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VA's Top Health Official Doesn't Know Why VA Remains Without A Secretary

Oct 24 2007

Under Questioning from Sen. Murray, Dr. Michael Kussman cannot provide reason for absence of VA Secretary during time of war; Challenges accuracy of recent reporting on waiting times for veterans with Traumatic Brain Injury

Listen to Audio of Murray questioning Dr. Kussman

(Washington, D.C.) – Today, U.S. Senator Patty Murray (D-WA) questioned the Department of Veterans' Affairs' (VA) top health official, Dr. Michael Kussman, about why a nominee for VA Secretary has still not been selected by the Bush Administration. Senator Murray also questioned Dr. Kussman on a Charlotte Observer article which found that Iraq and Afghanistan veterans suffering traumatic brain injury, multiple wounds and serious illnesses were waiting longer for appointments than the VA's 30-day standard. The questioning was part of a Senate Veterans Affairs Committee hearing. Senator Murray is a senior member of the Senate Veterans Affairs Committee.

VA Remains Without a VA Secretary

The VA has gone without a Secretary nominee since Secretary Jim Nicholson announced his resignation on July 17th. Senator Murray is deeply concerned about what this vacancy means for a VA facing many challenges and desperately in need of strong leadership. Senator Murray is also concerned about what this vacancy says to veterans and active duty troops at a time of war.

Senator Murray:

"We've been three months without a nominee and I'm beginning to hear from a lot of veterans who are very, very concerned that a lack of a nomine signals that the Administration doesn't have a priority for veterans at a time when we are at war and we have issues with wait times, mental health, an all the other things this committee has been discussing.

"Dr. Kussman, Do you have any idea why we have not had a nominee sent over for Secretary of Veterans Affairs?"

Dr. Kussman:

"No, Senator I don't. But I can assure you were still doing our jobs."

Murray went on to say the "We need someone who's going to stand up for our veterans at a time of war."

Wait Times for Veterans with Serious Injuries

Senator Murray also questioned Dr. Kussman about a Charlotte Observer article  that brought to light troubling revelations about health care appointment wait times for veterans with serious injuries.

Senator Murray:

"I was really discouraged a see this and I was even more disc to see the vas response to that report was attacking their own data saying the reports  can't be used to judge service because they don't show all appointment… I am compelled to ask you why is the VA spending money on these reports?"

Dr. Kussman:

"We believe that their interpretation of the data did not reflect what was going on."

Dr. Kussman said that he believes that 95% of VA patients receive appointments within 30 days. He could not provide an exact reason why the Charlotte Observer story was inaccurate he said that he wasn't sure but that it may have been an issue of how the data was interpreted and whether data was being analyzed as a snapshot or a continuum.

Senator Murray:

"It's not just a newspaper article. We continue to hear that from our veterans. They don't care whether they are a snapshot or a continuum."

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Senator Murray's opening statement from today's hearing follows:

Chairman Akaka, thank you for holding today’s hearing. 

Mr. Chairman, Veteran’s Day is only a few weeks away.  Many of us go home to our states and celebrate the day with veterans at remembrance ceremonies and events. But Veteran’s Day is not just a ceremonial holiday.  It’s also a time to ask if we have done enough for those who served our country. 

And that’s a very timely question today with so many new veterans coming home every day from places like Iraq and Afghanistan – and with an aging population of veterans, who need more care. When these brave men and women signed up to serve our country, we agreed to take care of them. They kept their part of the bargain.  Now we need to keep ours.

Today’s hearing is, in essence, about this country keeping its commitment to our veterans and ensuring that we are giving them everything they need. And it’s the third legislative hearing held by this committee.  The Veterans’ Affairs Committee held two previous legislative hearings several months ago, when we considered other benefits and health bills. 

Many of the bills that were considered during those two hearings were eventually included in the health and benefits omnibus bills that have passed out of this committee and are awaiting floor time. The fact that we have had to schedule a third legislative hearing is, I think, a real testament to the amount of concern members of this committee have about the way the VA is being run.

Near the top of that list is the VA’s ability to care for veterans with mental health problems. Last week, USA Today reported that the number of Iraq and Afghanistan veterans seeking care for Post Traumatic Stress Disorder at the VA increased by almost 70 percent last year. 

And unfortunately, that number of returning veterans with PTSD and other mental health ailments is probably too low. Many service members and veterans don’t seek care because of the stigma surrounding treatment, or because they fear that a mental health diagnosis will hurt their career.

As troops are deployed overseas for their third, fourth, and now even fifth tour of duty, the likelihood of PTSD and other mental health conditions increases. We have all heard about the lack of providers across the country and the lengthy delays in getting an appointment.  The VA is facing some real challenges on this front. 

The two mental health bills being considered today provide slightly different approaches to dealing with this challenge, and I look forward to hearing from today’s witnesses about which approach they think will work best.

I’m also looking forward to discussing a bill I introduced earlier this year, which would ensure that the VA is prepared and equipped to deal with what may be one long-term effect of Traumatic Brain Injury – the occurrence of epilepsy.

My bill would establish six epilepsy centers of excellence in the VA system.  It’s based on the successful MS Centers of Excellence and Parkinson’s Disease Research, Education and Clinical Centers already operated by the VA.

At a May hearing in this committee, Dr. John Booss – a former national director of neurology at the VA – testified that VA-funded research, done with the Department of Defense, found that more than half of veterans who suffered a penetrating TBI in Vietnam developed epilepsy within 15 years. 

For these veterans, the relative risk for developing epilepsy more than 10 to 15 years after their injury was 25 times higher than non-veterans in the same age group.

Dr. Booss expressed strong concern that the VA lacks a national program for epilepsy with clear guidelines on when to refer patients for further assessment and treatment of epilepsy.  He urged the committee to create a network of epilepsy centers of excellence.

It’s too early to determine the impact of TBI-induced epilepsy created by the Iraq and Afghanistan wars.  But we know from past wars that many injuries associated with service take years or even decades to develop.

This bill will ensure that the VA is prepared to care for those veterans who need care down the road.   And I hope to work with my colleagues to make this important idea a reality soon.

Thank you Mr. Chairman.