Leo Adam Biga's My Inside Stories

Very rarely do I write anything that even edges up on hard news.  This story from 2000 is one of those exceptions.  It had to do with complaints filed against the Omaha VA Medical Center and the watchdog role local veteran activists assumed in agitating for change and monitoring government responses and remedies.  The Department of Veterans Affairs has a spotty even inglorious and sometimes infamous track record in attending to the medical needs of servicemen, past and present, and horror stories abound of poor conditions and treament experiences in veterans’ facilities.  Of course, much good is done as well.  But given that problems persisted before the last solid decade or more of returning combat vets requiring care the problems have, from I gather, only mutiplied in the crush of patients overwhelming the system.

From the Archives: Veterans Cast Watchful Eye on the VA Medical Center                

©by Leo Adam Biga

Originally appeared in The Reader (www.thereader.com)

 
A Call for Action
Last September saw the release of a long-awaited federal report stemming from an investigation by the Department of Veterans Affairs’ Office of Inspector General into complaints about the Post Traumatic Stress Disorder (PTSD) program at the Omaha VA Medical Center. The investigation followed requests by Sen. Bob Kerrey, D-Neb., and Sen. Tom Harkin, D-Iowa, to examine complaints made to them, many in impassioned letters and phone calls, by veterans.

After the October 1999 investigation, nearly a year passed before the inspector general issued a 50-page report substantiating such concerns as insufficient staff, poorly coordinated services, long scheduling delays, inadequately administered drugs and a weak patient advocacy program. Other beefs, including allegations about negligent care, were not supported. Kerrey characterized the findings as showing “there are serious problems…inside an organization that is for the most part dedicated to high quality care.” The report made 16 recommendations for addressing the problems. Concurrent with the PTSD review the entire medical center was the subject of a routine comprehensive inspector general assessment, the timing of which may have been pushed up given the heat coming down from Washington, and its report surfaced more concerns and remedies amid overall good health care practices. In what was described as a coincidence, the center’s director and chief medical officer retired in June.

A hospital spokeswoman said the center has already implemented several changes and is on pace to complete others by target dates. Veterans who called for the initial study are pleased with some changes but assert old problems still persist. Todd Stubbendieck, legislative assistant in Kerrey’s Washington, D.C. office, said,
“Our understanding is everything is being implemented there. We’ve heard no additional patient complaints.”

Raising Hell
The reports, written in the cold, clinical language of bureaucratic Washington, mute the rage some veterans express at the insensitive and unresponsive manner in which they insist they’ve been treated. David Spry, vice president of the local chapter of the Vietnam Veterans of America, has become a mouthpiece and advocate for their discontent. His own experiences as a post traumatic stress disorder patient (in Lincoln), as a veterans legal custodial aide and as a past Veterans Advisory Committee member at the Omaha VA facility put him in a unique position to assess center practices and to glean feedback from the veterans community. Much of the discord has centered on a few key staff members and administrators and their perceived arrogance toward veterans. “They treated us with disrespect and that’s what a lot of the complaints are about,” Spry said. “It’s like, They’re the system, and we’re only veterans. What do we know? They thought we had no brain, no mouth, no nothing once we left their building, but we were comparing our notes about this place with other veterans groups.”

Spry turned veterans’ dissatisfaction into a cause that eventually got lawmakers and government oversight bodies to take action. For Spry, a Vietnam combat veteran, the process of getting officials to finally take seriously the red flags he and others originally raised more than three years ago has been an odyssey akin to battle. The role of whistle blower has taken its toll, too. “It hasn’t been easy. In 1997 we started to complain vigorously to VA management about this. We got nowhere. Our complaints never even got into the minutes of the meetings of the Veterans Advisory Committee. The things we were concerned about were problems we didn’t seem to be able to get corrected internally, so we went to a congressman,” he said, referring to former Rep. Jon Christensen (R-Neb.). Veterans aired grievances to Christensen and VA officials but, Spry said, little headway was made. “Then, when Christensen became a lame duck, we were kind of at a loss.”

