Nurse trying to help Marine becomes 11th Filner accuser

I talked to Filner for the last time a couple of years ago when he was in Orlando. He was Chairman of the House Veterans Affairs Committee. I told him I was sick and tired of hearing about the problems with PTSD and suicides and wanted to start hearing what works. After all Vietnam veterans and their families have had a lot of success stories. He said they needed to start listening to us, but the problem is, he didn't want to hear any more in reality. They just kept repeating what had not worked. Now comes news of something else he was doing at the time and it is repulsive if this woman is telling the truth.

Nurse trying to help Marine becomes 11th Filner accuser
CBS
Posted: August 6, 2013

SAN DIEGO (CNS) - The count of women who have publicly accused Bob Filner of sexual harassment stands at 11 after a nurse seeking help for an injured Marine ensnared in Veterans Administration red tape said the Filner sought a personal relationship with her.

During a news conference Tuesday, August 6, Los Angeles attorney Gloria Allred, said Filner made his advances on licensed vocational nurse Michelle Tyler in the mayor's office on June 11, about a month before he was first accused of sexual harassment by three of his formerly biggest political supporters.

Allred said Tyler had seen Filner when he was a congressman and leader of the House Veterans Affairs Committee because the Marine, Katherine Ragazzino, had not been able to resolve her problems with the VA, and he asked her to return if the issues persisted. Ragazzino said she suffered a traumatic brain injury and Post Traumatic Stress Disorder during her service in Iraq.

Allred said that at the latest meeting, Filner seemed willing to help Tyler, "but at a price," notably a "personal and sexual relationship."
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UPDATE
Two female military veterans accuse San Diego mayor of sexual misconduct
Los Angeles Times
By Tony Perry
Published: August 7, 2013

Two more women -- both military veterans -- say they were the targets of unwanted and unpleasant sexual advances by San Diego Mayor Bob Filner.

Eldonna Fernandez and Gerri Tindley told CNN their encounters with Filner came at a meeting of female military veterans while he was a member of Congress.

Fernandez, a retired Air Force master sergeant, said she met Filner at a "Healing and Hiring Fair" sponsored by the San Diego-based National Women's Veterans Assn. of America.

Tindley, an Army veteran, said she met Filner at the same event, where she gave a speech about sexual assault in the military. The group was organized to provide support for women who have been sexually abused.

The descriptions given to CNN by the two women are consistent with accounts of other women who have accused Filner, as a member of Congress and now mayor, of sexual harassment.
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Congressman Filner now Mr. Mayor

Filner Resigns, Sworn In As San Diego Mayor
National Journal
By Steven Shepard and Scott Bland
December 3, 2012

Rep. Bob Filner, D-Calif., resigned on Monday, an hour after he was sworn in as the new mayor of San Diego. Filner's resignation was confirmed by his Capitol Hill office and the House parliamentarian.

Filner narrowly defeated Republican city Councilman Carl DeMaio in the November general election, 52 percent to 48 percent. He was sworn in shortly after 1 p.m. Eastern time, according to U-T San Diego, which also reported that Filner is only the second Democrat in 40 years to hold the office.
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VA finds problems but cannot fix them

Filner: VA finds problems but cannot fix them

By Rick Maze - Staff writer
Posted : Wednesday Jun 9, 2010 12:15:41 EDT

The Veterans Affairs Department is good at finding waste and inefficiency, but it could be faster to take action to fix these problems, according to testimony at a Wednesday congressional oversight hearing.

Since October, the VA inspector general has issued 120 reports containing 232 recommendations for saving $673 million, said Rep. Bob Filner, D-Calif., the House Veterans Affairs Committee chairman. That is good news, he said, showing the VA IG is doing “high-quality” and “essential” work.

However, VA has 124 open reports with a combined 756 recommendations, including 16 reports with 45 recommendations that are more than one year old, said Richard Griffin, the VA’s deputy inspector general. The oldest open report dates back to Sept. 30, 2005, he said.
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VA finds problems but cannot fix them

Filner urges quick approval of some VA claims

More and more claims will be made from veterans seeking treatment and compensation just as more and more claims wait to be honored. While they wait, there is not just the financial suffering they are subjected to as bills cannot be paid due to their wounds, there is the emotional harm inflicted that should matter to all of us.

Think of it this way. They risked their lives serving this country. Then because of that service, they were wounded yet when they come home, they are left to fend for themselves. They file claims to have their wounds taken care of and compensated for the income they can no longer work for. Delays in honoring those claims are dishonoring their service.

