The Department of Veterans Affairs (VA) committed to implementing several recommendations put forward in a February 2016 VA Inspector General report by last Friday, September 30, 2016; Days after that target date, the federal lawmakers are calling on VA leadership to provide more information regarding its efforts to address the crisis of veteran suicides

In a letter to VA Secretary McDonald, Klobuchar and the other members of Congress expressed their serious concerns regarding the “epidemic level” of suicides among veterans, and asked the VA to share what it is doing to ensure that veterans in crisis can turn to the Veterans Crisis Line

 

WASHINGTON, DC – U.S. Senator Amy Klobuchar, along with several other members of Congress, have urged the Department of Veterans Affairs (VA) to ensure that no call from a veteran in crisis goes unanswered. The VA committed to implementing several recommendations put forward in a February 2016 VA Inspector General report by last Friday, September 30, 2016. Days after that target date, the federal lawmakers are calling on VA leadership to provide more information regarding its efforts to address the crisis of veteran suicides. In a letter to VA Secretary McDonald, Klobuchar and the other members of Congress expressed their serious concerns regarding the “epidemic level” of suicides among veterans, and asked the VA to share what it is doing to ensure that veterans in crisis can turn to the Veterans Crisis Line.

“Troubling to us are recent reports showing that the Veterans Crisis Line (VCL) has not served as the beacon of hope it was intended to be,” the lawmakers wrote. “Instead, it has become yet another source of bureaucratic frustration for too many veterans - with one third of calls being diverted to an outside contractor, and many of those being directed to an answering machine or being put on hold. This is unacceptable and disingenuous to our veterans who have served in the armed forces and are in need of help.”

In addition to Klobuchar, the letter was also signed by U.S. Senators Johnny Isakson (R-GA), Richard Blumenthal (D-CT), and John Thune (R-SD) and U.S. Representatives David Young, Jeff Miller, and Mark Takano. The letter follows a recent VA report on “Suicide Among Veterans and Other Americans 2001-2014.” According to that report:

  • 65% of all Veterans who died from suicide in 2014 were 50 years of age or older.
  • Veterans accounted for 18% of all deaths from suicide among U.S. adults. This is a decrease from the 22% that was estimated in 2010.
  • Since 2001, U.S. adult civilian suicides increased 23%, while Veteran suicides increased 32% in the same time period.  After controlling for age and gender, this makes the risk of suicide 21% greater for Veterans.
  • Since 2001, the rate of suicide among US Veterans who use VA services increased by 8.8%, while the rate of suicide among Veterans who do not use VA services increased by 38.6%.
    • In the same time period, the rate of suicide among male Veterans who use VA services increased 11%, while the rate of suicide increased 35% among male Veterans who do not use VA services.
    • In the same time period, the rate of suicide among female Veterans who use VA services increased 4.6%, while the rate of suicide increased 98% among female Veterans who do not use VA services.

Klobuchar has been a leader in the fight to improve mental health care for our nation’s soldiers. She recently cosponsored the bipartisan No Veterans Crisis Line Call Should Go Unanswered Act, which would improve the Veterans Crisis Line. Last year, legislation she cosponsored to help prevent veteran suicides was signed into law by the President. The Clay Hunt Suicide Prevention for American Veterans Act helps expand access to mental health services for veterans by establishing a loan repayment program to help the VA recruit more psychiatric specialists, enhances resources for veterans transitioning into civilian life, and improves the VA’s ability to address traumatic brain injuries. She also introduced the Service Member Mental Health Review Act in 2013 to help veterans who may have been discharged with improper mental health diagnoses get their records corrected and their benefits restored. In June, Klobuchar and Senator Joni Ernst (R-IA) introduced a bipartisan bill that would establish a patient self-scheduling appointment system at Veterans Affairs Medical Facilities. The bipartisan Faster Care for Veterans Act would direct the Secretary of the VA to commence a pilot program under which veterans could use the internet to schedule and confirm appointments for health care at VA medical facilities.

The full text of the lawmakers’ letter is below:

Dear Secretary McDonald,

The recent release of the Department of Veterans Affairs’ (VA) report on “Suicide Among Veterans and Other Americans 2001-2014” confirmed what we have all believed – the incidence of veteran suicide is at an epidemic level. Finding and implementing all possible remedies to prevent these tragedies must be the top priority of VA. Most urgently, veterans must be able to reach assistance during episodes of crisis, which is why the Veterans Crisis Line (VCL) is so vital. Troubling to us are recent reports showing that the VCL has not served as the beacon of hope it was intended to be. Instead, it has become yet another source of bureaucratic frustration for too many veterans - with one third of calls being diverted to an outside contractor, and many of those being directed to an answering machine or being put on hold. This is unacceptable and disingenuous to our veterans who have served in the armed forces and are in need of help.

These complaints were substantiated in a February 2016 report from the VA Inspector General (VAOIG). The report included seven recommendations; your agency concurred with these and committed to implementing them by September 30, 2016. As that date has now passed, we ask you to confirm that you have met this commitment, and we seek your input on how Congress and VA can work together to strengthen the VCL and ensure that it has the resources necessary to perform its urgent mission.

 

We would also like to bring your attention to provisions in the government funding bill enacted at the end of last month, P.L. 114-223. These provisions require VA to provide individuals who contact VCL with the immediate assistance of a trained professional and to adhere to all relevant requirements of the American Association of Sociology. Both the statutory nature of these requirements and the purpose they serve necessitate VA’s compliance without delay.

Hiring additional personnel for the VCL facility in Canandaigua, New York, as we know VA has recently done, is an important first step. So too are your efforts to open a back-up call center in Atlanta, which is scheduled to start taking calls next month. Your push to increase monitoring for efficiency and quality assurance, and to establish a Clinical Advisory Board to share best practices are crucial to improving services at the VCL. However, given the millions of calls placed to the VCL each year, and the crucial nature of timely intervention, we must do more to ensure – without delay – that no call goes unanswered.

By October 15, 2016, we respectfully request that you that you confirm compliance with the new legal standard established in P.L. 114-223. we also ask that you provide the information requested below no later than that date, so that we may be assured VA has addressed the deficiencies identified by the VAOIG:

  • Please provide the dates upon which VA completed, or plans to complete, each action item identified in VAOIG’s recommendations.
  • Please provide a copy of the draft VCL Veterans Health Administration Directive and draft VCL Employee Handbook.
  • Please provide the algorithms developed to provide guidance during the emergency dispatch process.
  • How is VA ensuring that the steps put in place to address concerns about services provided by contractors - contract modifications and a Quality Assurance Surveillance Plan for the back-up call center – will be adequate?
  • What quality assurance measures has VA put in place for the VCL?
  • How many employees have completed the new employee orientation?
  • Does the VCL provide individuals who contact VCL with the immediate assistance of a trained professional and adhere to all requirements of the American Association of Sociology, as is now legally required by P.L. 114-223? If not, how and by when will VA ensure that it meets this statutory obligation?

As important as it is to ensure veterans in crisis can turn to the VCL, many more reforms are required to address veterans’ suicide - including telemedicine for mental health consultations, improvements to housing assistance programs, and reforming the broken benefits appeals process. We remain eager to work with you to comprehensively address this crisis. We look forward to your confirmation that VA has completed the VAOIG’s recommendations and complied with its statutory obligations.

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