Senate Committees Approve Legislation Addressing Veterans' Services; Mental Health Care Issues Addressed

Main Category: Veterans / Ex-Servicemen
Also Included In: Mental Health
Article Date: 19 Jun 2007 - 5:00 PDT

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The Senate Armed Services Committee on Thursday unanimously approved legislation that would improve medical care for service members returning from active duty in Iraq and Afghanistan, CongressDaily reports (Gambrell, CongressDaily, 6/15). The bill would eliminate inconsistencies in the disability compensation system and calls for a review of cases in which service members received low disability ratings to determine whether they were given adequate benefits. The measure would increase military severance pay and provide $50 million to improve diagnosis, treatment and rehabilitation of veterans with traumatic brain injury or post-traumatic stress disorder.

The legislation also would provide more counseling for families of service members wounded in combat. In addition, the bill would require the Department of Veterans Affairs secretary and the Department of Defense secretary to develop a comprehensive care plan for veterans by Jan. 1, 2008. The two departments also would be required to establish an interagency office to develop a joint system for electronic health records.

Committee Chair Carl Levin (D-Mich.) said, "This is record-breaking time we've been able to put together such a comprehensive bill and a much-needed addition to the treatment and care of wounded warriors and veterans" (AP/Arizona Daily Star, 6/15). Richard Daley, associate legislative director of Paralyzed Veterans of America, said the measure, along with similar veterans' legislation passed this year, has greatly improved veterans' care. He said, "This could be one of the best years for veterans in decades" (Whitney, McClatchy/Lexington Herald-Leader, 6/15). The measure now moves to the Senate floor (AP/Arizona Daily Star, 6/15).

Military Construction-VA Appropriations Bill
Also on Thursday, the Senate Appropriations Committee voted 28-1 to approve a military construction-VA spending bill, CongressDaily reports (Kreisher, CongressDaily, 6/15). The Appropriations Subcommittee on Military Construction, Veterans' Affairs and Related Agencies on Wednesday approved by voice vote the $109.2 billion draft spending bill that includes $64.7 billion for discretionary spending. Under the bill, the VA would receive $43 billion, $3.6 billion more than requested by President Bush. Military construction accounts would receive $21.6 billion -- $400 million more than sought by Bush and $8.8 billion more than the fiscal year 2007 level (Kaiser Daily Health Policy Report, 6/14).

Sen. Larry Craig (R-Idaho), who cast the single "no" vote on the legislation, said he was concerned about the 17% funding increase. He said, "I don't know how a responsible administrator, working 24-7, could spend this much."

However, Committee Chair Robert Byrd (D-W.Va.) said VA "has consistently underestimated the resources necessary to meet the growing needs of veterans returning from Iraq and Afghanistan," which has resulted in shortfalls that have affected the quality of veterans' health care (Kreisher, CongressDaily, 6/15).

Mental Health
The DOD health system has "fallen significantly short" of meeting the needs of troops and their family members, according to a task force study released on Thursday, USA Today reports (Zoroya, USA Today, 6/15). The 14-member task force was created by Congress last year to study the mental health needs of U.S. troops within the DOD system (Chedekel/Kauffman, Hartford Courant, 6/15). The task force comprises leading medical and mental health military and civilian officials, including Navy Surgeon General Donald Arthur.

For the report, the task force gathered research and took testimony at 38 military facilities. The report found that the "current operational tempo has exposed fundamental weaknesses in the U.S. military's approach to psychological health."

In addition, the report found that DOD mental health staff is "woefully inadequate" to deal with conditions such as PTSD. The panel's key recommendations include:

• All troops should undergo an annual psychological assessment;
  
  
• Mental health workers should be embedded permanently in military units to help alleviate the stigma of seeking mental health treatment;
  
  
• Psychologists should receive up to $15,000 in annual raises for recruitment and retention purposes;
  
  
• Tricare, the military's health system, should increase reimbursement rates for mental health providers;
  
  
• All military facilities should have a staff ratio of five mental health workers, including a psychiatrist, to every 5,000 to 8,000 people;
  
  
• Training, which the report found to be "insufficient and inconsistent both across and within the military services," should be improved; and
  
  
• Military assistance programs should reach more people, including help for substance abuse problems (USA Today, 6/15).
  

Sens. Barbara Boxer (D-Calif.) and Joseph Lieberman (I-Conn.), who last year pushed for legislation to improve mental health screenings for service members, commended the report. Boxer said, "It's a groundbreaking report," adding that "if the intent of the authors is carried out here, ... we are going to see enormous changes" (Hartford Courant, 6/15). The senators in a news conference on Thursday said that they will work to find funding to implement the task force's recommendations. In addition, the senators said they would seek a meeting with DOD Secretary Robert Gates to encourage changes to the system that do not require congressional approval (USA Today, 6/15). DOD spokesperson Cynthia Smith said Gates' office is reviewing the task force report (Hartford Courant, 6/15).

Mental Health Staff
In related news, Army officials on Thursday said they plan to hire 25% more psychiatrists, psychologists and social workers to help soldiers with PTSD and other mental health needs, the AP/Seattle Post-Intelligencer reports. The Army finalized a contract this week that calls for spending $33 million to add about 200 mental health workers to the more than 600 mental health professionals already working at three dozen Army medical centers. The hiring is expected to begin immediately, according to Elspeth Ritchie, psychiatry consultant to the Army Surgeon General (Jelinek, AP/Seattle Post-Intelligencer, 6/14).

Separately, VA on Thursday announced that it would hire additional counselors at each of its 153 medical facilities. VA said the unspecified number of new mental health professionals would join the 9,000 other such workers already on staff (AP/Arizona Daily Star, 6/15).

Waiting Times
The Charlotte Observer on Thursday examined how lawmakers "want an explanation" from VA officials regarding "new evidence that the [agency] overstates how quickly it provides medical care." The Observer this week reported on a draft report that found 75% of service members' appointments at 10 VA hospitals occurred within 30 days of patients' requested dates, compared with testimony from VA officials that 95% of appointments occur within a 30-day period.

Rep. Bob Filner (D-Calif.), chair of the House Veterans' Affairs Committee, said, "Too often we only hear that everything is fine when we need an honest appraisal of what's going on." He added, "Everybody tries to put on their best face, but I can't serve ... the veterans if I can't get correct information. I'm still struggling to find the mechanism to provide us with the accountability we need" (Hopkins/Adams, Charlotte Observer, 6/14).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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