Sunday, January 13, 2008

Hat tip to Billings Gazette

Billings Gazette OPED ON Veterans Healthcare


Published on Sunday, January 13, 2008

Gazette Opinion: VA must catch up with veterans' growing needs

In the past six years, 1.5 million U.S. military personnel have served our country in the wars in Afghanistan and Iraq. About half of them have since left military service.

These new veterans have swelled the Veterans Administration health care enrollment nationwide. And many have found the system wasn't ready to provide the care needed.

The VA is scrambling to meet their needs. The budget Congress approved just before Christmas should provide a significant increase in resources for both VA health care and benefits administration - $3.7 billion more than President Bush requested. As of last week, Bush had yet to authorize that "emergency" spending, but has indicated he will.

Because of the intense, prolonged combat work that many thousands of U.S. military members have experienced in these ongoing wars, post-traumatic stress disorder has emerged as the most common mental health problem among new veterans. Mental health issues overall are estimated to account for nearly a quarter of all the illnesses and injuries the VA is treating.

The influx of veterans and the gaps in the care system have been apparent in Montana as they have been elsewhere. Improvements are under way.

Tragedy spurs improvement

Tragically, it was the death of a Helena National Guardsman, Chris Dana, that finally prompted changes in outreach, education and mental health services. Dana's family, friends, fellow Guardsmen and Gov. Brian Schweitzer pushed for improving how both the Guard and the VA will serve returning combat veterans. For example, because returning service members may not realize they have a mental health problem or may be reluctant to seek help, since April 2007, all returning members are supposed to receive additional screenings.

Phay Lloyd, who coordinates services to Iraq and Afghanistan veterans for VA Montana, now has direct contact with the Montana National Guard and Reserves. Earlier in the wars, Lloyd said, VA didn't get information on returning personnel. Since last year, the Guard has required all members returning from deployment to enroll with the VA. A couple of weeks ago, Lloyd said, the VA received contact information on all Montana Guardsmen who have served in Operation Enduring Freedom and Operation Iraqi Freedom and will contact them to inform them of VA services.

VA Montana is recruiting for 16 new mental health professional positions, including two psychiatrists, according to Joe Underkofler, director of the statewide VA health system. The plan is to station one new psychiatrist in Billings and one in Helena. For now, the VA has just three psychiatrists on staff statewide, all at the VA hospital in Helena. But all 10 outreach clinics have telemedicine capabilities, so it's possible for patients at the clinics to be seen remotely by VA psychiatrists. For now, the Billings VA clinic at King Avenue West and 24th Street West has just one mental health professional on staff, a licensed professional counselor who also is a chemical dependency counselor.

VA Montana has contracted most of its mental health services to the private, nonprofit regional mental health centers that are headquartered in Billings, Great Falls and Missoula. The Billings-based center has satellite offices in surrounding counties and also subcontracts VA service to the Eastern Montana Mental Health Center, which has offices in Miles City and several other towns.

The VA wants to "increase our mental health presence in Billings," Underkofler said. This spring the VA will put out a request for proposals for a new Billings VA clinic with twice the space of the existing site to accommodate mental health services as well as expand primary care. Underkofler wants to open the larger clinic by September.

Tremendous growth in enrollees

VA Montana has more than 31,000 veterans enrolled for health care, about a third of all Montana veterans, Underkofler said. That enrollment number represents tremendous growth. In 2001, VA Montana served 17,000 veterans. Last year, VA Montana counted 250,000 patient visits to VA facilities and an additional 25,000 veteran visits to mental health centers around the state.

The VA and the U.S. military are playing catchup. Finally, changes have been made and services are expanding, especially in the critical area of mental health care. Will these new and planned improvements be enough to meet needs of the growing veteran ranks?

The VA's newly appointed secretary, James Peake, should institute independent patient satisfaction surveys and report publicly on how well the department is meeting veterans' expectations. On mental health care, the VA also must tackle the stigma that keeps people from seeking the help they need. Again, the department ought listen to veterans, their families and service organization about how to make care more accessible and less intimidating.

Congress was right to boost VA funding. Senators and representatives must keep tabs on that money and the department's performance. The war isn't over; the need for Iraq-Afghanistan veteran mental health care is just beginning.

Monday's Gazette opinion will address concerns about the VA's handling of disability claims.

Copyright © The Billings Gazette, a division of Lee Enterprises.


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