By Congressman Bill Delahunt
I know I have been writing quite a bit lately about inefficiencies and inequities in the medical care being provided our veterans by the government they have honorably served.
Unfortunately, this is an issue that will not go away. And, with increasing numbers of our service people being deployed overseas, the problems only grow larger. So I must continue to speak out. Following are three more examples, two of them involving mental health issues.
Post Traumatic Stress Disorder
The current method for making sure former U.S. military personnel with service-connected post traumatic stress disorder (PTSD) get fair and equal disability compensation from the VA is not working and should be revised, according to a new report from the Institute of Medicine and National Research Council.
The study was commissioned by the VA in the wake of a significant increase in the number of PTSD disability claims that has discovered inconsistencies in awards to veterans from different parts of the country. The report questions the effectiveness of the VA's current method for assessing PTSD disability, suggesting this leads to disparities in the payments awarded to claimants. Some receive too little compensation, others receive too much and, in some cases payments being awarded to claimants who should not get any at all.
Between 1999 and 2004, the number of PTSD cases rose by 80 percent from 120,265 to 215,871. Compensation payments went up almost 150 percent in the same period, from a total of $1.72 to $4.28 billion.
According to the report, the available information suggests that female veterans are less likely to get compensation. This could partly be due to the difficulties of proving non-combat related PTSD, some stemming from sexual assault or harassment while in service. The report recommends that the VA increase its efforts to assess, record and manage PTSD claims related to sexual assault, perhaps by ensuring disability raters get quality reference materials and criteria-based assessment data on which to judge claims appropriately and fairly.
The Suicide Crisis
The American Psychological Association, in a recent study, came to similar conclusions on the mental health crisis and the gaps that exist in the military health care system as well as VA.
Among the legislation that has been proposed to address the mental health care crisis is the Joshua Omvig Veterans Suicide Prevention Act, which I strongly advocated as a cosponsor. Joshua Omvig was a young solider who took his own life in 2005 after coming home from Iraq tormented by PTSD.
The bill would direct the Secretary of Veterans Affairs to develop and carry out a comprehensive program designed to reduce the incidence of suicide among veterans. The requirements would include:
1. Mandatory training for appropriate staff and contractors of the Department of Veterans Affairs who interact with veterans;
2. Screening for suicide risk factors veterans who receive medical care at a VA facility;
3. Tracking of veterans;
4. Referral of at-risk veterans for counseling and treatment;
5. Designation of a suicide prevention counselor at each VA medical facility;
6. Research on best practices for suicide prevention;
7. Mental health care for veterans who have experienced sexual trauma while in military service;
8. 24-hour veterans' mental health care availability;
9. A toll-free hotline;
10. Outreach and education for veterans and their families; and
11. Peer support counseling.
I am pleased to report that it passed the House of Representatives by a vote of 423-0 and is now being considered by the Senate.
It is critical that we have as effective a system as possible to cure the mind as well as the body of returning servicemen. They have more than earned the respect and appreciation of their country. It is time we gave them a mental health care system worthy of them.
Category 8 Veterans Denied Health Care
Since January 2003, nearly 400,000 veterans have been denied enrollment in the VA's health system because they have no service-connected disabilities and have incomes that exceed a VA means test. The Administration's decision to suspend enrollment in VA health care for these "Priority Group 8" veterans was explained four years ago as necessary to ensure continued access to VA care for higher priority veterans-those with service disabilities, low incomes or special needs.
I agree with the statement by Rep. Bob Filner, the Chairman of the House Committee on Veterans Affairs, when he says the current situation represents "an unacceptable rationing of care".
When veterans without disabilities are denied enrollment because their incomes rise above $27,790, there is something terribly wrong with the system. The Administration argues that the wars in Iraq and Afghanistan, in fact, make opening VA health care to all veterans more difficult given the rising strain on staff and resources.
Group 8 veterans who have served in the Iraq or Afghanistan wars do gain access to VA health care for two years under current law. And if they enroll during that period they can remain enrolled. The VA estimates that 1.7 million new Group 8 veterans would enroll-if given the chance-and 600,000 would seek VA care. The added cost to VA over the next 10 years would be $33 billion.
I see this, however, as not just a budgetary matter. This is a moral issue that we must address because we owe that much to the men and women who put on the uniform when called. This is why I am a proud cosponsor of HR 463, which would repeal the ban on all Category 8 Veterans and allow them to receive VA services.