Just as advocates are reaching the Vietnam veterans so they seek help for PTSD because they are finally understanding what it is, now we have a flood expected from Vietnam veterans exposed to Agent Orange. Does it end there? No because we also have two active military campaigns producing more wounded veterans every day. We also have Gulf War veterans still trying to be compensated for what the Gulf War did to them the VA still doesn't quite understand.

These men and women are suffering for having served. They should not have to see their lives as veterans subjected to delays in honoring their service wounds.

“If there is a 1 percent error, and there could be, so what? You would be helping the 99 percent of veterans who are honest,” Filner said.

Considering the service organizations like the DAV verify claims made before they even begin to start the process with the VA, most of the evidence is already gathered together. Very few claims presented are fraudulent. Doing this is the right thing to do for the sake of the veterans. After getting them through the process and honoring their claims, there would be more time for them to review claims for fraud. Then, they would be treated as any other criminal charged with VA fraud and would have to pay the money back, plus see some jail time. We need to stop treating them all as if they are already guilty.

Filner urges quick approval of some VA claims

By Rick Maze - Staff writer
Posted : Friday Mar 26, 2010 16:59:14 EDT

The Veterans Affairs Department’s large and stubborn backlog of benefits claims could be reduced almost overnight if VA automatically approved any claims prepared with the help of a certified veterans service officer from a veterans organization or a state or local government veterans office, says the chairman of the House Veterans’ Affairs Committee.

The idea, floated March 26 by Rep. Bob Filner, D-Calif., chairman of the House Veterans’ Affairs Committee, is not new — and is not endorsed by all veterans groups.

Filner has been talking for several years about the idea of VA accepting some claims without a long review process and then doing spot-checks to look for cheaters, which he has described as similar to the way tax return audits are handled by the International Revenue Service.

His current initiative is somewhat different in that he is now talking only about automatic payment of claims that are prepared by people who have undergone VA training so they have some expertise in the requirements for a valid claim.
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Filner urges quick approval of some VA claims

VA claims process needs radical changes

Filner: VA claims process needs radical changes

By Rick Maze - Staff writer
Posted : Saturday Aug 1, 2009 10:33:21 EDT

Improving the veterans’ claims process will require more than just hiring more staff, the House Veterans’ Affairs Committee chairman said Friday.

Rep. Bob Filner, D-Calif., said in an interview that radical change is needed to eliminate the backlog of claims and make the whole process easier for veterans by automatically accepting claims for disabilities rated at 30 percent or less, with only spot-checking for accuracy.

Filner called this the “IRS model,” a reference to the Internal Revenue Service process of auditing a small percentage of federal income tax returns, not every one.

He said automatic claims approval, with some auditing, is a way of clear what he estimates are 100,000 claims from Vietnam veterans related to exposure to Agent Orange. And the practice also could put a big dent in the overall backlog of all claims pending before VA, which Filner estimates to be almost 1 million.

“When you are getting to a 1 million backlog, the insult is so great you really have to do something,” he said.
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VA claims process needs radical changes

Training and Support for Veteran Caregivers Bills Pass VA Committee

Veterans’ Affairs Committee Passes Bill to Provide Training and Support for Veteran Caregivers
Written by Imperial Valley News
Thursday, 16 July 2009

Washington, DC - The House Committee on Veterans’ Affairs led by Chairman Bob Filner (D-CA), approved four bills that would improve benefits and services to veterans provided by the Department of Veterans Affairs (VA).

“Today, this Committee passed a slate of bills that will have a significant impact on the lives of veterans when they become law,” said Chairman Filner. “I would specifically like to thank the freshman Members of this Committee for their ability to get right to work and address the needs of our Nation’s veterans.”

The Committee approved a comprehensive bill to expand necessary life insurance options for veterans and their families, as well as improve medical services at VA hospitals and clinics around the country. Also passed were bills to streamline the process for nonprofit research and education corporations to participate in VA research endeavors, increase the amount available to disabled veterans for structural improvements for their homes, and provide essential support and training to those caring for this Nation’s wounded veterans.
H.R. 3219,
H.R. 1293
H.R. 3155

H.R. 2770, as amended – Veterans Nonprofit Research and Education Corp orations Enhancement Act of 2009 (Filner)


This bill would modify and update provisions of law relating to nonprofit research and education corporations so they can better support VA research. Specifically, this bill expands the general authorities on establishing nonprofit research corporations by authorizing the creation of multi-medical center research corporations where two or more VA medical centers share one corporation and improves accountability of the corporations by detailing the audit requirements.
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Training and Support for Veteran Caregivers

Congress turns up heat on burn pits

Congress turns up heat on burn pits

By Kelly Kennedy - Staff writer
Posted : Wednesday Jul 15, 2009 13:33:14 EDT

Two lawmakers have called upon the Government Accountability Office, the investigative arm of Congress, to determine if open-air burn pits for waste disposal in Iraq and Afghanistan are exposing troops to harm, as well as if there are any alternatives.

