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TAMMY DUCKWORTH SAYS WOUNDED VETS SHOULD HAVE
ACCESS TO PRIVATE SPECIALISTS -- Chief of
Illinois Vets'
Dept. testifies before U.S. Senate Vets'
Committee.
Tammy Duckworth
Story here...
http://blogs.suntimes.com/sweet/
2007/03/tammy_duckworth_chief_of_illin_1.html
Story below:
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Tammy Duckworth, chief of Illinois Vet Affairs:
Tells Senate panel wounded vets deserve care from private sector.
WASINGTON--Wounded Iraq war vet Tammy Duckworth, now chief of vets
affairs for Gov. Blagojevich, told a Senate panel on Monday that the U.S
Department of Veterans Affairs is "is absolutely not ready to treat
amputee patients" at the same high level of care she received--and
should be allowed to get help from the private sector.
Duckworth, a Democrat who lost her bid for Congress from a suburban
House district last year, lost both her legs and wounded an arm after
her helicopter was shot down in Iraq.
This is an excerpt from Duckworth testimony, as prepared....
Prepared testimony......
Testimony for US Senate Committee for Veterans Affairs
27 March 2007
MAJ Ladda Tammy Duckworth, Director, Illinois
Department of Veterans’ Affairs.
Mr. Chairman, members of the committee. It is indeed a pleasure to be
here to testify. I am honored to have the opportunity to follow up on my
March 2005 testimony on the Seamless Transition from DOD to VA
healthcare.
When I last appeared before this committee, I was newly injured and
still an inpatient at Walter Reed Army Medical Center. The care that I
received and continue to receive at Walter Reed is above the best. The
personnel there are incredibly talented and dedicated. It is unfortunate
that they are not given adequate resources to support our Wounded
Warriors.
Since my last appearance, I have undergone the transition from DOD to VA
healthcare and have had an overall positive experience. However,
compared to the experiences of other service members, I know that my
mine is not uniform across the nation. Even before I left Walter Reed,
the USDVA representative had reached out to me and coordinated with the
OIF/OEF coordinator at Hines VA Hospital. I had an early tour of the
facility and met my future physicians. The one negative experience was
the prosthetics department, which, while eager to meet my needs, was
many decades behind in prosthetics technology. I now receive care at
Hines but also continue to return to Walter Reed. The staff at Hines
have been very helpful, and shown great initiative. For example, even
though my physical therapist at Hines had not treated a high-functioning
amputee like myself before, he prepared for my treatment by reaching out
and coordinating with my Physical Therapist at Walter Reed. Both
therapists did this of their own initiative.
I continue to return to Walter Reed for its prosthetics program. I also
travel to a specialist in Florida for state-of-the-art care. Recently,
Hines sent a prosthetist with me to Florida to learn about the high-tech
artificial legs that I obtain from the private practitioner there. He
was overwhelmed by the technology. The USDVA is absolutely not ready to
treat amputee patients at the high tech levels set at Walter Reed. Much
of the technology is expensive and most of the VA personnel are not
trained on equipment that has been on the market for several years, let
alone the state-of-the-art innovations that occur almost monthly in this
field. I recommend that the VA expand its existing SHARE program that
allows patients to access private prosthetic practitioners. There is
simply not enough time for USDVA to catch up in the field in time to
adequately serve the new amputees from OIF/OEF during these critical
first two years following amputation. Perhaps after the end of the
current wars in Iraq and Afghanistan, the VA will have time to advance
its prosthetics program.
In addition to medical treatment, Seamless Transition is also the
passing from one administrative program to another. The Seamless
Transition initiative needs to be expanded to each state’s VA, and more
importantly, local counties and municipalities. The current model for
Seamless Transition focuses on transition from the DOD to the USDVA
entities within the state. It is also important to involve each state’s
VA agency as there are many state programs that are unique to the state.