Making the Case
That’s when, in 1998, Spry and fellow Vietnam Veterans of America service officers brought complaints, which grew in the wake of a national hospital accreditation survey, to the inspector general office, the Senate Subcommittee on Veterans Affairs and Kerrey. Spry said a year elapsed before Kerrey’s office took serious interest. Then, at the request of top Kerrey aides, Spry and his comrades were asked to gather veterans’ gripes and, once Kerrey saw the more than 100 letters of complaint, he asked the inspector general office to get involved. At the time, Kerrey said, “…this Vietnam Veterans post has made a persuasive case that something’s going on here that’s not good.” According to Spry, “This organization of ours really became quite passionate about this. We really pushed very hard. We had a lot of people looking into this and we finally got somebody to listen to us. It helped tip the scales when Sen. Kerrey came on board.”

Long before the inspector general weighed-in, the VA Medical Center followed-up its own internal program review by inviting the director of the VA system’s National Center for PTSD, Fred Gusman, to conduct an on-site assessment of the Omaha PTSD program in July 1999. Hospital spokeswoman Mary Velehradsky said, “We recognized we did have some systems problems as well as some patient care issues, and our inviting Mr. Gusman was a way to have another set of eyes look at that and to fix the problems and to make it a stronger program.”

Gusman’s findings of a “systemic problem” was confirmed by the inspector general, which included Gusman’s data in its report. He has made a follow-up visit to the hospital and, with inspector general staff, is overseeing program modifications.

A Thorn-in-the-Side
By the time the inspector general took a hard look at the Omaha facility, Spry said he was persona non grata with hospital officials. “I became a little too much of an irritant and they banned me from the facility except for medical treatment for my own service-connected disabilities. But that wasn’t good enough. They took away my freedom of speech, too. I am to have no contact with anyone or anyone with me. They’re doing anything they can to shut me up.” Veteran Tom Brady, who worked with Spry to document complaints about the center, said Spry has been singled-out: “Certainly, there are consequences to exposing practices that are subject to sanctions. He’s been one of the driving forces behind a lot of things and now they treat him like he’s a dangerous person.” Velehradsky confirmed the restrictions but added, “There are reasons people can be banned from a facility and I can guarantee you there was nothing connected to the IG (inspector general) incident.” She did not specify the reasons in this case.

As unofficial watchdogs, Spry and Brady chart the center’s progress in making changes. “We’re trying to monitor what’s going on, but we’re limited in going up there. From what we can tell, they have implemented a number of things that we’re really happy about. We’ve seen improvements in scheduling, in medications and in one-on-one therapy. We’ve seen a considerable difference in staff morale. The hospital is a lot happier.” But he and Brady remain critical of some program staff they feel lack expertise in working with PTSD patients. A psychologist whom the majority of complaints was filed against remains while a popular social worker has left. The two veterans also continue to be disenchanted with what they feel is the distant voice veterans have there. “We’re still not a cooperating partner — not because we don’t want to be,” Spry said.

According to Velehradsky the center has long had in place mechanisms for veterans to speak out with management and has recently increased these feedback avenues. She said the PTSD program has been strengthened with new procedures and the addition of specialized staff. She added recent patient surveys indicate high approval ratings and that veterans not wishing to be treated in the Omaha program have the option of being seen in a Lincoln clinic.

Standing Guard
It is perhaps inevitable disenfranchised veterans and entrenched VA Medical Center managers see things differently. Where Spry feels “it’s kind of a shame we had to go to this extent to push the bureaucracy around to get them to look at things,” Velehradsky said: “When you have an outside set of eyes look at your program and make recommendations it does make you stronger. We welcome it. It’s been very helpful and we continue to make improvements.”

While Kerrey has termed the VA episode a victory for veterans, the ever vigilant Spry remains wary and vows to carry on the fight if need be. His never-say-die attitude was formed as a Marine in Vietnam while under siege from overwhelming forces at Khe Sanh during the Tet Offensive in 1968. “I kind of made a commitment to myself and to the 1,500 of us who died at Khe Sanh that I don’t ever want to lose another battle again. And that’s why I’ve fought this (VA) thing. Have I been tenacious about this? I certainly have. All I want to do is make things better.”

Related articles

• Suicidal veterans may not be getting help they need (pri.org)
• Disabled vets increasingly cheated by fund managers (sfgate.com)
• Inspector General Report: VA Understates Delays In Handling Veterans’ Mental Health Claims (theveteransdisabilitylawfirm.com)
• Bill proposed to change PTSD military programs (thenewstribune.com)