“Preliminary reports have indicated that fumes from these burn pits produce a considerable amount of contaminants that may cause short- and long-term harm to our service members serving in proximity to these operations,” wrote Sen. Russ Feingold, D-Wis., and Rep. Bob Filner, D-Calif., in a letter dated July 9.

And on Tuesday, Feingold and Sen. Ron Wyden, D-Ore., proposed an amendment to the 2010 defense authorization bill that would “prohibit the disposal of covered waste in an open-air burn pit during a contingency operation lasting longer than one year” and would direct the secretary of defense to submit a report about what is burned in the pits and a plan for alternative options. The House has already passed a similar amendment in its version of the defense policy bill.
read more here
Congress turns up heat on burn pits

Congressman says gay sailor's death is a possible hate crime

Congressman says gay sailor's death is a possible hate crime [Updated]
10:10 AM July 2, 2009
Rep. Bob Filner (D-Chula Vista) said today that he has asked the Department of Defense and the Marine Corps to investigate whether the killing of a sailor, who was gay, at Camp Pendleton was a hate crime.

Filner, chairman of the House Veterans Affairs Committee, said he wanted a complete investigation of circumstances surrounding the death of Seaman August Provost, 29, of Houston. Provost's body was found about 3:30 a.m. Tuesday in a guard shack on the western edge of the sprawling base.

Gay leaders in San Diego had asked Filner to intervene. Nicole Murray-Ramirez, chairman of the San Diego Human Relations Commission, said Provost's family believes the sailor had been harassed by other personnel on the base.

Filner said initial indications are that Provost was shot and his body burned. He said his committee also will investigate the case.
go here for moreCongressman says gay sailor's death is a possible hate crime

Advanced VA funding approved by House

Bill Seeks to End Delays in Veterans’ Care
By JAMES DAO
Published: June 23, 2009
The House approved legislation on Tuesday that is intended to prevent delays in federal financing for veterans’ health care programs, a problem that has disrupted services provided by the Department of Veterans Affairs for decades, officials say.


The bill, which has been a major lobbying priority of veterans’ organizations in Washington, would allow Congress to appropriate funds for health care programs one year in advance.

Officials say that for 19 of the last 22 years, the department’s budget has been approved late, usually because of fiscal wrangling on Capitol Hill. As a result, veterans’ groups and officials say, the directors of veterans’ health care centers and clinics have often been unable to proceed on time with new services, staff expansions or renovations.

A similar bill sponsored by Senator Daniel K. Akaka, Democrat of Hawaii and the chairman of the Committee on Veterans’ Affairs, has bipartisan support and is expected to pass the full Senate.

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Bill Seeks to End Delays in Veterans Care

Filner Releases Views on VA Budget Request

News
Filner Releases Views on VA Budget Request
FOR IMMEDIATE RELEASE
March 13, 2009

House Veterans’ Affairs Committee Chairman Bob Filner (D-CA) released the following statement upon submitting the Committee’s Views and Estimates letter to the House Budget Committee:

“The Administration’s preliminary budget request for the Department of Veterans Affairs calls for a total budget of $113 billion, a $15 billion increase above 2009 levels. The request includes $52.5 billion in discretionary funding – an increase of $4.9 billion from 2009, or 10.3 percent. The bulk of discretionary spending goes to VA medical care. This budget proposal marks the first time any President has submitted a budget that exceeds the recommendations of the Independent Budget. The budget forecast calls for a $25 billion increase over the next five years. Although we understand these numbers are not binding on future years, and the levels are lower than the amounts that will be needed, we applaud this move toward presenting a more honest and accurate look at our financial picture.

“The House Committee on Veterans’ Affairs supports the President’s budget and has recommended an additional $800 million above the Administration proposal. This increase includes $600 million to safeguard veterans’ medical care funding and $200 million to assist the VA as it begins its transformation into an organization more aligned with the needs of veterans. We believe the VA can meet the needs of our veterans with this proposed budget.

“Over the past decade, this Committee has raised a number of issues on behalf of our Nation’s heroes that have not been addressed by the Executive branch. It is refreshing to receive a budget proposal that focuses on the issues of homelessness prevention, increasing education benefits, expanding health care access to more veterans, and cleaning up the claims backlog. Although this budget outline lacks detail and specifics, I look forward to working closely with President Obama and Secretary Shinseki to meet the needs of our veterans, provide for a strong and accountable Department of Veterans Affairs, and ensure uninterrupted benefits and services. We must spend these resources wisely as we work to create a 21st Century organization that serves our veterans. Americans demand this and our veterans deserve nothing less.”

