Jeff Miller Sgt. Schultz Excuse for VA Problems

Opening Statement of The Honorable Jeff Miller, Chairman, House Committee on Veterans' Affairs

Hearing on 06/12/2014: An Examination of Bureaucratic Barriers to Care for Veterans

"Welcome to today’s Full Committee oversight hearing, “An Examination of Bureaucratic Barriers to Care for Veterans.”

As we all well know, during a Committee oversight hearing in early April, we came forward with the results of a Committee investigation that had uncovered evidence suggesting that dozens of veterans died while waiting for care at the Phoenix Department of Veterans Affairs (VA) health care system. Just over two months later, we know now that in addition to twenty-three veteran deaths that the Department linked to delays in care earlier this spring, at least thirty-five more veterans died while awaiting VA care in the Phoenix, Arizona, area.

What’s more, a VA audit released earlier this week found that over fifty-seven thousand veterans have been waiting ninety days or more for their first VA medical appointment and sixty-four thousand veterans who have enrolled in the VA healthcare system over the last decade never received the appointment they requested. That is one-hundred and twenty-one thousand veterans who have not been provided the care they have earned.

That number exceeds the population of several mid-sized U.S. cities like Athens, Georgia, or Abilene, Texas, or Santa Clara, Texas, or Evansville, Indiana. And, I fear that there is more yet to come.

Yesterday I spoke to a group of VA providers from across the country at an event for the National Association of VA Physicians and Dentists (NAVAPD). Speaking about the current crisis engulfing the Department, NAVAPD has stated that VA’s, “procedures and processes are inconsistent, inconsistently applied, and often prevent efficient use of personnel...” This statement echoes the serious calls for alarm we have heard from many others in recent weeks.  

During a recent Committee hearing, Dr. Daigh [DAY], VA’s Assistant Inspector General for Healthcare Inspections, testified that VA suffers from, “…a lack of focus on health care delivery as priority one,” as a result of, “…several organizational issues that impede the efficient and effective operation of [the VA health care system] and place patients at risk of unexpected outcomes.”

In an article published last week in the New England Journal of Medicine, a former VA Under Secretary for Health – Dr. Kenneth Kizer - and a current staff physician at a major VA medical center wrote that the systemic data manipulation and lack of integrity VA is experiencing are but, “…symptoms of a deeper pathology,” because, “[q]uite simply, VA has lost sight of its primary mission of providing timely access to consistently high-quality care.”All of these remarks go to prove what we already know. The VA health care system and the bureaucratic behemoth that accompanies is complex and its problems are even more complex.

I believe that the majority of VA’s workforce – in particular, the doctors and nurses who provide our veterans with the care they need – endeavor to provide high-quality health care. Unfortunately, VA leadership has failed those employees almost as much as it has failed our veterans and correcting those failures is going to take a lot more than the band-aid fixes the Department has proposed thus far – it is going to take wholesale systematic reform of the entire Department, starting with holding senior staff accountable.

VA hasn’t gotten where it is today due to just bloated and ineffective middle management; or lack of training and professional development for administrative staff; or inefficient or nonexistent productivity and staffing standards; or cumbersome and outdated IT infrastructures. The Department got where it is today due to a perfect storm of settling for the status quo. VA cannot continue business as usual.  The status quo is unacceptable.  It is time for real change – again, beginning with accountability up to the highest levels of VA bureaucracy. I hear repeatedly from the VA about its delivery of high-quality, patient- centered care…but this Committee will not rest until we hear that same assessment from every veteran seeking care. It is time for VA to tell us the bad news, not just the good."

OK,,,another Sgt. Schultz. (If you are my age you remember Hogan's Heroes.) "I know nothing, I am not here - I did not even get up this morning!" Good ole Sgt. Schultz kept walking in on one problem after another but to stay out of trouble, he pretended he never knew what was going on. Our elected officials are doing the same thing and frankly, it is pissing veterans off around the country. Jeff Miller is from Florida. We're number 3 largest veterans population in the country. Veterans complain about the way they are being treated. Not just to the press. They actually use the press as a last ditch effort to get the help they should have in the first place. They contact their members of congress because they know if it is happening to them, it is happening to others.

United States Representative Jeff Miller serves Chairman of the House Committee on Veterans' Affairs. The Committee on Veterans’ Affairs is responsible for authorization and oversight of the Department of Veterans Affairs (VA.) VA is the second largest department in the federal government with over 300,000 employees and a budget of over $150 billion. Miller also serves on the House Armed Services Committees (HASC.) As a senior member of HASC, Miller has proven to be a strong advocate for our men and women in uniform, and he is one of the leading proponents of Naval Aviation, Special Operations, and Research, Development, Test and Evaluation (RDT and E.) Miller was instrumental in helping establish Eglin Air Force Base as the joint primary training location for the F-35 Lightning II. Congressman Miller was appointed to serve on the House Permanent Select Committee on Intelligence (HPSCI). The HPSCI provides policy guidance and sets classified funding levels for the sixteen agencies of the Intelligence Community funded by the National Intelligence Program and the Military Intelligence Program. Recently, the Intelligence Committee has held important hearings on the Foreign Intelligence Surveillance Act, U.S. Intelligence Operations against Al Qaeda, and Security Clearance Reform. (Mr. Miller was sworn in as State Representative in 1998 and again in 2000 to serve District 1)

UPDATE Here is a reminder of what has been going on in Florida since Miller has been in office. Regarding the length of time, this is just since 2007. 2007 Tampa VA unlicensed psychologist

TAMPA - Providing the very best mental health care to soldiers returning from combat in Iraq and Afghanistan is one of the highest priorities for the U.S. Department of Veterans Affairs.

