Shulkin seeks to increase service and accountability at Veterans Affairs

On Thursday, Nov. 2, Dr. David Shulkin, Secretary of the U.S. Department of Veterans Affairs, will deliver the 2017 Disabled American Veterans (DAV) Distinguished Lecture at Harvard Law School. This is the fourth annual event in the DAV Distinguished Speaker Series, which provides a forum for national leaders to address the critical issues facing our nation’s disabled veterans and to engage in conversation with the local community. The series is co-hosted by the Veterans Legal Clinic at the Legal Services Center of Harvard Law School and the Harvard Law School Armed Forces Association.

Poster promoting Disabled American Veterans (DAV) Distinguished Speaker Lecture event The 2017 DAV Distinguished Lecture event will be held at 12 p.m., in Milstein East B on the second floor of Wasserstein Hall on the Harvard Law School campus. The event is open to the public.


In advance of his visit to the law school, Secretary Shulkin answered a few questions about the Department of Veterans Affairs and its service to veterans:

A VA study found that 20 veterans commit suicide each day. What is the Department of Veterans Affairs doing to increase the availability of mental health services for all our veterans? And what is being done to increase the availability of these services for individuals who — due to PTSD or other mental health issues developed while in service — may have left the military with less than honorable discharges and are therefore may not be eligible for existing veterans benefits?

Dr. David Shulkin, Secretary of the U.S. Department of Veterans Affairs

Credit: U.S. Department of Veterans Affairs Dr. David Shulkin, Secretary of the U.S. Department of Veterans Affairs

Nothing is more important to me than making sure that we don’t lose any veterans to suicide. Twenty veterans a day dying by suicide should be unacceptable to all of us. This is a national public health crisis and it requires solutions that not only VA will work on but all of government and other partnerships in the private sector, nonprofit organizations.

Within weeks of becoming Secretary, I authorized emergency mental health services for those who were less than honorably discharged. That  population of veterans is at very high risk for suicide. Under this initiative, former service members with an OTH (Other Than Honorable) administrative discharge may receive care for their mental health emergency for an initial period of up to 90 days, which can include inpatient, residential or outpatient care. During this time, VHA and the Veterans Benefits Administration will work together to determine if the mental health condition is a result of a service-related injury, making the service member eligible for ongoing coverage for that condition.

How is the Department of Veterans Affairs responding to the changing nature of warfare and science and its effects on the health of veterans? For example, improvements to how our military triages injuries in battle mean that more veterans are returning home after service rather than dying in battle, but they have much more complex physical and psychological injuries.

Advances in emergency, trauma and general medicine at the Department of Defense have improved the survival of seriously injured service members. It starts with the training of an entire team, from combat medic to the surgeon and those providing care during and after evacuation. It is truly an amazing system. As a result, many veterans seen from the most recent wars in Iraq and Afghanistan are coming home with multiple and more severe long-term injuries. In addition, these veterans are experiencing some injuries at higher rates than seen in past wars, including Post Traumatic Stress Disorder (PTSD), amputations and Traumatic Brain Injuries (TBI). VA has in turn improved its ability to better diagnose and treat these conditions in veterans who fought in previous wars; such as the case of PTSD in Vietnam-era veterans. Advances in prosthetics, medical and mental health treatments have also improved the quality of life for veterans with these conditions.

The effects of environmental toxins on service members are much better understood today than they were years ago. How is the VA addressing these challenges?

VA works closely with its counterparts at the Department of Defense and the Centers for Disease Control for a synergistic approach to care and for sharing of information, joint campaign efforts and studies on environmental exposures. We have a better understanding of the implication of environmental toxins such as Agent Orange, burn pits and environmental hazards. VA is a leader in efforts to research, diagnose, monitor and treat these exposures and this will likely have implications for civilian environmental exposure concerns as well.

In your role as Secretary of Veterans Affairs, you head the largest integrated healthcare system in the U.S. Coordinating the safety, availability and quality of care in such a large system is complex. Recent news stories report on serious incidents of substandard care, including in the New England area at the VA hospital in Bedford and at a facility in New Hampshire. What is your approach to addressing these issues?

I have made clear that the VA will hold employees accountable when the facts demonstrate that they have failed to live up to the high standards taxpayers expect from us. In May, I established the VA Office of Accountability and Whistleblower Protection to help protect employees who expose problems and assist in using all available authorities to discipline or terminate any VA manager or employee who has violated the public’s trust and failed to carry out their duties. In June, the President signed into law the VA Accountability and Whistleblower Protection Act — this is an important step forward for our modernization of VA. It allows us to hold ourselves accountable for the work we do for our veterans. Recently, VA became the first agency to post information on employee disciplinary actions online.

VA is posting online wait times for every one of our 168 Medical Centers across the country, which is updated on a weekly basis. No other health system in the country has done anything like that, and no one is as transparent as we are.

Regarding the Bedford facility mentioned above, once I heard of the incident I reminded Veterans Health Administration leadership that I expected them to make decisions involving employee accountability independently in the interests of veterans. Since I was made aware, the VA has taken a number of actions on this issue.