Iraq Vets Storm the Hill, Congress Rapidly Responds

Paul Rieckhoff
Exec. Director of Iraq and Afghanistan Veterans of America (IAVA)
Posted February 12, 2009 01:56 AM (EST)

Iraq Vets Storm the Hill, Congress Rapidly Responds
Earlier this week, I told you about an amazing group of Iraq and Afghanistan veterans that were coming to Capitol Hill for a historic trip to Congress, to advocate on behalf of their fellow vets. Today, I want to tell you just one of their extraordinary stories.

Rey Leal served as a Marine in Fallujah during some of the heaviest fighting, earning a Bronze Star with valor as a Private First Class, an almost unheard of accomplishment for a soldier of his rank. But when he returned to southern Texas, he needed help coming home from war. Instead of having resources at his fingertips, his closest VA hospital was over five hours away. Rey’s a tough Marine, and a boxer, but he shouldn’t have to fight to get care at a veterans’ hospital. And at his nearest outpatient clinic, there was just one psychologist, taking appointments only two days a week.

The psychologist only works two days because that Texas clinic, like many VA clinics and hospitals, has to stretch its’ funding to make sure the money lasts the whole year. They don’t know how much funding they’ll have next year because the VA budget is routinely passed late. In fact, 19 of the past 22 years, the budget has not been passed on time. As a result, the VA is forced to ration care for the almost 6 million veterans that depend on its services.

For the millions of veterans like Rey, we must fix this broken VA funding system.

Imagine trying to balance your family’s budget without knowing what your next paycheck will be. That’s what we’re asking of the largest health care provider in the nation to do. And it doesn’t work.

click link for more

Key lawmaker says he’s losing faith in VA

Key lawmaker says he’s losing faith in VA

By Rick Maze - Staff writer
Posted : Friday Oct 17, 2008 12:44:19 EDT

The chairman of the House Veterans’ Affairs Committee says he completely understands why many veterans have lost confidence in the Department of Veterans Affairs.

“I am sure there are good people working there who are trying very hard and have the best of intentions, but they are bunglers,” said Rep. Bob Filner, D-Calif. “You lose confidence in these people by watching them.”

Filner, a frequent critic of VA, cited two examples: the department’s abandoned plans to use a private contractor to help launch the new GI Bill benefits program next year, and VA’s order Thursday to its 57 regional offices to stop shredding documents after veterans’ claims materials were found in piles of paper waiting to be destroyed.

“This is an insult to veterans,” Filner said.
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More mental health care, abuse aid in VA bill

More mental health care, abuse aid in VA bill
Audrey Hudson (Contact)
Friday, September 26, 2008

Legislation passed by the House on Thursday would expand veterans' treatment for substance abuse and mental health care, including post-traumatic stress disorder (PTSD), as well as provide counseling for families of veterans.

The House approved by voice votes the Veterans' Mental Health and Other Care Improvements Act and the Veterans' Benefits Improvements Act.

The Senate is expected to pass both measures before Congress wraps up its work this weekend.

The benefits package would provide a faster system to process claims, expand pilot programs that offer adjustable rate loans and offer legal help to military reservists who lose their jobs because they are deployed overseas.

"It's a disgrace that veterans have to wait months or years for the benefits they have earned because of a bureaucracy that simply doesn't work," said Rep. John Hall, New York Democrat.

"A nimble, responsive VA claims system could go a long way to help our nation live up to its commitment to care for wounded veterans and their families. It could prevent suicides, bankruptcies, poverty, family disruptions and homelessness among our nation's disabled veterans," Mr. Hall said.

Rep. Bob Filner, California Democrat and chairman of the House Veterans' Affairs Committee, said the bills would help modernize the Department of Veterans Affairs (VA) to become a "21st-century world class entity that reflects the selfless and priceless sacrifices of those it serves - our veterans, their families survivors."
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VA mishaps shake Congress' confidence

VA mishaps shake Congress' confidence
Audrey Hudson (Contact)
Wednesday, September 24, 2008

A key congressional leader says he has no confidence in the Department of Veterans Affairs and would have pulled his own children out of the VA's human subject study that used a drug with dangerous side effects that is being prescribed to veterans with mental disorders.

"I don't have confidence in the leadership that allowed this to happen," said Rep. Bob Filner, California Democrat and chairman of the House Veterans' Affairs Committee, which oversees the VA.

A review released Friday of a smoking-cessation study on veterans suffering post-traumatic stress disorder (PTSD) found that the VA was responsible for numerous "unacceptable failures" in ensuring safeguards for soldiers in the experiment.

