November 09, 2017    

The Diehl Plan to Improve Veterans Health Care and Post Military Development

The Goals of the Diehl Plan

As our next United States Senator, Geoff Diehl wants to ensure that each and every veteran who has served and sacrificed for their country has quality medical care and the support system they need to make the transition back to a civilian life. To that end the Diehl plan supports allowing veterans to take control of their own health care as well as enhanced efforts in the areas of professional training and education of the public regarding veterans’ issues, with an increased focus on support for women veterans.

Ensure that every Veteran has the choice to seek care either at the VA facility or a private service provider of their choice:
Currently veterans are waiting 2 months for appointments and 1 in 6 VA clinics are over capacity. The reasons for the backlog are twofold. One, medical records are not easily accessible causing a lag in care and two, insufficient medical personnel. Currently Secretary Shulkin has announced plans for a new uniform IT system – the EHR project which should alleviate this problem but the new system is 1 to 2 years away from implementation. Conservatively, it will take 18 months for the VA to launch the new Cerner electronic health record and another seven to eight years to transition the whole legacy EHR system. In the meantime, to help fill this time gap in implementing the new system we need a commission whose mission it is to make sure that all hospital record systems and patient portals are compatible beginning with a pilot program here in Massachusetts. The second part of the equation can be addressed by allowing veterans to choose care outside of the VA system without having to meet the wait time and distance requirements of the pilot Veterans Choice Program and expanding the parameters of that program to give veterans more care options beyond the proposed CARE bill.

Increase the number of mental health care providers available to Veterans:
According to data released by the U.S. Department of Veterans Affairs in 2016, 20 veterans commit suicide every day. The Massachusetts Veteran suicide rate is significantly higher than the national suicide rate. To combat this horrifying statistic we need to hire more mental health care clinicians in the VA medical centers, increase funding for veterans suicide call centers and make available private mental health care providers.

Expand Opioid addiction clinics and treatment programs dedicated to Veterans:
After recklessly prescribing opiates for years calling them non-addictive, the U.S. Department of Veterans Affairs, in 2013, officially launched an Opioid Safety Initiative that has brought the VA’s opiate prescribing down 30%. However, it did this by ordering a drastic cutback of opiates for chronic pain patients. This response has resulted in mandated medication cut-offs, regardless of patient well-being, which many physicians believe puts veteran patients at risk. Today, 60% of veterans who fought in the Middle East and 50% of older veterans have chronic pain, yet there has been a 56% drop in chronic pain VA patients receiving opioids. The VA does not keep an accurate count of how many veterans have died of legal or illegal drug overdoses. Nor does it regularly monitor opiate use by its patients who seek legal or illegal drugs outside the VA. The VA did not begin reporting all patients getting opiates to state databases until the end of 2015, a delay that allowed those patients to do more doctor-shopping and drug-dealing in search of opiates. VA pharmacies were finally compelled to share prescribing records by a federal opioid abuse law passed in July 2016, but by the end of last year, 18 state VA programs still weren’t reporting. Our Veterans Administration owes our veterans a better response than this having played a key role in causing the opioid crisis in the armed forces. Geoff Diehl will support more funding for and expand the opiate clinics and treatment programs which are available to both our men and women veterans.

Appoint an independent watchdog to the VA to perform regular inspections:
In the past few months, we have been inundated with horror stories about the substandard care at some of our VA Hospitals here in New England. In Massachusetts, we all read about the story of Bill Nutter who died at the Bedford VA Medical Center. In New Hampshire, the Manchester Veterans Affairs Medical Center had its ratings raised from three stars to four stars despite a fly infested operating room and patients, including some with life-threatening conditions, who are unable to get any care at all because the program for setting up appointments with outside specialists had broken down. In Maine, a Veteran had her leg amputated at the VA as the result of medical malpractice by her assigned podiatrist. Problem practitioners are not being reported to the National Practitioner Data Bank, which allows them to keep working with patients elsewhere. They have also failed to ensure VA hospitals report disciplined providers to state licensing boards and have signed secret settlement deals with dozens of doctors, nurses and healthcare workers that included promises to conceal serious mistakes even after they were fired.  The VA has demonstrated that it is not capable of policing itself. To correct this situation we need an independent watchdog to perform regular VA facility audits and inspections and who will have control over the VA hospital rating system, so that veterans and their families will feel more secure in the care they are receiving. It will also be the job of the watchdog to report all settlements made by the VA for substandard care.

