Commission urges upgrades to veterans' care

updated 1:53 p.m. ET July 25, 2007

WASHINGTON - A presidential commission on Wednesday urged broad changes to veterans’ care that would boost benefits for family members helping the wounded, establish an easy-to-use Web site for medical records and overhaul the way disability pay is awarded.

The nine-member panel, led by former Sen. Bob Dole, R-Kan., and Donna Shalala, health and human services secretary during the Clinton administration, also recommended stronger partnerships between the Pentagon and the private sector to boost treatment for traumatic brain injury and post-traumatic stress disorder.

A 29-page report was presented to President Bush in the Oval Office, just after the Senate addressed some of the issues Wednesday morning by passing sweeping legislation to expand brain screenings, reduce red tape and boost military pay.

“Gone are the countless calls for appointments,” said Shalala, who said the proposals would provide more customized, personalized care to injured Iraq war veterans. “Gone are the days of telling the same thing to doctors over and over again.”

Bush said he has instructed Veterans Affairs Secretary Jim Nicholson and Defense Secretary Robert Gates to take all the recommendations seriously and implement the ones they have the power to enact. He called on Congress to make the recommended changes under its authority.

That way, Bush said, “we can say with certainty that any soldier who has been hurt will get the best possible care and treatment that this government can offer.”

About six of the 35 proposals require legislation, while the rest call for action primarily by the Pentagon and Department of Veterans Affairs. The expected price tag for the whole package was about $500 million each year, with added costs that could push it to $1 billion in later years.

'Need for fundamental changes'
Among the recommendations was an indirect rebuke of the VA — a call for Congress to “enable all veterans who have been deployed in Afghanistan and Iraq who need post-traumatic stress disorder care to receive it from the VA.”

Only recently, the VA has taken steps to add mental health counselors and 24-hour suicide prevention services at all facilities, after high-profile incidents of veterans committing suicide. In the past, the VA had failed to use all the money for mental health that was allotted to it.

“Making the significant improvements we recommend requires a sense of urgency and strong leadership,” the report read. “The experiences of these young men and women have highlighted the need for fundamental changes in care management and the disability system.”

The report does not seek to directly criticize or lay blame for shoddy outpatient treatment at Walter Reed Army Medical Center that brought a public outcry for change and creation of the commission. It cited a need to move forward, saying there was no need to “reiterate” the findings of news reports that uncovered substandard care by the Defense Department and VA.

Report details
Among the proposals:

• Boost staff and money for Walter Reed until it closes in the coming years. Also urges Pentagon to work with the VA to create “integrated care teams” of doctors and nurses to see injured troops through their recovery.
• Restructure the disability pay systems to give the VA more responsibility for awarding benefits.
• Require comprehensive training programs in post-traumatic stress and traumatic brain injuries for military leaders, VA and Pentagon personnel.
• Create a “My eBenefits” Web site, developed jointly by the VA and Pentagon, that would let service members and doctors access private medical information as the injured move from facility to facility to receive treatment.
• Provide better family support, because one-third of injured Iraq war veterans reported that a family member or close friend had to relocate to care for them. It calls for training and counseling for families of service members who require long-term care and improved family leave and insurance benefits for family members.

“We owe our wounded soldiers the very best care, and the very best benefits, and the very easiest to understand system,” Bush said. “And so they took a very interesting approach. They took the perspective from the patient, as the patient had to work his way through the hospitals and bureaucracies. And they’ve come up with some very interesting and important suggestions.”

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