Veterans Affairs’ mental-health system denounced at hearing

Wednesday’s hearing before the Senate Committee on Veterans’ Affairs followed the release of an inspector general’s report Monday that found the VA has greatly overstated how quickly it provides mental-health care for veterans. By Steve Vogel, The Washington Post WASHINGTON — The Department of Veterans Affairs’ mental-health-care system suffers from a culture where managers give more importance to meeting meaningless performance goals than helping veterans, according to testimony before a Senate committee Wednesday. The hearing before the Senate Committee on Veterans’ Affairs followed the release of an inspector general’s report Monday that found the VA has greatly overstated how quickly it provides mental-health care for veterans. “They need a culture change,” Linda Halliday, the VA’s assistant inspector general for audits and evaluations, told the committee. “They need to hold facility directors accountable for integrity of the data.” VA practices “greatly distorted” the waiting time for appointments, Halliday said, enabling the department to claim that 95 percent of first-time patients received an evaluation within 14 days when, in reality, fewer than half were seen in that time. Sen. Patty Murray, D-Wash., chairman of the committee, said the findings show a “rampant gaming of the system.” Nicholas Tolentino, a former mental-health administrative officer at the VA Medical Center in Manchester, N.H., told the committee that managers pressed the staff to see as many veterans as possible while providing the most minimal services possible. “The plan that was ultimately developed gamed the system so that the facility met performance requirements but utterly failed our veterans,” said Tolentino, a former Navy corpsman who went to work at the facility in 2009. One manager directed the staff to focus only on the immediate reason for an appointment and not to ask the veteran about any other problems because “we don’t want to know or we’ll have to treat it,” according to Tolentino. “VA is failing to meet its own mandates for timeliness and instead is finding ways to make the data look like they are complying,” said Murray, who requested the report. “It’s mind-boggling,” said Sen. Scott Brown, R-Mass., who raised concerns that the long waits leave veterans at heightened risk for suicide. “We fully embrace that our performance measures need to be revised,” William Schoenhard, deputy undersecretary for health for operations and management, told the committee. The data was often based on available appointments, rather than the patient’s clinical needs, according to the inspector general’s office. If the patient was given an appointment two months later because of a lack of openings, the veteran would still be recorded as having been seen within two weeks of the desired date. The office issued reports in 2005 and 2007 raising similar concerns that the VA was using faulty data to calculate wait times. “This has been an issue for many years and hasn’t been resolved,” John Daigh Jr., assistant inspector general for health-care inspections, told the committee. Under pressure to reduce waiting times, the VA announced last week that it plans to hire 1,600 mental-health workers, an increase of more than 9 percent. The Oregonian reported this week that the Northwest region, which includes Oregon, Washington, Alaska and most of Idaho, would receive only 10 of those positions. But the VA already has about 1,500 vacancies in mental-health specialties, positions that have been hard to fill given better pay in the private sector. “How are you going to ensure that 1,600 positions … don’t become 1,600 vacancies?” Murray asked. Schoenhard said the department is studying ways to better recruit and retain mental-health professionals. “In the interim, you have soldiers who are killing themselves,” Brown said. Tolentino, who said his complaints “largely fell on deaf ears,” resigned from the Manchester facility in December. “Ultimately, I could not continue to work at a facility where the well-being of our patients seemed secondary to making the numbers look good,” he said.

Dear Friends and Clients,

In furtherance of our firm’s culture of commitment to always act with compassion, concern and commitment to our clients, community and colleagues, we have been taking precautions to ensure that we are still fulfilling our ethical and moral obligations while prioritizing health, wellness and safety of all we can.

As you know, the COVID-19 pandemic has introduced changes to many lives and businesses in our communities, and around the world. We, much like our neighbors and friends, have been taking precautions to ensure that we are still fulfilling our ethical and moral obligation to our clients, while also prioritizing the health, wellness and safety of our employees.

Until further notice, our offices will be closed to the public to encourage social distancing and to help prevent the spread of COVID-19. Our team is still hard at work, many from home, and you may still call, email, live chat or video conference us if you or a loved one is seeking legal assistance. As the first law firm to offer our clients secure online access to their case file more than a decade ago, we have always been believers in using technology to make life easier and information more accessible. In these present times it has been a smooth transition for us to continue to offer our clients the same seamless and thorough service that you deserve and are accustomed to.

This pandemic is unlike anything any of us have faced in our lifetimes, and while we can continue to emotionally support one another through it all, staying home and keeping your distance is vital to the health and wellness of our communities. It does not feel good to break routines, cancel events and retreat from our normal, day-to-day socializing, but let us remember that, in times of strife, prior generations were asked to go to war and we are simply being asked to stay home. Your isolation equals more lives saved, and more time for medical providers to prepare for the treatment of patients battling COVID-19.

When the dust settles, we will join together with a greater appreciation for our lives, local businesses, loved ones and health. Until then, we will continue to offer guidance from a safe distance.

Very truly yours,

Andrew G. Finkelstein and the staff of Finkelstein & Partners, LLP