Legion testifies on VA mental health care care

The American Legion submitted written testimony for the record at a May 21 hearing by the House Veterans’ Affairs Subcommittee on Health. The hearing covered several pending bills, including the Veterans Integrated Mental Health Care Act. It would improve the delivery of mental health care, especially to rural veterans, by providing an integrated delivery model through care-coordination contracts.

In its testimony, the Legion noted that veterans should not be denied earned care based on where they choose to live. While it is not feasible for every community to have a full slate of VA-administered services, every community has access to medical care in some form.

For example, the Legion conducted a site visit to Martha’s Vineyard last year for its System Worth Saving (SWS) report on rural health care. In 2000, a contract was signed between the Providence VA Medical Center and Martha’s Vineyard Hospital. Through the contract, veterans living on Martha’s Vineyard were able to receive care at the local hospital through fee-basis instead of having to travel from the island to Providence. That contract lapsed in about 2004, but VA didn’t realize it until 2008 when the hospital acquired new management.

Veterans on Martha’s Vineyard found out the contract had expired when Martha’s Vineyard Hospital sent collection bill notices to them for medical expenses previously covered. Although a new contract was finally signed in the fall of 2012, it took four years to correct the oversight while veterans needing treatment had to commute from the island to Providence – a trek involving a ferry ride and a two-hour drive.

VA should develop and implement a process to ensure that all VA and non-VA purchased care contracts are entered into a tracking system to ensure they remain current. If a contract does expire, VA should make every effort to hold stakeholder meetings with veterans from those communities to get their input and keep veterans who are enrolled in such contracts/services informed.

The American Legion’s Resolution No. 46 supports this legislation because it would help to facilitate contracts that provide mental health care to veterans who live in areas without VA medical facilities.

Another Legion-supported bill is the Demanding Accountability for Veterans Act, which would improve the accountability of the Secretary of Veterans Affairs to the department’s Inspector General.

The American Legion’s Resolution No. 99, passed last year at its National Convention in Indianapolis, states that "bonuses for VA senior executive staff [should] be tied to qualitative and quantitative performance measures developed by VA." While the Legion refrains from commenting on the specific nature of these performance measures, it believes the implementation of such measures are a necessary step toward creating a culture of stronger accountability within VA. This bill, by establishing particular performance standards tied to bonuses received by VA senior executive staff, moves toward addressing this issue.

The Legion also supports the Veterans Timely Access to Health Care Act, which would direct the VA Secretary to ensure that veterans seeking hospital care and medical services get access within 30 days from the date of initial contact. It directs the VA Secretary to periodically review the performance of VA medical facilities in meeting such a standard.

The American Legion has long been concerned with the inordinate wait-times experienced by many veterans when attempting to access VA medical care. While VA medical care is among the best in the world, access has proven to be a problem for too many of those who have earned it through their service.

On March 6, the House Veterans’ Affairs Subcommittee on Oversight and Investigations held a hearing, "Waiting for Care: Examining Patient Wait Times at VA." The American Legion, in addition to submitting testimony, provided an attachment for the record that contained numerous stories from Veteran Integrated Service Networks across the nation, detailing first-hand accounts of the barrier to care these wait times present – up to eight months, in some cases. While the Legion would prefer a standard of 14 days instead of 30, this legislation is a step in the right direction.