For example, in Illinois we provide Veterans’ Care, a health insurance
plan for veterans. We also provide additional funds for accessibility
modifications to disabled veterans’ homes. New benefits are added at the
state level more quickly than can be tracked by the USDVA. For example,
as of January this year, Illinois gives up to a $600 rebate on
employer’s state taxes for each Persian Gulf War, OIF or OEF veteran
that they hire.
One of the greatest difficulties for state VA agencies is the tracking
of returning service members who come home from active duty status. We
at the states only find out about these individuals if they self-report
to our agency. It appears that a significant difficulty with the
Seamless Transition between DOD and USDVA is the sharing of service
member’s information. The DOD and USDVA are still negotiating a
Memorandum of Agreement (MOA) for this process. Recently, the USDVA
announced a new program that was pilot-tested in Florida called the
Florida Seamless Transition Program. This program for sharing
information between USDVA and state VA agencies is just now being
expanded to other states. It basically allows wounded service members at
DOD medical facilities to voluntarily give permission to have their
contact information forwarded to their home state’s VA agency. Only
seven service members chose to participate, but this is an excellent
start.
A related aspect of information sharing between DOD, USDVA and state VA
agencies is the technical aspect of data sharing. The USDVA and DOD each
have their own excellent medical records keeping system. Unfortunately,
most state agencies that operate health facilities such as long-term
care facilities do not have electronic records keeping due to the
prohibitive costs. At the very least, the USDVA and the DOD should be
able to electronically share data so that the wounded service members’
medical records can simply be transmitted electronically once they enter
the USDVA healthcare system. If there are issues of patient privacy, the
records could be given to the service member on a CD ROM, to be turned
over at the patient’s discretion once they begin seeing their USDVA
healthcare provider.
Any Seamless transition program must also include comprehensive
screening for Traumatic Brain Injury (TBI), Post Traumatic Stress
Disorder (PTSD) and vision loss by both the DOD and the USDVA Health
Care systems. I know that efforts are underway to strengthen these
assessments by both the DOD and the USDVA. However, there is no standard
procedure in place to insure that all war wounded are screened
nation-wide.
Currently, there is an issue with TBI screenings. Some service members
who are not screened for TBI, are being identified as suffering only
from PTSD. However, it is possible to have both PTSD and TBI or either
condition alone. My concern is that service members with TBI are not
diagnosed and then return to civilian life without this medical
condition noted on their records. The symptoms of TBI can result in
inability to work or even aggression that results in homelessness and
entry into the criminal justice system. At that time, these veterans are
then often diagnosed as having PTSD and treated for PTSD even though the
main injury is TBI. What is significant about this situation is that TBI
and PTSD have many treatment methods that are the exact opposites.
One additional screening criteria that is critical is testing for vision
loss. At the Hines USDVA Hospital, all poly-trauma patients are
routinely screened for vision loss as soon as they enter the facility.
The result of these screenings is that 60% of the poly-trauma patients
at Hines have been found to have some form of functional vision loss.
Vision loss, an acute injury on its own terms, can also negatively
affect how patients perform on tests for TBI, which are heavily reliant
on vision. Hines is the only USDVA facility in the nation that conducts
routine screening of patients in its poly-trauma centers. This is
because it is the initiative of the excellent Blind Rehabilitation
program at Hines.
I would like to close by saying that I have had a surprisingly positive
transition to the VA system. I also understand that this may not be the
same across the board for all returning service members. There are
problems that can be resolved such as the establishment of standard
screening criteria for major injuries such as TBI, PTSD and vision loss.
I would also strongly urge this committee to consider eliminating the
two year window for free VA care for OIF/OEF veterans. This is a new
time limit that will limit veterans’ ability to access care for injuries
such as PTSD, which may not become evident until over two years after
their service. We have more work ahead of us, but much of it can be
resolved through information sharing, use of patient advocates, and a
willingness to access private healthcare specialists.
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Larry Scott --
