NEWS FROM….

CONGRESSMAN LANE EVANS

RANKING DEMOCRATIC MEMBER

COMMITTEE ON VETERANS AFFAIRS

    U.S. HOUSE OF REPRESENTATIVES

FOR RELEASE: May 16, 2000

Mandatory Health Care Programs for Seriously
Disabled Veterans at Risk
Department of Veterans Affairs Cannot Demonstrate
Its Compliance with Law

Washington, DC—Expressing his extreme disappointment with the Department of Veterans’ Affairs for failing to provide adequate information about its programs for some of VA’s most seriously physically and mentally impaired veterans, Lane Evans (D-IL), the Ranking Democratic Member of the House Committee on Veterans Affairs, today released the findings from a report by the General Accounting Office (GAO). "This report condemns VA’s credibility on its claim that it is maintaining services for blind, paralyzed and seriously mentally ill veterans."

Evans’ concerns about whether VA was complying with a law to maintain certain services for vulnerable veterans led him to request the GAO study almost three years ago. Problems with VA’s data systems initially hampered GAO’s efforts to assess care. Ultimately, Congress’s watchdog agency was compelled to conclude that it lacked the evidence to assure Congress VA was complying with the law.

"VA’s inability to demonstrate to Congress that it is complying with the law to maintain these programs is completely unacceptable. Maintaining excellent programs for the nation’s most disabled veterans is the reason we have a unique veterans’ health care system," said Evans.

The GAO report concluded that VA must take significant steps to improve and refine its databases that systematically collect and process information about these programs.

GAO also reported that VA has also failed to implement another congressional mandate to develop performance measures for fiscal managers that address these programs. In addition, GAO noted that VA’s headquarters has not specifically assigned responsibility for overseeing these special programs. The result is a lack of accountability for maintaining their capacity at the top level of the agency.

Evans reiterated the value of the programs. "They help veterans through traumatic physical losses such as paralysis, blindness, or serious mental impairment, including

-more-

combat-related post-traumatic stress disorder, and help them live the most independent lives possible" said Evans. "Good rehabilitative care ensures that veterans with serious disabilities are able to live as independently as possible. It’s the best investment we can make in disabled people’s futures, but VA health care managers forced to live within tight budgets don’t always make decisions that favor these longer-term gains."

In 1996, Congress enacted legislation to ensure that the capacity of certain special emphasis programs (for paralyzed, vision-impaired, seriously mentally ill veterans and veterans using prosthetics) were maintained. "As VA allowed its field officials to make more local decisions and encouraged adoption of managed care, Congress wanted to make sure that these nationally based, high-cost programs that meet our most disabled veterans needs were maintained," Evans explained.

Veterans and their advocates believe VA has failed to meet this mandate. Last spring, the House Veterans Affairs Subcommittee on Health conducted a hearing in which veterans’ groups and special advisory groups expressed significant concerns about the state of VA’s special programs for disabled veterans. Dr. Richard McCormick, Chairman of the VA’s Committee on Care of Severely Chronically Mentally Ill Veterans, stated that his committee was "broadly concerned with trends in VA’s capacity to provide care for seriously mentally ill veterans". Under the law, VA is required to maintain its funding levels for mental health services.

McCormick indicated that the Committee had hoped that, by maintaining its budget and shifting expensive inpatient care into less expensive settings, VA would be better able to meet veterans’ demand for mental health services. However, he has not been encouraged by findings that the sizable reduction in inpatient care has not allowed more unmet demand for services among seriously mentally ill veterans to be satisfied.

Testimony from Thomas Miller, Chairman of the VA Federal Advisory Committee on Prosthetics and Special-Disabilities Programs, was equally critical. "Programs such as Blind Rehab and Spinal Cord Injury are high cost programs and therefore seem to attract the attention of the budgeteers and number crunchers as the most likely targets for cost savings. Consequently, staffing standard guidelines and models of service delivery are being challenged. Decisions are being made without the critical input of the program Subject Matter Experts."

Both advisory groups have failed to endorse at least one of the two reports VA is required to submit to Congress annually.

Evans also indicated he was not optimistic about changes VA has made to improve the problems, "While VA is making efforts to improve, we are anticipating that the soon-to-be-released capacity report for fiscal year 1999 will offer more of the same," said Evans. The last two capacity reports released by the VA in compliance with the 1996 law assessed the status of workloads, expenditures, and performance measures for the special emphasis programs. GAO used the capacity reports for much of its analysis in concluding that VA’s information was inadequate.

Evans promised continued aggressive oversight of VA’s management of the special programs. He stated that his first action in this regard would be to ask VA to develop a plan for implementing GAO recommendations. "As long as administrators justify decisions about programs for the catastrophically disabled according to cost and fail to account for the critical benefit they provide veterans, the budget ax will continue to threaten them. I mean to ensure that these programs are maintained for our veterans at an adequate level to meet their needs."