ph.Docters, not MDoctors.

    The VA is the living embodiment of a fully functioning Obamacare: it will maintain you in your decline, and then usher you out of life.

  9. Just an Old Dog says:

    I always get an impression that Veterans are considered more of a disruption and inconvenience than the reason the VA exists.

  10. Anon says:

    The VA has limits for how many veterans can be on a primary care provider’s panel to make sure the veterans can get appointments in a “timely” fashion. There is no limit for the caseload/panel of a mental health provider. I am a therapist with over 100 veterans on my current caseload. How often do you think I can see each veteran? Don’t forget to take into account that each veteran I see for CPT or PE (the best treatments for PTSD) needs to be seen weekly. Over 70% of the veterans on my caseload right now have PTSD. When veterans need to be seen and there are no spots on the schedule, I make them, skipping lunch staying a few hours late every week to write my notes, etc. Even if seeing extra patients means working more than the 40 hour schedule without overtime or comp pay. I know I won’t get either but do it anyway because it is what my veteran needs.

    I have had veterans involuntarily admitted, although to be honest all but one of them believed they needed to be admitted and agreed with the decision when I made it. The one who didn’t agree at the time was delusional and came back after his medications were re-started and said he agreed in hindsight.

    None of my veterans have had their firearms confiscated, although hundreds have received free trigger locks after we discussed firearms safety around their family members and visitors to their home who don’t have any training in weapons safety. This isn’t counting the many veterans who already have their own trigger locks or gun safes. That’s the important information. One unsecured gun in a houseful of people without training in weapons safety will do more damage than dozens (and yes, I have multiple veterans with dozens of guns who have even trusted me enough to admit it). One veteran with severe dementia voluntarily gave the family heirloom gun which he hadn’t used in over 15 years to a family member after agreeing having firearms around the house might not be safe since he had already come within seconds of pulling the trigger. A few others are on the not-allowed-to-buy-a-gun list because a judge formally committed them to a mental hospital. It’s important to note that being admitted, even involuntarily, isn’t enough to get on the not-allowed-to-buy-a-gun list. You have to be committed by a judge after a court hearing with legal representation. The VA does not turn over information about the firearms you own.

    All but one of the mental health providers in my clinic is either a veteran or first-degree relative (child, spouse, sibling, parent) of a veteran or current service member. IN most cases both are true. I have family members who receive VA mental health services, including combat related PTSD from Vietnam or Iraq, and I treat my veterans the way I would want my family to be treated. I buy supplies the VA won’t provide for my groups and individual patients with my own money and pay to attend training seminars to develop new skills. Thanks to the idiots in HR and the ban on travel because of their ridiculous conferences, even our trainings in the therapies that do work have been put on hold. I make copies of any paperwork, manuals or handouts I need because the clerks tell me “that’s not my job.” I feel guilty if I have the flu/a cold/unexpected surgery and stay home because that means the veterans I don’t see won’t get scheduled for at least another 6 weeks because I have already filled all the “real” slots plus the ones that don’t even really exist.

    I try to explain to the veteran I have diagnosed with combat-related PTSD how his claim was denied after one visit with a C&P examiner he didn’t know and wasn’t honest with because of lack of trust even though I have clearly documented the diagnosis, the effect on his functioning and year’s worth of treatment. Even when this makes no sense to me and I am angry that my professional opinion has been completely ignored. I give him the name and contact information of a VSO to help with the appeal, making sure to give him the information on the one other veterans have said actually listens, helps, and gets results, not the one who seems to be punching a clock for a check.

    Then I read milblogs that I used to love before I came to work for the VA and learn that I:

    - Should be treating more veterans
    - Am not trusted
    - Do not maintain the confidentiality of my veterans(the single most important ethical principle of my profession)
    - Apparently can’t be a good therapist because I am a Ph.Doctor not an MDoctor (You might want to do some research DaveO- most psychiatrists have at most 6 months of training in therapy, if that. The rest is all on medications and that is what they do with their patients- meds not therapy. It’s also interesting how few people know that it is more difficult to get into a Clinical Psychology PhD Program than to get into med school.)
    - Am responsible for the stupid decisions that VBA makes (and yes, I do think they often make stupid decisions on ratings and have written letters in support of the appeals my veterans submit).
    - Consider veterans to be a disruption and inconvenience

    Thank you all for clearing up what I really think, feel and do as a VA mental health provider.

  11. DaveO says:

    Anon,

    I’ve been to Hampton, OKC, Fort Sill, Shreveport, Fort Belvoir, and Washington DC VAMC. My psychiatrists (both of them) were of MD and Ph.D. I saw an MD once, in the hallway as he was headed out the door.

    So yes, I’ve done my homework. It’s why I’m glad I have (for a little while longer at least) civilian insurance – it’s what’s kept me alive the last few years.

    So Anon – do your homework. Travel a bit. See how the other side lives. These tales aren’t urban myths.

  12. AW1 Tim says:

    ANON,

    I stand by everything I’ve said, because I’ve seen it happen. It might not happen where you are, but it has happened, and as stated above, it aint no urban legend.

  13. Eric says:

    Anon,

    It is appreciative that you do the extra help and put out the extra individual effort. However, I’m sure that you’ve even experienced some of the similar situations being stated here.

    As well, you even mention having to do things yourself because “clerks don’t think its their job”

    Thank you for doing what you can, if there were “many” more like you, there wouldn’t be these issues.

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