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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.

Andrew Finkelstein

Mr. Finkelstein is the Managing Partner of Finkelstein & Partners, LLP. He has become a noted consumer activist through his representation of injured individuals against corporate wrongdoers and irresponsible parties. An accomplished litigator, Mr. Finkelstein has represented Plaintiffs in wrongful death and catastrophic personal injury cases. He has successfully handled dozens of multi-million dollar cases.