The smoking-cessation study at one time included more than 200 veterans who took the drug Chantix, which was later found to have psychosis and suicidal behavior among its possible side effects.

The internal review was prompted by an investigation by The Washington Times and ABC News published in June, which found that the veterans were not notified in a timely manner about new warnings from the Food and Drug Administration (FDA) about the drug's side effects.

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Research limiting veterans' treatment

VA study finds mental-health care is lacking
Research limiting veterans' treatment
By Steve Liewer
UNION-TRIBUNE STAFF WRITER

September 5, 2008

Top mental-health officials for the VA San Diego Healthcare System are spending little time treating the burgeoning caseload of stressed-out war veterans because they are immersed in research, according to a new internal investigation by the Department of Veterans Affairs.

The medical director of the two main treatment programs for post-traumatic stress disorder “did not substantively participate in (their) operations” because of research work, said the report, which was issued last week by the VA's inspector general.

Other administrators are so tied down with research that they have been forced to work overtime and/or hand over certain patient-care duties to assistants.

“The people who do the PTSD clinical work are very, very good, but they are swamped,” said Bill Mahedy, a chaplain and former psychologist at the hospital whose complaint prompted the investigation. “Good leadership would have made sure the research tail isn't wagging the clinical dog.”

The imbalance may have contributed to delays in treatment for some veterans at peak times, the report said. Staff shortages also prevented follow-ups or caused poor follow-up with more than 80 percent of Iraq and Afghanistan war veterans who failed to make their appointments.

Young veterans frequently miss daytime appointments because of their work duties, said Bill Rider, a Vietnam War veteran who mentors local service members through the nonprofit group American Combat Veterans of War.

In the new report, investigators said they couldn't accurately track the nearly 1,200 PTSD cases diagnosed since 2003 among veterans of the Iraq and Afghanistan wars because of a chaotic record-keeping system.

They also said each of the local VA health system's three case workers for Iraq and Afghanistan veterans handled 120 patients, far above the VA standard of 25 to 30 cases.

“This is not the way to deal with these heroes coming home,” said Rep. Bob Filner, D-San Diego, chairman of the House Committee on Veterans' Affairs.
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http://www.signonsandiego.com/news/military/20080905-9999-1m5va.html

Agent Orange:FILNER PLEDGES "ALL VETERANS" WILL BE COVERED

FILNER PLEDGES "ALL VETERANS" WILL BE COVERED

BY NEW AGENT ORANGE EQUITY ACT -- House Vets'

Chair says reintroduced bill will cover "all veterans"

exposed to Agent Orange "anywhere" and "at any time."

He said, "The issue is exposure. Exposure to Agent Orange. Not where it happened or when it happened."

This afternoon (Thursday, August 21, 2008) I spoke on the phone with Rep. Bob Filner (D-CA), Chairman of the House Committee on Veterans' Affairs.

I wanted him to clarify his Agent Orange Equity Act of 2008. For more about the Act (with backlinks), click here...
http://www.vawatchdog.org/08/nf08/nfAUG08/nf081108-7.htm


As introduced, Filner's original Act would do away with the VA's rule of "boots on the ground" in Vietnam to receive presumptive status for exposure to Agent Orange, and include the "Blue Water Navy" and a few others. But, it would leave out those exposed to Agent Orange outside Vietnam. For more on the "Blue Water Navy" ruling and Court case, click here...
http://www.yourvabenefits.org/sessearch.php?q=haas&op=and


Now, Filner has clarified his intent.

Filner plans to reintroduce the legislation and have it be absolutely inclusive.

As mentioned above, Filner said, "The issue is exposure."

Filner says his New Agent Orange Equity Act will be sure to include specifics such as: Exposure to Agent Orange in Laos, Cambodia and Thailand (known as the three "nearby" countries), and will also include Guam and the United States of America.

Filner told me, "All veterans exposed to Agent Orange, anywhere, at any time, should be compensated." "And that includes non-combat veterans," Filner added.

This is exceedingly good news for all veterans exposed to Agent Orange.
go here for more
http://www.vawatchdog.org/08/nf08/nfAUG08/nf082208-6.htm

How one vet's persistence paid off

How one vet's persistence paid off
Paul Weaver wanted answers from the VA about his disability benefits. In the end, the Iraq war vet helped many others.
By Jill Carroll Staff writer of The Christian Science Monitor
from the July 23, 2008 edition
It was an average-looking letter that landed in Paul Weaver's mailbox. But bearing news that his veteran's disability benefits had been stopped, it felt more like a ton of crashing bricks.

He felt shock, then resignation.

He thought "I can't do this anymore. I have to move on."