But at the nation's busiest VA hospital, the James A. Haley VA Medical Center in Tampa, the most-troubled and vulnerable veterans are often treated by the least-experienced psychologists, according to a complaint to the state.

About 12 of Haley's 34 psychologists - more than a third - are unlicensed and receive little if any direct supervision, according to a complaint filed Nov. 29 with the Florida Board of Psychology.

2008 Military suicides and PTSD

The numbers showed a 20 percent increase over the prior year, despite efforts to include "more training and education programs, the hiring of more mental health professionals, and the addition of screening programs."

While acknowledging the impact of combat stress and the multiple tours of duty faced by these soldiers, there was also a shift to focusing on other issues such as financial stressors, family discord, and employment concerns as contributing to the suicide rate for these troops.

How little we have learned!

Having worked for 30 years as a military psychologist and a VA Vet Center Team Leader, it is critical not to separate environmental stressors from Post Traumatic Stress Disorder. War veterans in intense combat environments develop PTSD at exceeding high rates. In Vietnam, the estimate was generally in the 30 to 40 percent range for developing combat stress and for Iraq, given the multiple tours, the rates should be much higher. (William Weitz)

1,250 Florida Veterans called VA suicide hotline in six months. More than 55,000 people - including about 22,000 who identified themselves as veterans - have called the Department of Veterans Affairs’ suicide hotline during its first year in operation and CBS News has learned that many of the calls, in recent months, have come from the mid to south central part of the country.

Dying veteran fought for care

TAMPA - A day after the St. Petersburg Times reported on his plight, the family of a dying veteran says the Department of Veterans Affairs has agreed to provide the care he was previously denied.

The VA will not only admit James Carroll, 64, who is dying of chronic lymphocytic leukemia, to the James A. Haley VA Medical Center in Tampa. It will also pick up the full cost of the private medical care he was forced to receive when he was turned away from Haley.

Carroll's sister, Nancy McEndree, said today that several VA officials, including Haley's chief of staff, have contacted her since the Times reported his story Thursday. The entire episode was a "misunderstanding," she said they told her.

A Haley social worker told her the VA will pay all of Carroll's medical bills, McEndree said. The VA originally said he should seek care through Medicare because Haley was full.

2009 Florida bill to help homeless veterans was vetoed by Governor Scott. No clue what Miller had to say about this one.

Scott also vetoed $12 million for a homeless veterans program in Brevard County pushed by Haridopolos, a Brevard resident.

Scott spoke standing in front of a sign saying "Promises Made, Promises Kept."

Followed by a report in 2011 about more cuts for homeless veterans.

“I care completely about all these programs,” said Scott, whose budget cuts earlier this year slashed funding to some veteran and farm surplus programs that helped the homeless.

2011
Lawsuit seeks to help VA pension beneficiaries wrongly purged from Medicaid rolls

At least Miller got the bonus money for VA when things were bad,,, all the way back in 2012.

The awards have come under increased scrutiny by Congress since testimony in April that some executives may have been “gaming the system” to make it appear more veterans seeking mental health counseling were getting appointments within a required time.

Hitting the right numbers translated into executive bonuses, said a former senior VA official with the agency’s New Hampshire system.

Last week Rep. Cliff Stearns, R-Fla., submitted a bill that would bar all bonuses to senior executive services employees at the VA.

“I want to ensure the best care for our veterans, but the VA continues to have an unmanageable backlog, extremely long wait lists, and a poor record on oversight. Given this troubling record, the VA should discontinue paying bonuses to its top executives,” he said when his bill was adopted as an amendment to the VA’s 2013 budget.

Rep. Jeff Miller, chairman of the House Veterans Affairs Committee, told Military.com that VA funding “should first and foremost be allocated to caring for veterans.”

Another report from 2012 on how the VA in Florida was lacking funds for mental health.

A swamped Veterans Administration is the first place for those seeking help to turn.

After that, it is private or state programs. The problem is that Florida ranks 50th out of 50 states and the District of Columbia in mental health funding. Experts say the state is losing ground

This could go on and on but the truth is still the truth. It didn't matter if the head of the Veterans Affairs Committee was a Democrat or Republican since both parties were responsible for all this suffering. What does matter is that politicians do not get to just pretend they were not there when it all started.