Kathie Costos
January 30, 2015
There is a report out of California that is a reminder of exactly what has been going on in this country. People hear about problems and they want to do something. When politicians want to get their names on bills, they put together a bunch of words, figure out who will make money off the deal and then zip-a-dee-doo-dah, they pull a magic trick.
California
State and county officials cannot show how billions of dollars collected through a voter-approved tax on millionaires are being spent or whether the related programs have helped people with mental illness as voters intended, a state watchdog commission reported Tuesday.
The Little Hoover Commission report is the latest review to find that the state has little evidence to show that $13 billion in Proposition 63 funds have been effectively spent.
An investigation by The Associated Press in 2012 found that tens of millions of dollars generated by the tax went to general wellness programs for people who had not been diagnosed with any mental illness. Those programs include yoga, gardening, art classes and horseback riding. The state auditor reported similar findings a year later.
"After 10 years the state still can't document whether $13 billion raised through the act has improved the streets of California and the lives of its residents," the commissioners wrote.
And then when problems got worse, people wanted something done to help. Caring people didn't really care about what it would cost as long as people were helped. Short memory spans as folks got back to their own lives, they were not reminded of what already failed that was paid for, so as more people were suffering, they wanted politicians to do something to fix it.
They just never bothered to track the tragic results with more suffering who could have actually been helped if politicians made sure they understood the problem, knew the facts, history and researched what had already been done comparing failures to successes before they wasted time and money causing more years of more suffering.
On the topic of fee basis care, when a veteran gets medical care outside the VA and they pay for it.
What GAO Found
The Department of Veterans Affairs' (VA) fee basis care spending increased from about $3.04 billion in fiscal year 2008 to about $4.48 billion in fiscal year 2012. The slight decrease in fiscal year 2012 spending from the fiscal year 2011 level was due to VA's adoption of Medicare rates as its primary payment method for fee basis providers. VA's fee basis care utilization also increased from about 821,000 veterans in fiscal year 2008 to about 976,000 veterans in fiscal year 2012.
GAO found that several factors affect VA medical centers' (VAMC) utilization of fee basis care--including veteran travel distances to VAMCs and goals for the maximum amount of time veterans should wait for VAMC-based appointments. VAMCs that GAO reviewed reported that they often use fee basis care to provide veterans with treatment closer to their homes--particularly for veterans who are not eligible for travel reimbursement. In addition, VAMC officials reported that veterans are often referred to fee basis providers to ensure that VAMC-based clinics that would otherwise treat them can meet established VA wait time goals for how long veterans wait for an appointment. However, GAO found that VA has not established goals for and does not track how long veterans wait to be seen by fee basis providers.
But hey, we just believed reporters as if it was never done before when Congress said they wanted to do it after causing all the hoopla last year.
Then there is suicide prevention among veterans. We know these programs failed or we would be seeing more veterans committing suicide during a time when there has never been more "awareness" and more charities popping up across the county. As it is, bill after bill has been sold as something different but as we've seen, there is nothing new to see here. Suicide Prevention Efforts of the Veterans Health Administration, Erin Bagalman Analyst in Health Policy January 10, 2013 is yet one more indication no one is being held accountable for failures but above all that, no one is being held accountable for the money either.
Joshua Omvig Veterans Suicide Prevention Act
The Joshua Omvig Veterans Suicide Prevention Act (P.L. 110-110), enacted in 2007, required the VA Secretary to develop and implement a comprehensive suicide prevention program, and to report to Congress on the program. The Congressional Budget Office estimated that implementing the Joshua Omvig Veterans Suicide Prevention Act would have “little, if any, cost,” because the VA already had implemented or was planning to implement each of the specific requirements.
The textbox below lists the required elements and additional authorized elements of the comprehensive suicide prevention program.
Joshua Omvig Veterans Suicide Prevention Act (P.L. 110-110)
Required elements of the comprehensive suicide prevention program include the following:
• mandatory suicide prevention training for appropriate VA staff and contractors;
• designation of a suicide prevention counselor at each VA medical center;
• outreach and education for veterans and their families to promote mental health;
• mental health assessments of veterans and referrals to appropriate treatment;
• availability of 24-hour mental health care for veterans;
• research on best practices for suicide prevention; and
• research on mental health among veterans with military sexual trauma.
Additional authorized (but not required) elements include the following:
• a 24-hour toll-free hotline staffed by trained mental health personnel;
• peer support counseling; and
• other actions to reduce the incidence of suicide among veterans.
But there was more,
National Defense Authorization Act for Fiscal Year 2008
Section 1611 of the National Defense Authorization Act for Fiscal Year 2008 (P.L. 110-181) directed the VA and DOD Secretaries to jointly develop a comprehensive care and transition policy for servicemembers recovering from serious injuries or illnesses related to their military service. The law specified that the policy must address (among other things) the training and skills of health care professionals, recovery coordinators, and case managers, to ensure that they are able to detect and report early warning signs of suicidal thoughts or behaviors, along with other behavioral health concerns. The law further specified that the policy must include tracking the notifications made by recovery care coordinators, medical care case managers, and nonmedical care managers to health care professionals regarding suicidal thoughts or behaviors, along with other behavioral health concerns. A 2009 Government Accountability Office report indicates that DOD and VA have developed the relevant policies.
Veterans’ Benefits Improvement Act of 2008
Section 809 of the Veterans’ Benefits Improvement Act of 2008 (P.L. 110-389) grants the VA Secretary authority to advertise in the media for various purposes, including suicide prevention. Caregivers and
Veterans Omnibus Health Services Act of 2010
Section 403 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (P.L. 111-163) requires the VA Secretary to conduct a study to determine the number of veterans who died by suicide between January 1, 1999, and May 5, 2010 (i.e., the date of enactment). As of this writing, the study has not been completed.
As you discover more veterans are committing suicide, you need to remember, we've been down this road for so long now that the road wore out for far too many veterans we were told congress intended to save.
