Veterans’ health treated like the ‘discretionary’ expense it is

Words from Abraham Lincoln's second inaugural address -- "to care for him who shall have borne the battle, and for his widow, and his orphan" -- serve as the motto for the Department of Veterans Affairs, which was created in 1930. [Image courtesy of the National Archives and Records Administration]

Words from Abraham Lincoln's second inaugural address -- "to care for him who shall have borne the battle, and for his widow, and his orphan" -- serve as the motto for the Department of Veterans Affairs, which was created in 1930. [Image courtesy of the National Archives and Records Administration]

While the Department of Veterans Affairs struggles to address a scandal over service delays, a local coalition of activist veterans has won an investigation into shortcomings of the VA’s crisis hotline.

The VA’s inspector general is investigating a complaint by the Coalition of Veterans Organizations regarding a number of cases where veterans in crisis were unable to receive assistance from the hotline, according to CVO chair Bruce Parry. The coalition represents over a dozen Chicago-area chapters of veterans groups.

In one case, a woman veteran called Rochelle Crump, president of National Women Veterans United. Homeless and depressed, the vet was “having an episode,” Crump recalls. “She was saying things like, ‘I might as well not be alive, I might as well be dead.’”

A Vietnam-era Army veteran who worked for more than two decades as a benefits counselor at the VA and for the Illinois Department of Veteran Affairs, Crump says, “I’m not a social worker, and I’ve dealt with this kind of thing enough to know when it’s time to get help.”

She initiated a three-way call to the hotline, and the person answering offered no assistance, “never asked what’s the issue,” and simply told the callers to contact their local VA facility, Crump says. Since it was Martin Luther King Day, a federal holiday, most of the offices at the facility were closed, she said.

Crump then sent a message to the hotline’s online chat line. “A message came back saying we will contact you within 24 to 48 hours,” she said. She then called another hotline number and got a recorded message.

“It’s so disheartening that it’s 2014 and we’re still dealing with this,” she said.

In another case, she says, a woman veteran who had previously attempted suicide and was threatening to self-mutilate called the hotline and got no answer. In addition, a member of the Harold Washington Post of the American Legion reported contacting the hotline for immediate assistance and then waiting three hours for an ambulance to arrive, CVO reports.

Veterans calling the hotline “are often distraught, suicidal, homicidal and depressed”; they may be intoxicated, and may even be armed, Parry wrote in a letter from CVO to then-Secretary Eric Shinseki in April. “It is painful to imagine that while lives are at stake, a system that was put in place to save lives is not functioning.”

CVO urged transforming the hotline into a system that mirrors a 911 emergency call center with backup by on-call personnel with training in crisis intervention, along with recording and monitoring of calls.

Parry said CVO had no response to its April complaint — and no followup from Senators Richard Durbin or Mark Kirk, who received copies — until this month, when the VA Office of Inspector General informed them an investigation had been opened.

Meanwhile, in light of the VA’s larger problems, the group is continuing an ongoing campaign for full funding for veterans services.

House and Senate negotiators have reached agreement on a $17-billion measure to reform the VA in the wake of the death of scores of veterans who were on fraudulent waiting lists for health care. It includes $5 billion to hire additional doctors and nurses and authorization to open 27 new clinics.

It also includes a provision for the first time requiring the VA to pay for private care for eligible veterans who have waited more than 14 days for an appointment. That concerns Parry.

“It’s the next step toward the privatization of the VA,” he says. “It’s another step in the erosion of veterans’ health care.”

Vouchering out VA health care has been a goal of conservatives for several years, over opposition from veterans groups who say the VA provides superior health care; the issue is capacity and access. Proponents of vouchering “are using the delays as a pretext to advance their agenda,” Parry says.

CVO has long backed legislation that would move VA healthcare funding from discretionary to mandatory status, based on a formula including the number of veterans and the cost of care. Currently funding requires an annual appropriation from Congress, which turns it into “a political football,” Parry said.

The group also backs full access to VA healthcare for all honorably-discharged veterans. Since the 1980s, the VA has instituted means testing, enrollment fees, copays, and even exclusions cutting off some veterans altogether; the process of proving eligibility can be a “bureaucratic nightmare,” Parry said.

In 2011 CVO pushed Cook County and 21 other Illinois counties to hold an advisory referendum on full mandatory funding for veterans health care. The referendum won the support of over 93 percent of voters, winning well over 1 million votes.

Demand for veterans services is surging as a result of recent wars. Some 2.5 million US service members have been deployed to Afghanistan and Iraq since 2001; 670,000 of them have been awarded some level of disability, with 100,000 additional claims pending, McClatchy recently reported.

The full bill won’t come due for several decades. Modern warfare results in a far higher proportion of injuries to fatalities, and the volunteer army in Afghanistan and Iraq faced longer deployments and often multiple deployments, putting them at higher risk of post-traumatic stress disorder. Of 1 million new veterans from 2002 to 2009, more than 220,000 were diagnosed with a mental health issue, according to the VA.

High levels of traumatic brain injury and hearing loss in recent conflicts have long-term impact, experts say. And a large proportion of women veterans have been subject to military sexual trauma.

“They find the money to fight the wars; that’s no problem,” Parry says of Congress. “They need to find the money to take care of the veterans who come back from the wars.”

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