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Committee Discusses Mental Health, Care Delivery Issues at VA

During a Senate committee hearing, a former mental health administrator under the Department of Veterans Affairs told lawmakers that the culture of VA's mental health care system typically has focused more on meeting insignificant performance goals than on providing quality care to veterans, the Washington Post's "Federal Eye" reports (Vogel, "Federal Eye," Washington Post, 4/25).

Nicholas Tolentino -- a former Navy service member and employee at the VA Medical Center in Manchester, N.H. -- testified before the Senate Veterans' Affairs Committee, which conducted the hearing one day after a VA inspector general's report found that the department overstated its promptness in delivering mental health care.

According to Tolentino, top-level managers' pay and bonuses often were tied to the number of patients that their medical centers served. He added that at the New Hampshire medical center, managers instructed employees to "have contact with as many veterans as [they] can" even if they were not able to adequately serve them because the managers needed to justify their requests for federal funding (Norman, CQ HealthBeat, 4/25).

Linda Halliday -- VA's assistant inspector general for audits and evaluations, who also testified before the committee -- said VA medical facilities "need a culture change," adding, "They need to hold facility directors accountable for integrity of the data" (Vogel, Washington Post, 4/25).

Corrective Steps

William Schoenhard, deputy undersecretary of health for operations and management at the Veterans Health Administration, said that VA health administrators "fully embrace that our performance measures need to be revised" ("Federal Eye," Washington Post, 4/25). He added that an Office of Mental Health Operations would be established to oversee the departments' Mental Health Program.

In addition, administrators will visit each medical facility this year to review their mental health programs and have created a comprehensive plan to address scheduling issues. A work group also has been established to determine the best methods for measuring veterans' wait times. Schoenhard also said VA is hiring an additional 1,900 mental health workers to help alleviate the issue (CQ HealthBeat, 4/25).

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