Mr. Weaver had sought treatment at US Department of Veterans Affairs (VA) facilities a few years earlier for what had been diagnosed as a serious illness as well as for post-traumatic stress disorder (PTSD) from his Marine Corps deployment to Iraq in 2003, where he was a machine-gunner with the original invasion force.

Now it was July 2007, and he wanted to leave the battle behind him – even if it meant giving up thousands of dollars a month in disability benefits. But his father, a retired senior chief petty officer with the Navy, wouldn't hear of it.

"You can't just have a civilian tell you 'no,' " Paul Weaver Sr. told his son. "They owe you a day in court."

He decided to fight – and unwittingly started a chain of events that would lead to improvements in the local San Diego VA system, benefiting thousands of others. They are the kinds of improvements called for by Congress, veterans groups, and the public as the VA system comes under increased scrutiny with the arrival of a new generation of veterans from the Iraq and Afghanistan wars.

Rep. Bob Filner (D) of California, chairman of the House Veterans Affairs Committee, says years of underfunding and poor leadership are to blame for the system's shortcomings, particularly a shortage of mental-health services for the new veterans.

"It's a long history of not being funded properly," says Representative Filner. "Morale goes down in a place when you get asked to do more and more with less and less."

Even with a 40 percent increase in VA funding over the past two fiscal years, says Filner, spread throughout the VA's vast bureaucracy, the money "takes a while to filter down." Some 250,000 VA employees are spread among about 1,500 facilities from medical centers to community clinics to nursing homes. In the last year, the VA started a suicide hot line, made plans to hire suicide prevention coordinators for each medical center, and convened panels of mental-health experts to advise the department on improving suicide prevention.

Veterans' mental health and suicides have become critical issues. One reason: More survive war thanks to better armor and battlefield treatment, but are also more likely to be left with serious mental injuries, according to experts who have studied US casualty causes and rates in Iraq and Afghanistan.
go here for more
http://www.csmonitor.com/2008/0723/p02s01-usmi.html

McNerney tries to keep open V.A. hospital

McNerney tries to keep open V.A. hospital
Monday, August 11, 2008 | 8:51 PM
By Mark Matthews
LIVERMORE, CA (KGO) -- The government's move to shut down a Veterans Affairs Hospital in Livermore is running into opposition from veterans and some high level supporters. They want to change the hospital's mission, to specialize in returning veterans suffering from post-traumatic stress disorder.

Bob Filner (D) of Chula Vista, the chairman of the House Veterans Affairs Committee, came to Livermore at the request of East Bay Congressman Jerry McNerney (D) of California's 11th District. McNerney sits on that committee and together they both lit into the V.A. accusing the agency of worrying more about saving money, than saving lives.

In front of the V.A. Hospital in Livermore, patients boarded a bus to the V.A. Hospital in Palo Alto making the hour long ride each way because the VA is closing its Livermore facility a little at a time.

"Like upstairs the fifth floor is gone, parts of the four floor is gone," said a veteran.

The V.A.'s goal is to build another hospital in the San Joaquin Valley and eventually lease out the Livermore property with its hospital and its expansive lawns.

"And the whole idea of shutting this place down, what do you guys think about that?" asked Congressman McNerney to a group of veterans.

Congressman McNerney, who represents parts of Livermore and much of the surrounding area, is pushing to keep the Livermore facility in the hands of the V.A. On Monday, he brought the chairman of the House Veterans Affairs Committee to see it.

"The vision we have is to great veterans that are just coming back from Iraq or from conflict areas," said Congressman McNerney.

And it wouldn't be just for veterans who ask for help, but every veteran returning from combat, would come to a place like this to be evaluated for post-traumatic stress disorder.

"We need to have a mandatory evaluation of every person that's coming back as part of their active duty so there is no stigma about it," said Chairman Filner.
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Mental wounds said to raise war casualties tenfold

Military Update: Mental wounds said to raise war casualties tenfold

By Tom Philpott

Rep. Bob Filner (D-Calif.), chairman of the House Veterans Affairs Committee, charged Bush administration officials Wednesday with continuing to downplay the mental trauma and brain injuries suffered by veterans of wars in Iraq and Afghanistan.

Filner said an April RAND Corp. study, "Invisible Wounds of War -- Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery," justifies a tenfold jump in the U.S. casualty count versus the figure of 33,000 American dead and wounded used by the Pentagon.

RAND researchers extrapolated from a survey they conducted of 1,965 veterans to conclude that nearly 300,000 service members and veterans of Iraq and Afghanistan wars are suffering from post-traumatic stress or major depression. Filner told the pair of researchers, who had summarized their findings for his committee, that their work probably understates the problem.