Create an online patient review system for VA medical facilities and providers:
In the interest of creating transparency in regard to VA medical care and in response to the recent trend of hiding substandard care by the VA, we will create an online patent review website where Veterans can research their provider and rate the care they received from both facilities and personnel.

Extend the Veterans exception to the statute of limitations for medical malpractice suits:
The Maine veteran who had her leg amputated because of malpractice did not know that malpractice had been involved in the loss of her limb until several months after the surgery. Officials at the VA hospital where she was initially treated admitted that her initial substandard care had been one of the reasons for her amputation.  She and five other Maine veterans are now suing the VA for fraudulently concealing that they received substandard care and were subjected to years of pain that hospital officials now say could have been avoided. The response of the federal government has been to move to dismiss the cases, arguing that the veterans waited too long to file the suits, even though the VA has admitted to the substandard care and that VA took years to notify the veterans that there were problems in their treatment. This is just one instance where the VA is being rewarded for delivering bad health care and hiding it. This miscarriage of justice can be avoided by creating a veterans exception to the statute of limitations which should not begin running until the veteran in question has been given all the information pertaining to their care.

Increase the percentage of women’s health based practitioners in VA facilities:
Almost 15% of veterans are women yet there are great gender disparities at the VA on a national level and a question of whether women veterans are getting equitable care. While Massachusetts is ahead of the curve in healthcare for women vets, there is still room for improvement. Additional funding is called for to increase the number of women’s health based practitioners in the VA as well as funding for such programs as daycare to accommodate women veterans with children.

More funding is needed in the area of housing for homeless veterans, in particular women veterans with children:
The most recent statistics tell us that there are close to forty thousand homeless Veterans in this country, a thousand of which live in Massachusetts. Many of our homeless veterans require specialized services to deal with issues such as post-traumatic stress disorder, traumatic brain injury, and service-related physical and mental health disabilities. To address this issue, more funding is needed for programs such as Home Front and Safe Haven, both of which provide assistance and residential services to highly vulnerable, chronically homeless veterans on both a transitional and permanent basis. Additional assistance is needed for women homeless veterans who can suffer the same service-related physical and mental health disabilities of their male counterparts, with the added complication of being the sole caregivers of children. In many instances, they find it necessary to be closer to school systems, daycare and medical facilities to name just a few of their special needs.

Allow Veterans to receive more college credit for their military training and experience:
Many colleges and universities eagerly recruit military veterans and the $10.2 billion a year in GI Bill benefits that come with them. But they are not necessarily supportive of the veterans once they get there. There are extra challenges confronting student-veterans, who are usually older than traditional-aged students and more likely to be juggling college with families, jobs, and service-related disabilities, and who often face significantly more red tape. Federal data shows an average of only 15 percent of full-time students receiving GI Bill money graduated with a two-year degree in 2014, the most recent period for which the figure is available. That includes those who took three years to do it—a particular problem considering GI Bill benefits cover a maximum of 36 cumulative months in college, which should be enough for a Bachelor’s degree but leaves little margin for error.  The proportion attending part-time that graduated within three years was 7 percent. This is ironic considering that a good percentage of veterans say they join up for the education benefits. Part of the solution to this of course is that we need to allow veterans college credit for military experience which would shorten the time and effort they need to get the degree increasing the likelihood that they will graduate. To aid in this goal we propose to enlist the Department of Education to work with our universities and colleges to create a college credit equivalency program for military training and experience.

Implement programs to help ease veterans transitioning back into civilian life:
We will launch a Public Service Announcement Program to educate the public regarding the benefits of hiring highly trained veterans and explaining the truth behind PTSD and non-reserve service members not being subject to recall into the military. In addition, we will establish workshops for Veterans to help them translate their military experience into a civilian resume as well as make it easier for Veterans to get civilian certification and licensing based upon their military training and experience. This goal will be accomplished by a state assessment of the equivalency of military training courses and the issuance of official state documentation to permit veterans with equivalent training and experience to receive certification by endorsement.