VA Failing – Troops Suffer

Vets face long wait for care

Funding shortfalls, closed clinics keep many from needed drug or alcohol treatment.

By Gregg Krupa / The Detroit News
Scott Erskine / Associated Press

William Maxwell couldn’t find the help he needed in Detroit. “You know what they told me? If I am not chemically dependent, go home.”

• The U.S. Senate and House of Representatives must reconcile two supplemental appropriations. The House approved $975 million in additional spending, $525 million less than the U.S. Senate approved last week. But the country faces an additional deficit of $1.1 billion to $1.5 billion in veterans’ health care programs for 2006.

• U.S. Sen. Debbie Stabenow, D-Lansing, said that to avoid the annual tussle over spending on veterans’ health care, she will author legislation this summer to require that all veterans receive such services, with mandatory financing similar to how the Medicaid program works for people 65 years and older. “It’s called a mandatory spending category, meaning it would be viewed like Medicare, meaning you would service whoever is qualified,” Stabenow said.

• The American Federation of Government Employees, Local 933, continues to meet with officials at the John D. Dingell VA Medical Center to pursue complaints over contractual issues involving the closure of the inpatient substance abuse unit.

Despite warnings that more soldiers will need health care as they return from Iraq and Afghanistan, a substance abuse clinic that treated a dozen Michigan vets daily has been shuttered as part of an effort to close a $2.6 billion national deficit in health care programs for veterans.

That has left veterans with drug and alcohol problems scrambling for help that many cannot afford or find nearby.

“We told them,” said Marine Lance Cpl. Nathaniel Ganzeveld of Dearborn, who said he waited almost a year for adequate substance abuse care and other services.

“They didn’t listen. They made us all of these promises, and we’re still waiting for help.”

Since last summer, veterans in Metro Detroit and across the country have complained of waiting months or years for adequate medical services such as treatment for post-traumatic stress disorder, substance abuse and physical therapy.

The Veterans Administration repeatedly denied that its health care was inadequate and, in April, the Bush administration said the VA didn’t need the money; 220 Republicans in Congress opposed a bill originating in the Senate that would have provided $1.97 billion to improve services.

Then, last week, Veterans Affairs Secretary Jim Nicholson did an about-face: He told Congress that his department faces a $1.5 billion deficit in health care this year, and the prospect of a $1.1 billion to $1.5 billion deficit in 2006.

Both chambers scrambled to approve new spending by unanimous votes.

Within 24 hours of Nicholson’s dramatic testimony before the Senate Veterans Affairs Committee, the Senate approved a $1.5 billion supplemental appropriation for health services for veterans.

The House then approved a $975 million appropriation. Veterans are now waiting for the two versions to be reconciled, and the issue is far from settled.

How to help

The vets and their advocates say the human cost already is clear. What is unclear is when, or if, the additional spending under consideration in Washington would enable veterans’ health care services to catch up with demand, or whether the substance abuse clinic in Detroit at the John D. Dingell VA Medical Center would reopen.

The government no longer disputes veterans’ claims that they need more health services. Nicholson’s VA, which 10 weeks ago said 23,553 veterans of Iraq and Afghanistan will seek medical care, last week said the number is more like 103,000.

The surge in demand for VA health services also is supported by a report in the New England Journal of Medicine revealing that the number of cases of post-traumatic stress disorder is 15 percent to 17 percent higher for veterans of the war in Iraq than for veterans of Afghanistan. Substance abuse often follows post-traumatic stress, doctors say.

Nevertheless, veterans say that health services for vets of all ages remain in short supply. When the inpatient substance abuse program at the John D. Dingell VA Medical Center in Detroit closed in May, for example, some of its services folded into a ward for the mentally ill. But veterans who need the substance abuse services say they do not belong in a mental ward.

“Every time I go down to the VA, I try to get into the methadone program and they keep telling me it has a waiting list for over a year,” said Ganzeveld, 23. He traces his problems with substance abuse to morphine-based drugs prescribed for a serious back injury he suffered in combat, as well as to the post-traumatic stress disorder with which he has been diagnosed.

“Then they wrote me a letter and said the (Dingell) clinic is closed. Then they told me to go to Herman Kiefer (Hospital). And Kiefer says, ‘We can’t take you because you don’t live in Detroit.’ They gave me another number. I call them and they tell me, ‘You have to go back to the VA.’ I tell them I just got back from Iraq, and that Iraqi vets were going to be on top of the list for this because the conflict is still going on.”

