Veterans' Health Related Issues

Navigating VA Health Care –OIF/OEF Returning Servicemembers: 

Each VA Medical Center has a team of professionals responsible for helping returning servicemembers access health care and other services.  The team acts as both advocate and coordinator of services for returning service members.  For more information about this and related resources for OIF/EOF returning servicemembers, Click Here.    

Veteran Suicide –The Enemy Within: 

“For all that is being done to support our troops in battle, we must remember this truth: for many veterans, their battles do not end when they return from war.  Instead, war returns home with them, and within them.  They face an enemy that is hard to understand, and harder to defeat.  Their wounds, and their enemy, are unseen.  But the reality and the sometimes deadly consequences of these invisible wounds cannot be ignored.” -- Senator Daniel Akaka, Chairman of the Senate Committee on Veterans’ Affairs

Since assuming the leadership of the Committee on Veterans’ Affairs at the start of the 110th Congress, Chairman Akaka has led efforts to improve VA services for veterans with mental health concerns, and above all, to ensure that the Department does its utmost to prevent the tragedy of suicide among those who are serving, or have served, the nation.  He continues to closely monitor and spur coordinated efforts on the part of VA and the Department of Defense toward this goal.

111th Congress:    Amid reports in early 2009 of an  increased rate of suicide among active duty servicemembers, Chairman Akaka and the Ranking Minority Member, Senator Richard Burr, contacted the Secretaries of  DOD and VA, Robert Gates and Eric Shinseki, respectively, to urge their joint efforts to  make suicide prevention a priority. 

Click Here to View Chairman Akaka's Letter to VA

On February 24, 2009, VA Secretary Shinseki and DOD Secretary Gates met to address suicide among servicemembers. Chairman Akaka applauded their meeting, noting that it was a first step in an urgently needed campaign to ensure proper screening, diagnosing, and treatment of active duty servicemembers for psychological problems. 
 
110th Congress:  Within weeks of assuming the leadership of the Senate Committee on Veterans’ Affairs, Chairman Akaka focused attention on VA’s mental health care system following the death of Jonathan Schulze, a 25-year-old Iraqi War veteran who reportedly took his life while awaiting treatment from VA.  In a January 29, 2007, letter to Dr. Michael Kussman, then VA’s Acting Under Secretary for Health, Chairman Akaka requested an investigation into the circumstances of Mr. Schulze’s suicide and voiced concerns over systematic delays in providing timely assistance to veterans in emotional turmoil. 

On April 25, 2007, Chairman Akaka held a hearing at which families of veterans from Iraq and Afghanistan who had committed suicide, as well as a veteran with traumatic brain injury, described deficiencies in VA’s mental health care system.  The father of Justin Bailey, a veteran who died of an overdose of prescription drugs following service; the parents of Joshua Omvig, who took his life after serving in Iraq; and, a veteran with TBI testified before the Committee about their experiences with VA’s mental health care system.

Click Here to View Hearing Testimony

Mental  Health Care Reforms--S. 2162:  In response to the problems with VA mental health care identified in the April 25, 2007, hearing, Chairman Akaka authored legislation which set out sweeping reforms to the system in the proposed, “Veterans Mental Health and other Improvements Act of 2008.”  He introduced the bill, S. 2162, on October 15, 2007.  

The bill included provisions to set a minimum level of substance abuse treatment, provide programs to prevent relapse, and ensure m-patient treatment was available, when needed.  For veterans struggling with substance abuse and other mental health concerns, the bill required that care among different professionals be coordinated. Also mandated was a comprehensive review of VA’s residential care facilities, one of where Justin Bailey lost his life while being treated for substance abuse and PTSD.

Chairman Akaka called for support for S. 2162 in various forums, among them an April 30, 2008, press conference. At the conference, the Chairman, Committee Member Senator Patty Murray, along with leaders of the Disabled American Veterans and Mental Health America, urged increased access to mental health care among veterans
 
After the Committee favorably reported S. 2162, as amended, the Chairman began working with the Senate leadership to bring the measure before the full Senate for a vote.  On June 3, 2008, the Senate unanimously passed the bill. 

On September 11, 2008, Chairman Akaka spoke on the Floor of the Senate to draw attention to the record-high numbers of Iraq and Afghanistan veterans who have committed suicide.  He urged a deeper federal commitment to protecting veterans at risk and called on Congress to pass S. 2162 to provide VA with the direction and resources to help make this possible. 

