At 7:30 pm on Monday, June 23rd, 2014, the House Committee on Veterans’ Affairs held a hearing to evaluate the Department for Veterans’ Affairs further. This hearing is part of the House Committee on Veterans’ Affairs’ packed calendar of hearings and investigations into the VA, led by Committee Chairman Jeff Miller (R-Fla.). The June 23rd hearing addressed the backlog crisis, as well as the systematic and cultural issues within the Department for Veterans’ Affairs that caused the crisis.
Thomas Lynch, M.D., Assistant Deputy Under Secretary for Health for Clinical Operations, Veterans Health Administration, U.S. Department of Veterans Affairs, testified and was accompanied by Carolyn M. Clancy M. D. Assistant Deputy Under Secretary for Quality, Safety, and Value, Veterans Health Administration, U.S. Department of Veterans Affairs.
The questions asked during the hearing covered a wide range of the VA’s operations, including its mental health and behavioral health care system.
Chairman Miller (R-Fla.) asked about a letter the Office of Special Council sent to the president that day. The letter included an incident in which a veteran with a 100 percent service-connected psychiatric condition who resided in Brockton, Massachusetts and who was in a medical health facility for eight years, had only one psychiatric note on his chart. Chairman Miller asked why this was considered to have no impact on that patient’s care, even though the Office of the Medical Inspector substantiated that that there was only one psychiatric note over eight years.
Dr. Lynch replied that the Office of the Medical Inspector is the VA’s arm to objectively evaluate the quality of care and that the VA and the acting secretary have taken the concerns of the Office of Special Council seriously. According to Dr. Lynch, the acting secretary “has established a commission to evaluate concerns” that is scheduled to report back within the next 14 days, and Dr. Lynch does not want to draw conclusions until after seeing the results of the report.
Rep. Beto O’Rourke (D-TX) relayed the story of a primary health provider prescribing for mental health patients and seeing the mental health caseload that is coming in the VA. The provider said that he is troubled by the situation, but is not going to let people go untreated, even though he is not specifically trained to treat people for those kinds of problems. Rep. O’Rourke used the story to call attention to the need to reevaluate resources within the VA.
Following Rep. O’Rourke’s comments about mental and behavioral health care, Rep. David Jolly (R-Fla.) said that he was approached by a mother whose son had committed suicide while he was waiting for mental health services from the VA. Rep. Jolly recalled a bill that directed the VA to competitively contract with non-VA providers in certain communities where there was a need for additional mental and behavioral health capacity, as well as where there was a non-VA infrastructure that could provide that.
When Dr. Lynch replied that the VA has been actively working with the community and holding mental health care summits almost on a yearly basis to inform the community of opportunity to help veterans, Mr. Jolly reiterated that the department was directed by congress to produce demonstration projects and relieve capacity in certain areas, and asked whether the VA has done so. Mr. Jolly said that he and six others had sent a letter requesting an update on the projects on May 7th, 2014 and had received no response.
Dr. Lynch responded that “It is being implemented, Congressman” and promised to give Mr. Jolly the locations and to have the Office of Mental Health Operations provide further information about the five to six sites.
Additionally, the Washington Post published a piece on June 24th, 2014 about Rep. Miller’s efforts to investigate the VA. The article includes a story about Rep. David Scott (D- Ga.), whose district in Atlanta experienced a series of patient suicides at a VA medical center. VA officials initially refused Rep. Scott’s requests for information concerning the suicides, so he asked for Rep. Miller’s help. Rep. Miller traveled to Atlanta and demanded information from the VA hospital managers.