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Thursday, December 06, 2007

Confirmation Hearings Begin for Veterans Affairs Nominee James Peake

From AP:

Pledging to "do the right thing," Veterans Affairs nominee James Peake said Wednesday he will be an independent advocate for thousands of injured veterans and will fight for the needed funding for their care.

In a 2 1/2-hour confirmation hearing, the retired Army lieutenant general also vowed to work on making significant headway in fixing gaps in care and reducing delays in disability pay.

But Peake hedged on offering specific solutions, deferring to detailed briefings he will receive later if confirmed. He indicated his greatest mark on the agency in the waning months of the Bush administration might be improved communications with the Defense Department.

"I'm not much of a legacy guy," Peake said.

In educational interest, article(s) quoted from extensively.


Peake, 63, said as an Army surgeon general he on occasion clashed with an administration unwilling to provide adequate funding. Stressing that he believes in "working within the system," Peake said he eventually got the money by explaining "what we couldn't do."

"I understand I'm part of the administration," he said. "But I also have a responsibility to the administration and this committee to lay out the situation openly and honestly and to fight for the resources to do my job, which is to take care of veterans."

Peake also said he will closely consider a proposal — generally opposed by the VA — to guarantee a minimum level of annual funding. Veterans groups say that would shield the VA budget process from politics and eliminate future shortfall risks.

"I do have an open mind on the subject and intend to carefully study it," he said. ...

During the hearing, Peake also:

_Said he hoped to foster greater VA cooperation with the Pentagon in providing better treatment for mental health problems such as post-traumatic stress disorder and traumatic brain injury.

_Cited the sharing of medical records between the two departments as a "very high" priority. "I do believe we can make substantial progress" in 2008, he said.

_Said delays in disability pay — which average 177 days — could be reduced by "simplifying" the system, but did not offer specifics.

Peake has previously expressed support for a pilot program that was recently started at the recommendation of a presidential commission chaired by former Sen. Bob Dole, R-Kan., and former Health and Human Services Secretary Donna Shalala. The program seeks to eliminate duplication in the process at the VA and Pentagon.

_Expressed a commitment to improving veterans health care in hard-to-reach rural areas.

From the Los Angeles Times:

Peake is chief medical director and chief operations officer of QTC Management, a Diamond Bar company that contracts with the VA to perform physical exams of veterans seeking disability assistance. Murray has criticized Peake's nomination because of his ties to QTC. Peake told the senator that if he is confirmed, he will sever all ties with the company and turn over supervision of its contracts with the department to the VA's deputy secretary.

Throughout the hearing, Murray referred to horror stories of veterans with mental illnesses, including 22,000 who had been discharged because of "previous personality disorders" and thus lost access to the VA healthcare system. She said a third of all Iraq veterans have sought treatment for mental health problems and that veterans are twice as likely to commit suicide as other Americans.

Peake said outreach and education concerning mental health issues would be a top priority. "We don't want to be passive and wait for people to come to us sick," he said. "We have to reach out."

From the St. Louis Post-Dispatch:

Peake said he knew little about the 22,000 veterans who have been discharged for "pre-existing personality disorders." He told the Senate Veterans Affairs Committee that he was "aware of the issue" but needed to look into "the individual cases."

Sen. Patty Murray, D-Wash., a committee member and leading administration critic on the issue, said she found Peake's answers "disappointing."

Leaders of several veterans organizations at the hearing also said they were surprised by what they said appeared to be a lack of preparation by Peake, a physician who recently served as Army surgeon general.

"He's been in the system for a long time, he's an M.D., and he should be more knowledgeable about these issues," said Matthew Cary, president of Veterans & Military Families for Progress.

While major veterans service organizations support Peake's nomination, many of the same VSOs that do seemingly little to advocate for issues such as post-traumatic stress disorder or personality disorder discharges, another that does heavy lifting in this area is not behind Peake's nomination.

From Veterans for Common Sense:

While Peake comes with impressive military credentials, including combat duty and a Silver Star medal, he is very bad for VA and for veterans.

When it comes to fixing VA’s enormous systemic problems caused by Bush’s failures to fully fund VA, Peake’s lack of any VA-related experience will only exacerbate VA’s problems. Many people doubt Peake will be able to fully comprehend VA’s sprawling system of 1,400 medical facilities and 58 claims processing offices by the time Bush’s term ends in 14 short months. ...

Peake has no plan to make sure every veteran who needs to see a doctor sees one immediately – as veterans are regularly turned away from VA due to capacity problems. And Peake has no plan to promptly fix the surging backlog of 600,000 veterans waiting an average of six months for an initial VA disability claim decision – and waiting another dozen years if the veteran files an appeal.

[A]s the top Army general in charge of medical care at the start of [the] Iraq War, Peake failed to follow the law and make sure all our service members were given full medical examinations before and after deployment. Peake failed to raise the national alarm on the lack of body armor desperately needed by our troops. Peake failed to start programs to address the soaring number of veterans suffering from traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).

If Peake performed properly as Army Surgeon General, fewer unfit solders would have been sent to the Iraq War, only to commit suicide on the front lines. And if Peake had done his job, then screening for TBI and PTSD would have been in place in 2002, not in 2007, so veterans could get the best long-term out-patient medical care.

If Peake had done his job and worked with VA in 2003...then the Wall Street Journal would not have reported on the horrible and unconscionable treatment Jason Stiffler received in 2003 when the Army kicked him to the curb at Walter Reed without VA medical care and VA disability benefits. Stiffler suffered from TBI and PTSD, yet DoD and VA had no transition services.

In January 2004, Peake knew all the tragic details about the warehousing of hundreds of wounded combat veterans living for months without assistance in dilapidated quarters at Walter Reed, Fort Stewart, Fort Knox, and other posts because Bush and Peake went to war without a plan to care for casualties – now numbering 250,000 treated at VA hospitals. ...

After several government investigations and endless Pentagon promises, the military still does not provide VA with prompt or complete military service records and medical records so that VA can provide immediate healthcare and other benefits to disabled veterans.

Peake recently worked at QTC, VA’s deeply troubled disability claims exam contractor. According to one government report, QTC is responsible, in part, for failing to fix the enormous backlog of 600,000 disability claims. VA needs more qualified doctors and hard-working claims processors. VA must avoid more bloated and wasteful spending on contractors who are more interested in profits than in honorable public service helping our veterans. ...

The facts show hundreds of thousands of veterans are still waiting endlessly for their hard-earned disability benefits, and some veterans committed suicide after being improperly turned away from VA. At other VA hospitals, veterans are regularly turned away due to capacity problems. In the middle of two wars, Bush continues betraying our veterans by nominating unqualified leaders and supporting bad legislation.

Paul Rieckhoff, Executive Director for Iraq and Afghanistan Veterans of America (IAVA), has a few worthy questions for Peake.

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