Click Here to View Press Release

On September 27, 2008, the Senate unanimously voted for final passage of the bill, as amended by the House of Representatives.  As passed by the Congress, the bill’s mental health care provisions include those to:

• Set a standard minimum level of care for substance use disorder, and creating innovative enhancements to treatment

• Improve treatment to veterans with multiple disorders, such as PTSD and substance use disorder

• Mandate a review of VA's residential mental health care facilities, to ensure that they are adequately staffed

• Create a research program on PTSD and substance use disorder, in cooperation with the National Center for PTSD

• Enable VA to provide mental health services to veterans' families, and set up a program to aid the families of returning servicemembers

On October 10, 2008, the President signed S. 2162 into law as P.L. 110-387.  

Click Here to View Press Release

Oversight Actions –Holding VA and DOD Accountable:   In the spring of 2008, there were media reports that VA’s leading mental health expert tried to suppress data showing a rise in suicides among veterans. In an April 22, 2008, letter to VA Under Secretary for Health, Dr. Michel Kussman, Chairman Akaka called for the resignation of the VA official at issue. 

Click Here to View Press Release

In an April 23, 2008, hearing on the status of VA’s and DOD’s joint efforts to reduce suicide among servicemembers and veterans, Chairman Akaka took the  opportunity to underscore VA’s obligation to provide reliable data on the extent of veteran suicide to policy makers in the Congress.

In a related action on May 5, 2008, Chairman Akaka met with then-VA Secretary James Peake, to press for accurate information veteran suicides and stress the need for increased mental health outreach.
 
In a May 15, 2008, letter to then- VA Secretary Peake, Chairman Akaka requested broader data on veteran suicides not normally provided to the House and Senate Committees on Veterans’ Affairs.

“We will not know the true cost of war until we know the true rate of suicides among veterans.   Until the VA mental health care system meets the needs of those who have served, we will continue to see the tragic consequence of veteran suicides.” -- Chairman Akaka 

Click Here to View the Press Release

Chairman Akaka also took action following reports that a VA employee at Temple VA Medical Center was discouraging coworkers from making a diagnosis of PTSD in favor of a lesser determination to save the Department time and resources.  In a May 16, 2008, letter to then-VA Secretary Peake, the Chairman informed the Secretary that he had requested that VA’s Office of Inspector General examine the integrity of PTSD diagnoses, as well as compensation and pensions decisions for PTSD, at the facility.  He also urged Peake to follow up on related issues of concern. 

Click Here to View the Press Release

The Committee followed up with a hearing on June 4, 2008, to question the leading VA official who attempted to suppress data on veteran suicides, the Temple VA Medical Center employee at issue, and other mental health care officials.

“Recent incidents indicate a possible trend of system-wide or systemic indifference to the invisible wounds of war.  It is shameful, because veterans deserve better, and because it tarnishes the good work of the many VA mental health professionals who help veterans battle PTSD, depression, and other psychological wounds. Whatever the reasoning behind the mistakes that were made, VA must work to regain the confidence of veterans who now question whether VA is a friend or enemy.” --Chairman Akaka 

Suicide Prevention Hot Line and Mental Health Outreach Campaign: Chairman Akaka, along with several other Committee Members, cosponsored S. 479, the Joshua Omvig Veterans Suicide Prevention Act.  It required that VA establish a national suicide prevention hotline and undertake an outreach effort to veterans in a state of emotional crisis. On October 5, 2007, the House version of the bill, H.R.327, was enacted as Public Law 110-110.  In anticipation of this mandate, VA announced in August 2007 that it would set up a national toll-free suicide-prevention hotline and initiate a mental health outreach campaign. For more information, Click Here.

  

Billing for Military Sexual Trauma Care --Adding Insult to Injury

Servicemembers, both female and male, can experience sexually traumatic experiences during military service.  As with other forms of trauma, the impact can be deeply harmful and long lasting if untreated.  Victims of military sexual trauma (MST) may suffer from nightmares and sleeplessness,problems with drugs and alcohol, and, bouts of anger, depression and social isolation.

As a result of Congressional legislation, and increasing awareness of this potentially debilitating condition, the Department of Veterans Affairs provides counseling and treatment for MST without questions and without charge. 

 

Click Here to view VA’s on line information on MST.  

In late 2008, Chairman Akaka received a letter from a veteran noting that VA was billing her for MST treatment at the VA Outpatient Clinic in Austin, Texas, an action that would be deeply offensive to any veteran seeking such care and a serious violation of VA’s mandate to provide free care for injuries resulting from service.  The Chairman asked VA’s Inspector General to investigate any instances of inappropriate billing for MST care at the VA’s Austin Clinic.  On April 29, 2009, the Inspector General reported that over 80 veterans had been wrongly charged for MST care at the Clinic and that VA intends to refund payments to these veterans.

To ensure that other veterans are not being wrongly charged for MST care and to correct this problem if they are, a review of MST billing is being extended to other VA facilities in Texas and across the nation.

Click Here to View the Press Release 


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