"I personally think these are low estimates, just from my own studies," Filner said. "But if you take even the 300,000, (it's) 10 times the official casualty statistics from the Pentagon. Shouldn't this 300,000 be included?"
go here for more
http://www.vawatchdog.org/08/nf08/nfJUN08/nf061408-4.htm

As posted here way too many times,,,,take the numbers from Vietnam, toss in the 50% increase risk of PTSD for each re-deployment and you get a number no one is ready for. If you think there isn't enough room, staff, claims workers and mental health workers now, try doing it for over a million. This is not even including the older veterans the outreach work is finally reaching.

Less than 20 percent of VA facilities use Chaplains

In addition, less than 20 percent of facilities reported utilizing the Chaplain service for liaison and outreach to faith-based organizations in the community (e.g., inviting faith-based organizations in the area to a community meeting at a VA Medical Center (VAMC) to explain VHA services available, having a VA Chaplain accompany the OIF/OEF coordinator to post-deployment events in the community). Although facilities would need to tailor strategies to consider local demographics and resources, a system-wide effort at community based outreach appears prudent.

Less than 20% use Chaplains! As posted several times on this blog, the VA needs to change the rules of who they will allow to be Chaplains when you consider how few Chaplains they use. They need to be all over the country, especially in rural areas where help is hard to find. They need to be in every community doing the outreach work that has to be done to catch up to the need. One day we may actually get ahead of this but right now, we need to do everything humanly possible on an emergency basis just to catch up to the need. It is ridiculous that the tool of Chaplains is there, trained and ready to go but while the International Fellowship of Chaplains is good enough for the police, fire fighters and emergency responders, they are not good enough to take care of the veterans that are not being taken care of right now, today!

Everything that Dr. Michael Shepherd recommended is exactly what I've been trying to do since I started doing all of this. It is exactly what frustrates me the most. We know what needs to be done but they are not doing it. How many lives, marriages, families, careers and futures could have been spared needless suffering if they implemented all of this years ago when we finally understood what needed to be done?

This is the whole testimony

Testimony By Michael Shepherd M.D.
Physician, Office of Healthcare Inspections
Office of the Inspector General
U.S. Department of Veterans Affairs
Mr. Chairman and Members of the Committee, thank you for the opportunity to testify today on suicide prevention and the Office of Inspector General (OIG) report, Implementing the VHA’s Mental Health Strategic Plan Initiatives for Suicide Prevention. My statement today is based on that report as well as individual cases that the OIG has reviewed and reported on involving veteran suicides and accompanying mental health issues. In the process of these inspections, clinicians in our office have had the opportunity to meet with and listen to the concerns of surviving family members, and to witness the devastating impact that veteran mental health issues and suicide have had on their lives.

The May 2007 OIG report reviewed initiatives from the Veterans Health Administration’s (VHA) mental health strategic plan pertaining to suicide prevention and assessed the extent to which these initiatives had been implemented. In prior testimony, we have stressed the importance of the need for VA to continue moving forward toward full implementation of suicide prevention initiatives from the mental health strategic plan. In terms of other changes VA could make, we would offer the following observations:

Community Based Outreach – In our report, we noted that while several facilities had implemented innovative community based suicide prevention outreach programs, (e.g., facility presentations to New York City Police Department officers who are Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans, participation by mental health staff in local Spanish radio and television shows) the majority of facilities did not report community based linkages and outreach aimed at suicide prevention. In addition, less than 20 percent of facilities reported utilizing the Chaplain service for liaison and outreach to faith-based organizations in the community (e.g., inviting faith-based organizations in the area to a community meeting at a VA Medical Center (VAMC) to explain VHA services available, having a VA Chaplain accompany the OIF/OEF coordinator to post-deployment events in the community). Although facilities would need to tailor strategies to consider local demographics and resources, a system-wide effort at community based outreach appears prudent.

Timeliness from Referral to Mental Health Evaluation – In our report we noted that while most facilities self-reported that three-fourths or more of those patients with a moderate level of depression referred by primary care providers are seen within 2 weeks of referral, approximately 5 percent reported a significant 4-8 week wait. Because these patients are at risk for progression of symptom severity and possible development of suicidal ideation, Veterans Integrated Service Network leadership should work with facility directors to ensure that once referred, patients with a moderate level of depression and those recently discharged following hospitalization are seen in a timely manner at all VAMCs and Community Based Outpatient Clinics (CBOCs).

Co-Occurring Combat Stress Related Illness and Substance Use – Substance use may contribute to the severity of a concurrent or underlying mental health condition such as major depression. The presence of alcohol may cause or exacerbate impulsivity and acute alcohol use is associated with completed suicide. In a recent study published in the Journal of the American Medical Association (JAMA), Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning from the Iraq War, Milliken et al., found that soldiers frequently reported alcohol concerns on the Post Deployment Health Assessment and Reassessments “yet very few were referred to alcohol treatment.”