The VA hospital in Detroit has reduced an $8 million operating deficit to $3 million, officials say.

“Everyone knows there’s no services because there’s no money,” said Ganzeveld, who is at home in Dearborn but could be redeployed to Iraq. He says he struggles through pain, post-traumatic stress disorder and substance abuse as he tries to save his marriage and rebuild his life after risking it for his country.

Ann Talbot, a spokeswoman for the Dingell hospital, said the clinic was eliminated to achieve “efficiencies.” But she denied that veterans in need of substance abuse assistance have been turned away.

“We consolidated our units and decided we could be more efficient and treat people better in one larger unit, than to have two big units,” Talbot said.

Keeping promises

U.S. Sen. Debbie Stabenow, D-Lansing, worries that America is breaking a promise to the men and women who drove Saddam Hussein into his spider hole and took Afghanistan from Osama bin Laden’s allies, the Taliban.

“What concerns me most is that when men and women sign up to protect and serve us in the military or the National Guard, we say they will have access to health care when they come home,” said Stabenow, who for months urged more spending. “There should be no debate about whether there will be adequate health care services for veterans.

“In Michigan, veterans are waiting up to six months just to see a doctor. And many of them are having to drive several hours.”

William Maxwell of Detroit said he had to move to Battle Creek, home of the Battle Creek VA Medical Center, this year in search of adequate services. He is still looking.

Like other Vietnam veterans, Maxwell, 53, says he has been grappling with post-traumatic stress disorder for more than two decades.

“I’m not a blight on society,” Maxwell said. “I worked at GM for 20 years, everything from janitor to management, and I am trying to get back there. But my (post-traumatic stress disorder) has caused me some problems and I can’t get back in.”

In a sequence of events that veterans and their advocates say is often repeated, Maxwell first sought care for the stress disorder at the VA hospital in Detroit. He was told repeatedly that services were unavailable. “You know what they told me? If I am not chemically dependent, go home,” Maxwell said.

He took a drug test and, when no substances were found, a worker at the hospital motioned him aside with a suggestion that veterans with post-traumatic stress disorder say they often hear.

“I was made to realize that if I got high, I would get help,” Maxwell said. “So, I got high.”

But he still did not get help in Detroit, because the Dingell clinic closed in May.

Maxwell then moved to Battle Creek and enrolled in the program there. But the hospital recently terminated his substance abuse services, saying Maxwell had consumed alcohol — which he denies.

Feeling the impact

Meanwhile, fights reportedly have broken out in the mental health ward in Detroit since the consolidation of services. The Veterans Affairs Police have had to respond to the unit a few times, hospital employees say.

“Those two groups don’t belong together, and there’s been some trouble,” said William Scott, president of Local 933 of the American Federation of Government Employees, which has complained about the change of work conditions for its employees without proper notice.

Scott and others say hospital administrators intentionally reduced the number of veterans in the substance abuse program before closing it.

Talbot denied that. But she said she is aware of at least some tensions among veterans caused by the consolidation.

“There has been some bickering in the unit,” she said. “But I am not aware of a fight breaking out — although it may not have been reported.”

You can reach Gregg Krupa at (734) 462-2296 or [email protected].

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I’m going to be posting more of these stories, because we really need to spread awareness of the fact that we’re hanging these returning soldiers/marines out to dry. When a person suffering from post traumatic stress disorder abuses alcohol or drugs, the government has a responsibility to help them cope. Whoever ends up in jail and was denied treatment is someone the government put there.

But this is a drop in the bucket. Here in California, Nicole Parra, a State Assembly member, has introduced legislation that could be a model across the country. It authorizes judges to refer veterans diagnosed with post-traumatic stress and convicted of a crime — including drug offenses — to treatment programs instead of jail. The legislation itself simply extends a 1982 law designed to help Vietnam vets to include soldiers who fought in Iraq and Afghanistan. But what is promising is that it was introduced by Parra, who has traditionally been something of a drug warrior. It’s not exactly Nixon going to China but it is indicative of a subtle shift in the political and cultural wind. Noting that so many Iraq vets are coming home psychologically damaged, Parra says: “The question then becomes, do you incarcerate a soldier with a mental illness if they commit a crime or do you treat them so it doesn’t happen again. I say you treat them.”

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