Monday, June 15, 2015

Veterans' Hearing Update


On June 10, the House Veterans’ Affairs subcommittee on Oversight and Investigations conducted a hearing concerning the mismanagement of veterans’ mental health services and prescriptions.  Directed by subcommittee chairman and Veterans’ Bill of Rights (VBOR) affirmer Congressman Mike Coffman of Colorado, the hearing posed questions regarding the Veterans’ Health Administration’s (VHA) approach to Major Depressive Disorders, chronic pain and prescription abuse, and veterans taking their own lives.  The five-member panel of officials and experts included Dr. Carolyn Clancy, the VA Interim Under Secretary for Health, and Randall Williamson, Director for Health Care Issues at the Government Accountability Office (GAO).

As Mr. Williamson reminded the subcommittee, the VHA is on the GAO’s High-Risk List, a list of government programs and issue areas left particularly vulnerable due to “fraud, waste, abuse, and mismanagement.”  This comes as no surprise to those following the administration’s scandals over the past year, including the revelation that at least thirty-five veterans–some kept off official waiting lists–died waiting for care from the Phoenix VA medical center.  (This news was enough to force VA Secretary Eric Shinseki to resign from the cabinet, but led to only three VHA employees losing their job, according to a New York Times article this April.)

Congressman Coffman, highlighting the VHA’s ten different programs dealing with prescription abuse and suicide with little to no communication between them, asked “who will stand up and make a change?”  This unfocused effort is compounded by the lack of a system that allows the direct transfer of suicidal callers to a hotline for help, a change that though simple, will not be available to veterans calling the VHA until November or December of this year according to Dr. Clancy.

Dr. Clancy expressed appreciation to the room for the passage of the Clay Hunt Suicide Prevention for American Veterans Act, a law requiring annual third-party evaluations of the VA’s mental health care programs.  She was quick to add that of the twenty-two veterans who commit suicide daily, seventeen are not receiving mental health assistance from the VA.  She cited reducing the stigma surrounding Major Depressive Disorders and building relationships with veterans on trust and privacy as the focus of the VHA’s mental health goals. 

One onlooker, unsatisfied by Dr. Clancy’s responses, shouted “that is not enough!”  The man continued to yell over the panel amidst Chariman Coffman crying “out of order” and banging his gavel.  Later in the proceeding, Congressman and Doctor Dan Benishek of Michigan, an affirmer of the VBOR, stated he agreed with the outburst, continuing the subcommittee’s stream of criticism directed at the department.

Ranking Member Ann McLane Kuster of New Hampshire pointed out that over fifty percent of veterans enrolled in VA medical care experience chronic pain, and that this has led to nothing short of an “opioid abuse epidemic.”  She emphasized alternatives to long-term opioid therapy and questioned whether a higher level of informed consent should be expected from veterans before prescribing highly-addictive pain medications.  Dr. Clancy countered that many veterans come under VA care already dependent upon mismanaged prescriptions.  However, the Interim Under Secretary dodged the larger question at hand: Why does the VHA continue to treat opioid painkillers as a fix-all for the pain veterans experience?  As VBOR affirmer Congresswoman Kathleen Rice of New York stated later in the proceeding, “To be on opioids is to be trapped in a system of poor function and poor pain control.”  But the answer is shorter than that, and was stated by Coffman in the hearing.  “Drugs are a shortcut,” he opined.  And, much like falsifying wait times and failing to negotiate for third-party medical services, the Veterans’ Health Administration has trouble turning down shortcuts.

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