March 13, 2008 – Washington, DC — On Thursday, the House Veterans’ Affairs Oversight and Investigations Subcommittee, led by Chairman Harry Mitchell (D-AZ), conducted a hearing to assess how the Department of Veterans Affairs (VA) is caring for our nation’s most seriously wounded veterans following inpatient treatment. Specifically, the hearing addressed care coordination after the veteran has transitioned to independent living at home and assessed whether federal care coordinators are working as intended.
“There was a lack of preparation for veterans’ health care at the outset of this war,” said Chairman Mitchell. “The need to provide care and assistance to wounded service members, and their families, in significant number and for the long term has been largely ignored.”
Corporal Casey Owens was seriously injured during Operation Iraqi Freedom and testified about his transition following inpatient care: “While some of the problems I have encountered have been resolved, many have not. The learning curve of VA’s system is steep and its bureaucratic maze is hard to understand. The impression that I get from the VA is that some within the organization think it is the duty of the veteran to endure and resolve these problems on their own. Those, like me, who were paid as a Marine Corp Grunt to do their job to the best of their ability never questioned whether if we got injured my government would be there for me. We all knew it would. It is now time for those who are responsible for the VA to care for those who did their duty.”
Severely injured service members at the VA Polytrauma Rehabilitation Centers (PRC) are only a subset of the “severely injured.” There have been approximately 500 PRC patients, but the Dole-Shalala Commission estimated that there were 3,000 severely injured service members according to the criteria established in setting up the commission. All these service members should be receiving clinical and care management services, not just PRC patients.
In November 2007, VA announced the creation of Federal Recovery Coordinators (FRC), to act as the delegated authority for oversight and coordination of care for every eligible severely injured military service member from initial admission to the Military Treatment Facilities. This responsibility continues through the service member’s transfers between and among medical or other treatment facilities, discharge from medical facilities, retirement from Military Service, and throughout reintegration into the civilian community. The FRC is a resource for these service members and their families to ensure they have ready access to the right clinical and non-clinical resources.
Sergeant Ted Wade sustained a severe traumatic brain injury after his humvee was hit by an Improvised Explosive Device in Iraq. His right arm was completely severed above the elbow and he also suffered a fractured leg, broken right foot and visual impairment, among other injuries. His wife, Sarah Wade, testified about their experiences since her husband was wounded: “Ted has made a remarkable recovery by any standard, because we have strayed from standardized treatment, and developed a patient-centered path. I had to educate myself about, and coordinate, additional outside care. Often, access to the necessary services required intervention from the highest levels of government, or for us to personally finance them ourselves. But despite our best efforts, Ted is still unable to easily receive comprehensive care for all of his major health issues, due to shortcomings in the current system, and because of the time his needs demand of me, I have been unable to return to regular work or school.”
The witnesses offered many recommendations for improving the current process of transitioning from inpatient care to independent living at home. Some of the ideas shared included special monthly compensation for integration, changes to dependents’ educational assistance benefits and more flexible respite care options. Another recommendation was establishing a centralized group of personnel specifically for those wounded in Iraq and Afghanistan.
“These seriously injured veterans have a right to get on with their lives and focus on their recovery – not deal with endless paperwork and a stubborn bureaucracy,” said Bob Filner (D-CA), Chairman of the House Committee on Veterans’ Affairs. “We have lost the trust of many and we have a long way to go to provide the care worthy of their service and sacrifice. We must be prepared to welcome back every soldier, sailor, airman and marine with all the compassion this grateful nation can bestow.”
Corporal Casey Owens, Houston, TX, U.S. Marine Corps Combat Veteran
Sarah Wade, Chapel Hill, NC, Testifying on behalf of Sergeant Edward Wade, U.S. Army Combat Veteran
Meredith Beck, National Policy Director, Wounded Warrior Project
Todd Bowers, Director of Government Affairs, Iraq and Afghanistan Veterans of America
Madhulika Agarwal, MD, MPH, Chief Patient Care Services Officer, Veterans Health Administration, U.S. Department of Veterans Affairs
Lucille Beck, Ph.D., Chief Consultant, Rehabilitation Services and Program Director for Audiology and Speech Pathology Program, Office of Patient Care Services, Veterans Health Administration
Kristin Day, LCSW, Chief Consultant, Care Management and Social Work, Office of Patient Care Services, Veterans Health Administration
Prepared testimony for the hearing and an audio recording of the hearing is available on the internet at this link: http://veterans.house.gov/hearings/hearing.aspx?newsid=208.