AP Government Report

Earlier this month I went to a hearing at the Bedford County Board of Supervisors. Congressman Tom Perriello hosted a hearing about the state of rural veteran healthcare. Sadly, healthcare options for rural veterans are extremely poor. Congressman Perriello noted that unemployment for veterans is an "astronomical" figure - more than twenty percent.

Tom Perriello (left) talks with speaker Michael Mitirone before the hearing begins.

Carroll Thackston, the mayor of South Boston who has forty years' experience in the Army and the National Guard, said that many rural veterans have to travel as far as Richmond for treatment. Another speaker, Howard Chapman, said that many rural veterans have access to neither telephones nor transportation. This obviously makes healthcare nearly impossible.

Perriello listens as Carroll Thackston speaks.

Many speakers suggested Community-Based Outpatient Clinics, or CBOCs. CBOCs would run like more local VA hospitals (Dept. of Veterans' Affairs). However, CBOC technology has become largely outdated, and a lot of government money is needed to keep them running.

I have video of three of the speakers. The first is Carroll Thackston. I'm not sure how good the sound quality will be, but I'm posting the speech excerpts under each video.

"As a former Adjutant General of the Virginia National guard, I have deep concerns about the coming impacts on the VA system as a result of the extensive use of National Guard combat and combat support units during Operations Iraqi Freedom and Operation Enduring Freedom in Afghanistan. During my tenure as Adjutant General, in spite of actively seeking overseas operations for our ten National Guard Divisions, the Guard was more or less relegated to Homeland Security for domestic crises. That is not the situation the Guard finds itself in post 9-11."

"When you consider the demands being put on the Department of Veterans' Affairs by that intense combat environment and multiple tours of duty, combined with the effort to increase VA medical care eligibility for veterans, I believe the VA will be required to expand its network of healthcare facilities to meet those increased demands. News reports last week indicate that the VA is adopting new rules regarding Post-Traumatic Stress Disorder that will, in my opinion, drastically increase the clinical workload for the VA. Reports cite a 2009 Rand Corporation estimate that 'nearly 20 percent of returning veterans, or 300,000, will have symptoms of PTSD or major depression.' It will be interesting to see those new estimates updated to reflect the new rules announced last week."

The next speaker I have is Daniel Boyer. He also has experience in the Armed Forces, but I'm not sure which branch he's served in, nor how much experience he has.

"Access to VA services in rural areas is always a primary concern, and that is no different in our region. From my hometown of Galax, VA, we have the Salem VA hospital that is approximately 100 miles to the northeast. Also located in our region is the Johnson City, Tennessee, VA hospital that is approximately 125 miles to the west. Either of these can be quite a journey, particularly when a veteran has two non-contiguous appointments. It can be a frustrating process for a veteran to travel long distances for multiple appointments spread throughout the day. We are very thankful for our Community-Based Outpatient Clinic (CBOC) in Hillsville, and we believe that the addition of a second CBOC in Marion, although limited to three days a week, will provide even better assistance. There is clearly a need for the VA to open more clinics in rural areas, and the onus is on VA to find solutions for our veterans, whether it be through additional private contracting, private-public partnerships, collaboration at multiple levels of government, or other creative means to make sure veterans are getting the care they deserve."

"Closely tied to TBI [Traumatic Brain Injury] is our concern with proper diagnosis and treatment of mental health conditions. We applaud VA for raising awareness on mental health issues and for working to reduce the stigma attached to seeking mental health treatment. We urge the Congress to provide continuous oversight of VA mental health programs to ensure the need for counseling and other types of treatment is being met here and in all rural areas of the country. At the Salem, VA, facility alone nearly 2,500 veterans have received diagnoses that may be caused by PTSD. One concrete step that could be taken to ensure all veterans who struggle with mental health conditions receive timely and professional care is to staff our rural CBOCs to provide inpatient mental health counseling and other specialty services."

"The VA's suicide hotline is an effective tool for those who call, but we should work to ensure every veteran who is at the end of his or her rope know there is a helping hand. Again, it comes back to outreach. These programs must be visible in the everyday lives of veterans. We know this is especially challenging in highly rural areas and we hope the VA will redouble their efforts with regard to rural outreach - not only for the suicide prevention hotline, but for all their programs."

"The Independent Budget said it best when it stated that 'health workforce shortages and recruitment and retention of health-care personnel are a key challenge to rural veterans' access to VA care and to the quality of that care.' The VA must aggressively train future clinicians to meet the unique challenges rural veterans face. The VA already has existing partnerships with over a hundred schools of medicine in the United States. To not apply them, and expand upon them if needed, would essentially squander their vast resource. We cannot allow that to happen."

The final speaker I have is Lynn Tucker. She is the mother of three Iraq veterans: Ben, Jonathan, and Clay. Ben suffered a Traumatic Bran Injury (TBI) following a dirt bike accident, and since that it has become almost impossible for the family to find healthcare. Many of the VA workers they have contacted are incompetent, or they just don't care.

"In October 2006 Ben returned home after almost a year in hospitals and was totally dependent for all his care as he had no voluntary movement and was fed by a gastric tube. He was eligible for fifteen hours weekly with the VA Home Health Aide Program. Due to his rural location, locating and retaining certified nursing patients with the selected VA vendor was often impossible. Months would pass with no nursing help and no help from the VA in locating a vendor with nurses willing to drive the extra distance for a rural client. Just this last year we were able to retain a reliable and caring nurse through the VA when a new vendor was selected. With Ben's monthly VA disability payments another CNA [Certified Nursing Assistant] was employed after a period of four months with no nursing help. Overall low payroll compensation with the added expense of additional driving discourages CNAs from accepting rural clients."

"Veterans often have to wait for needed medications to be refilled. Just this past month, Ben needed renewal for a medication that took over twelve days to resolve. The CBOC in Danville received my request by fax and the receipt was confirmed by a nurse. Three of the medications arrived in the mail, but the one in question was not on Ben's prescription list in My HealthVet. I called the CBOC and left a message for the nurse line. No one called. Inquiries confirmed the message was retrieved off the voice mail, but no action was taken. Finally the nurse called to say we needed to contact Richmond for approval. In all it took twelve days for the CBOC to tell me to call Richmond. Consider this: If you needed medication for your hypertension would you be willing to forgo that for twelve days? Is that not harmful to your health? Living in a rural area with the nearest pharmacy thirty minutes away and the nearest VA pharmacy an hour and fifteen minutes away, this problem is compounded. Simple communication would have alleviated the wasted time, energy, and driving to fill this prescription."

"As a taxpayer and citizen of the United States of America, it is striking how we take for granted the lives of those who voluntarily put their lives on the line. Ben, Jonathan, Clay, and all veterans enlisted without knowledge of the outcome. They made a commitment to their country. Where is their country now? Where will their country be when all the veterans return from Iraq and Afghanistan? Will they, too, be burdened with forms, phone calls, red tape, and delays? Will they, too, be turned away and not cared for? We cared to send them."

I also learned a lot about Perriello from this hearing. Perriello seems really concerned with the state of veteran healthcare, and if he is reelected, this will probably be a top priority for him.

If you want more information, you can visit either www.wdbj7.com or www.newsadvance.com and search "Tom Perriello."