New bill in Congress addresses Atlanta VA failings

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The Atlanta Journal-Constitution has been following mismanagement charges at the Atlanta VA Medical Center since inspectors noted dozens of cases in which staff failed to follow procedures. A federal audit has since linked three deaths to lack of oversight at the Decatur facility. Today, the chairman of the House Veterans Affairs Committee proposes legislation to expand the role of contractors in providing care.

A top U.S. House member has drafted a new bill to expand outside contractors’ role in veterans’ mental health care, while better coordinating that care, in response to recent revelations about rampant mismanagement at the Atlanta VA Medical Center.

An April audit found more than 4,000 mental health patients at the Atlanta VA “fell through the cracks” when their care was farmed out to the DeKalb County Community Service Board. One of those committed suicide, and another died of a drug overdose.

A bill drafted — but not yet introduced — by Veterans Affairs Committee Chairman Jeff Miller, R-Fla., would give more veterans the option of seeking care with contractors but require the Department of Veterans Affairs to keep track of the patients’ appointments and prescriptions. Contractors also would have to meet new standards.

“I wish that I could say that the issues in Atlanta are an isolated aberration,” said Miller, who toured the Decatur facility last month along with members of the Georgia congressional delegation. “Unfortunately, that would be far from the truth. Rather, the Atlanta story is just the latest in a tragic series of incidents highlighting serious and systemic deficiencies plaguing the provision of mental health care to at-risk veterans through the VA health care system.”

Miller unveiled the proposal at a subcommittee hearing Tuesday to mixed reviews. The Department of Veterans Affairs did not take an official position on the bill, but as he left the hearing, VA Principal Deputy Undersecretary for Health Robert Jesse played down the need for a legal fix.

“I’m not sure that legislation solves that problem as much as a very concrete look at things,” Jesse said. “I think that’s probably the simplest way to say it. And we’ve got new leadership going into Atlanta that’s extremely talented, and I think there’s a great deal to come of it.”

On Monday, Leslie Wiggins started as the new director of the hospital, which serves 90,000 veterans and is the largest such facility in the Southeast. Further staff shake-ups are possible after a pair of scathing audits blamed the Atlanta VA for three veterans’ deaths. One of those came on the hospital’s mental health ward, where patients were not properly monitored, the audit found.

Miller’s bill, the Veterans Integrated Mental Health Care Act, focuses on outside mental health contractors rather than the problems within the hospital.

Adrian Atizado, of Disabled American Veterans, said at Tuesday’s hearing that the intention behind the bill was a good one, but making it law could impede progress on a larger effort. The VA is soliciting bids on a nationwide managed care system covering all types of health care — including mental health.

Health care companies “pay lots of money for consultants to look at these requirements in their request proposal and put in a sizable bid package,” Atizado told The Atlanta Journal-Constitution after the hearing.

“And all of a sudden here comes from Congress a new requirement, and they’re like: ‘Wait a minute.’ … It could throw this into a tizzy because this is a significant amount of money,” Atizado said.

The Veterans of Foreign Wars opposed the bill for similar reasons in written testimony. The American Legion, meanwhile, supported the bill, which it said would help rural veterans get easier access to VA care when a hospital is far away.

Responding to the criticisms, Miller said the Atlanta case brings urgency for a new law.

“We cannot wait to see what next year brings,” he said. “When a veteran is in need of mental health care services, the difference of a day or a week or a month can be the difference between life and death, between contentment and struggle. The time to act is now.”