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Senator Sanders speaks to Senate Committee on Veterans’ Affairs

The following is a statement from Senator Bernie Sanders (I-VT) given on July 16 to the Senate Committee on Veterans' Affairs.

Good morning and welcome to what I think will be a very important and productive hearing. We look forward to hearing from Mr. Sloan Gibson, acting secretary of the Department of Veterans Affairs (VA), who will discuss with us what he has been doing in the last six weeks since he assumed that position, and what he sees as the major challenges facing VA in the future.

First, I would like to take a brief moment to discuss the status of the Conference Committee. Last month, despite a very partisan environment here in Congress, 93 Senators put their differences aside to vote in favor of a significant piece of legislation, which Senator McCain and I worked very hard to craft, to address the very serious problems currently facing VA.

I am confident that my colleagues on the Conference Committee will also put their differences aside and come together to provide much needed access to health care for veterans in a timely manner, and give the secretary the ability to hold dishonest or incompetent senior officials accountable and the resources needed to increase capacity at VA medical facilities around the country.
I am pleased that, in reality, there are more similarities than differences between the House and Senate bills. We have been making significant progress in the last month and I believe that we can reach an agreement very soon. Millions of veterans are counting on us to do so. We can't afford to make them wait any longer for the care and services they have earned and deserve.

With that said, I would like to discuss, what I believe, are the biggest issues facing VA health care.

VA's challenges are well-documented. As any organization would, it faces significant challenges in providing timely and high-quality health care to millions of veterans all across this country. That's why it's important we have some context as we begin today's discussion. VA is the largest integrated health care system in America.

VA operates over 1,700 points of care, which include 150 hospitals, 820 CBOCS, and 300 Vet Centers.

In fiscal year 2013, VA provided 89.7 million outpatient visits.

VA conducts approximately 236,000 health care appointments per day.

Overall, according to veterans that I talk to in Vermont and around the country, according to the national veterans' organizations that represent millions of veterans, and according to a number of independent studies, VA does a good job at providing quality health care to veterans – once they get into the system. In fact, they have been doing some cutting edge work in a number of areas – including tele-health and CAM.

But the simple reality is that the problems they face are staggering.

Of the over 2 million men and women who served in Afghanistan and Iraq, studies suggest that 20 to 30 percent have come home with PTSD or TBI. Simply stated, that means the wars have created some 500,000 mentally wounded American veterans and, as a result, very serious problems regarding suicide, substance abuse, inability to hold on to a job, divorce and emotional problems for children and family members.

Since FY 2006, the number of veterans receiving specialized mental health treatment has risen from just over 927,000 veterans to more than 1.4 million in FY 2013. This means that in FY 2013, just over a quarter of those receiving care at VA were being treated for mental health conditions.

In other words, VA currently provides 49,315 outpatient mental health appointments a day. During the last four years (FYs 2009-2013), VA outpatient mental health visits have increased from 14 million a year to more than 18 million.

VA has noted on numerous occasions that it anticipates that its need to provide mental health services will continue to grow for the next decade as current military operations come to an end.

Ensuring timely access to high-quality mental health care is critical for our veterans and their loved ones. The stakes are high. Statistics show that on average 22 veterans a day commit suicide—that's more than 8,000 veteran deaths a year. Even one veteran suicide is too many. Eight thousand suicides are absolutely unacceptable.

While many individuals with mental illnesses do not commit suicide, it is clear the consequences of failing to properly address and treat mental illness are severe.

I, like most Americans, have major concerns about the inability of veterans in various locations across this country to access care in a reasonable period of time. According to a recent VA audit:

There are 46,236 veterans on lists waiting to be scheduled for medical appointments, and 8,126 of them have waited over 120 days to receive an appointment – that's 120 days before they are told when they are going to be seen.

More than 636,000 veterans have an appointment that are more than 30 days from the date that the appointment was initially requested or from the date that was desired by the patient. Of that amount, nearly 360,000 veterans are waiting between 31 and 60 days, nearly 180,000 are waiting between 61 and 90 days, and more than 40,000 veterans are waiting more than 120 days for their appointments. This doesn't account for how long new patients have been waiting on lists, so a new patient who waits for an appointment that is scheduled more than 30 days from when he or she asked for it may have also waited 120 days, just to receive that appointment.

This is unacceptable. VA must do much more to improve access to the VA Health Care System. We have a moral obligation to provide veterans with the timely access to the health care they need.

A lot of attention has been given to the provision in the bill that allows veterans to access outside care. That provision is important because it will immediately bolster VA's capacity to address veterans' health care needs.

However, the simple truth of the matter is that the VA needs more doctors, more nurses, more mental health providers and, in certain parts of the country, more space for a growing patient population. VA's ability to provide timely care both now and in the future must be strengthened by building capacity within the system. This is done by ensuring VA has the resources, including physical space and the health care providers and support staff necessary to provide such care.

I think I speak for everyone on this committee when I say we need more details on your current initiatives to address access issues, such as:

• How has the department's Accelerated Access to Care Initiative improved the care and services VA provides veterans and how long does the department intend to carry out expanded care options under this initiative, such as evening and weekend appointments.

•When does the department estimate it will roll out its updated scheduling system?

•Has VA completed all the recommendations in the IG's interim report on Phoenix?

In order to address the issue of long wait times, the department and Congress must work together. It is important that you keep us abreast of your initiatives and maintain close communication with the members of this committee.

Further, it is beyond words that some employees have lied or manipulated data. These issues must be dealt with immediately. The department must take swift action to hold those who may have manipulated data or failed to carry out their duties accountable for their actions.

Today I would like to hear:

• What actions the department has taken to reprimand employees who have lied and manipulated data.

• What has the department done to ensure such manipulation no longer occurs?

• What the department has done to improve other areas of concern identified by the IG, GAO, OSC, and other auditing organizations.

I believe it is important for the department to create an accountable, safe and transparent culture for its employees. Only then would we be able to prevent these egregious actions.

Finally, I have been deeply troubled by the recent Office of Special Counsel reports that detail deliberate retaliation against the brave VA employees who seek to improve the care and services veterans receive by exposing deep flaws within VA's system.

I will not accept honest whistleblowers – who want to improve the system – being silenced or having their concerns ignored. VA must have zero tolerance for the actions outlined by the Office of Special Counsel in recent weeks.

During today's hearing, I would like to hear what the department has done to prevent such retaliation from occurring.
With that, I look forward to hearing Acting Secretary Gibson's plans to address the critical issues I have highlighted.

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