Regardless of why a patient begins to abuse alcohol, with frequent and/or excessive use, physiologic and psychologic drives develop until alcohol misuse ultimately takes on a life of its own that is independent of patient history and circumstance. Functional ability and quality of life become dually impacted by both underlying anxiety and depressive symptoms and co-morbid substance use issues. For patients with concurrent conditions, an effective treatment paradigm may require addressing the primacy of not only anxiety/depressive conditions but also of co-morbid substance use disorders. VA should consider augmenting services that address substance use disorders co-morbid with combat stress related illness for inclusion in a comprehensive program aimed at suicide prevention.

Enhanced Access to Mental Health Care – Treatments for mental health problems may take time to show effect. For example, antidepressant medication, when indicated, may take several weeks to several months to effect symptom reduction or remission. For some patients, treatment may necessitate multiple visits that occur consistently over time and may entail multiple modalities including individual and/or group evidence based psychotherapy, medication management, and/or readjustment counseling. Therefore, efforts that enhance patient access to appropriate treatment may help facilitate both patient engagement and the potential for treatment benefit.

For example, ongoing enhancements in the availability of mental health services at CBOCs may help mitigate vocational and logistical challenges facing some veterans residing in more rural areas who otherwise may have to travel longer distances to appointments at the parent VAMC.

In certain locations, the VA may want to consider expanding care during off-tour hours to increase the ability for some transitioning OIF/OEF veterans to access mental health treatment while minimizing interference with occupational, and/or educational obligations. This would be consistent with the recovery model for mental health treatment which emphasizes not only symptom reduction but also promotion and return to functional status.

Facilitating Early Family Involvement – Mental health symptoms can have a significant and disruptive impact on family and domestic relationships. Relational discord has been cited as one factor associated with suicide in active duty military and returning veterans. In addition, some studies indicate that family involvement in a patient’s treatment may enhance the ability for some patients to maintain treatment adherence. VA should consider efforts to bolster early family participation in patient treatment.

Coordination between VHA and Non-VHA Providers – When patients receive mental health treatment from both VHA and non-VHA providers, seamless communication becomes an increasingly complex challenge. This fragmentation of care is particularly worrisome in periods of patient destabilization or following discharge from a hospital or residential mental health program. VA’s Office of Mental Health Services should consider development of innovative methods or procedures to facilitate flow of information for patients receiving simultaneous treatment from VA and non-VA providers while adhering to relevant privacy statutes. In addition, VA’s Readjustment Counseling Service and VA’s Office of Patient Care Services should pursue further efforts to heighten communication and record sharing for patients receiving both counseling at Vet Centers and treatment at VAMCs and/or affiliated CBOCs.

Mr. Chairman, thank you again for this opportunity to testify. I would be pleased to answer any questions that you or other Members of the Committee may have.

http://veterans.house.gov/hearings/Testimony.
aspx?TID=18680&Newsid=237&Name=%20Michael%20%20Shepherd%20M.D.

Here are some more links to the hearing

Opening Statements
Hon. Bob Filner Chairman, and a Representative in Congress from the State of California
Hon. Steve Buyer, Ranking Repubican Member, and a Representative in Congress from the State of Indiana
Hon. Stephanie Herseth Sandlin, a Representative in Congress from the State of South Dakota
Hon. Harry E. Mitchell, a Representative in Congress from the State of Arizona
Hon. Shelley Berkeley, a Representative in Congress from the State of Nevada
Hon. Jeff Miller, a Representative in Congress from the State of Florida
Hon. Ginny Brown-Waite, a Representative in Congress from the State of Florida
Hon. Timothy J. Walz, a Representative in Congress from the State of Minnesota
Hon. James P. Moran, a Representative in Congress from the State of Virginia
Witness Testimonies
Panel 1
The Honorable James B Peake M.D., The Secretary, U.S. Department of Veterans Affairs
Accompanied By:
Gerald Cross, Principal Deputy Under Secretary for Health, Veterans Health Administration
Ira Katz M.D., Deputy Chief Patient Care Services Officer for Mental Health, Veterans Health Administration
Panel 2
Stephen L Rathbun Ph.D., Interim Head & Associate Professor of Biostatistics, Department of Epidemiology & Biostatistics, University of Georgia
M. David Rudd Ph.D., Professor and Chair, Department of Psychology, Texas Tech University
Ronald Wm. Maris Ph.D., Distinguished Professor Emeritus, University of South Carolina