Richard F. Weidman, Executive Director for Policy and Government Affairs, Vietnam Veterans of America
Madam Chairwoman, Ranking Member Michaud, and distinguished members of the House Veterans’ Affairs Subcommittee on Health, Vietnam Veterans of America (VVA) appreciates the opportunity to present our views in regard to the substance contained in GAO-11-530 report, Preventing Sexual Assaults and Safety Incidents at U.S. Department of Veterans Affairs Facilities.
VVA commends Chairman Miller and Ranking Member Filner for requesting this review, commends you and Mr. Michaud for holding this hearing, and commends the General Accountability Office (GAO) for doing their usual measured and thorough report on this volatile issue. My name is Rick Weidman, and I have the privilege of serving as Executive Director for Policy and Government Affairs at VVA.
First we note that just as one veteran committing suicide is too many, even one sexual assault within the VA facilities anywhere in America is too many. Having said that, the context which we consider this very serious matter is important. The United States has a rate of reported rapes of about 3 per 10,000 of population, which ranks us as tenth most in the world of reported rapes. We do not know how many employees or how many patients were present at any given time during the thirty months of the time period at the five medical centers studied by the GAO, so do not know how to compare these terrible statistics to that of the population at large. In addition, there does not seem to be any way to tell how many sexual assaults go unreported. What we do know is that the more seriously rape/sexual assault is taken by the society or subset of the society, the more the rate of reporting goes up. That does not mean that sexual assault increases, but rather those victims become much more likely to report such inexcusable incidents when those in positions of authority back up and protect the victim against further harm.
The mere fact that this study was done and that you are having this hearing today will have a salutary effect on both making it clear that such behavior cannot and will be tolerated against any staff member or veteran in the Veterans Health Administration (VHA) system, and spurring action to make it less likely that such events will occur in the future.
The recommendations of the GAO that were accepted by the VA are sensible steps to improve definitions and reporting, improve training in procedures, and take physical steps to reduce risk to both patients and staff.
The initial step of creating a workgroup to define sexual assault, and the various manifestations, as well as clarifying when and how such incidents should be reported within the VA structure is a wise and necessary first step, and with a reasonable deadline of July 15. Similarly, creating a centralized tracking mechanism to allow management to be able to monitor such assaults is also a much needed step.
Addressing vulnerabilities in physical structures, particularly in regard to locked inpatient wards is also a pressing need that should be addressed as soon as possible at each and every facility.
The recommendation about establishing legal histories on individuals beyond the self reported information now used is, of course, perhaps the trickiest recommendation from the GAO to implement, as it involves elements of privacy, ethics, and legal constraints as well as perhaps conflicting obligations to all parties concerned. While this may be the most difficult task, it is perhaps the most important in terms of identifying high risk individuals. Exactly how to do this risk assessment in a way that protects others in the medical setting, while not compromising the supportive atmosphere necessary for treating veterans with mental health issues, will require careful thought, good training, and conscientious supervision.
Among a number of things that would seem to be evident from the findings is the need for a standardized “panic button” electronic device that every staff member can carry on his or her person to alert others when faced with imminent physical danger.
While it is not specifically mentioned in the GAO report in question, it is clear that there needs to be separate facilities/wards for female patients on the long term treatment wards. It has also long been the position of VVA that there is a need for a specific women’s clinic that does the full range of care, including psychological evaluations and treatment. Such a women’s clinic should be large enough to house most of the elements involved in a “one stop shop” for women veterans, and be situated in a location that is not isolated within the facility while still protecting confidentiality.
The GAO specifically noted how important it is to have involvement of all stakeholders in planning for steps that can and should be taken to modify physical structures to better protect personal safety. The GAO also noted that all stakeholders should be involved in modifying regulations, definitions, reporting pathways, and other elements that need to be modified to make VA medical facilities as safe as possible for all concerned.
Perhaps we should not be surprised that conspicuous by absence anywhere in the official VA response was any mention of the veterans who are the consumers of VA health care. The veterans are clearly stakeholders in this process, and the majority of the incidents discussed in the report were incidents where a veteran patient was the victim. Yet nowhere in the guidance to the local facility or the VISN is any mention of the need/importance of consulting veterans or veterans’ representatives. The VA response also had no mention of consulting with veteran stakeholders at the national workgroup level, much less having a VSO representative as part of this group.
This is unfortunately consistent with the attitudes toward veteran stakeholders that sometimes seem to pervade much of VHA. Frankly, for all the talk about increasing transparency, VHA was much more open and transparent seven years ago than it is today, and seemed to value input from veteran stakeholders much more than is the case today. Suffice it to say that it is important that stakeholders be consulted at every level, and listened to seriously. Further, since the attacks delineated in the GAO report are mostly on females, it would seem obvious to us that in particular female veterans who are consumers or their representatives should be involved in a meaningful way at the national, VISN, and at the local medical facility level. Similarly VHA female staff members at risk should be involved in the process as well.
Madame Chairwoman, thank you for the opportunity to appear here this afternoon to express the views of VVA. I will be pleased to answer any questions, Madam Chair.
VIETNAM VETERANS OF AMERICA Funding Statement
June 13, 2011
The national organization Vietnam Veterans of America (VVA) is a non-profit veterans' membership organization registered as a 501(c) (19) with the Internal Revenue Service. VVA is also appropriately registered with the Secretary of the Senate and the Clerk of the House of Representatives in compliance with the Lobbying Disclosure Act of 1995.
VVA is not currently in receipt of any federal grant or contract, other than the routine allocation of office space and associated resources in VA Regional Offices for outreach and direct services through its Veterans Benefits Program (Service Representatives).
This is also true of the previous two fiscal years.
For Further Information, Contact:
Executive Director for Policy and Government Affairs Vietnam Veterans of America.
(301) 585-4000, extension 127