What the VA can learn from the National Park Service
A recent trip to Grand Tetons NP and Yellowstone NP drove home the virtues of taxpayer dollars well spent. The National Park Service (NPS) budget of $3.09 Billion has to cover expenses for 63 National Parks, 429 sites, 85 million acres, all with only 20,000 employees. In Yellowstone alone, the NPS cares for over 300 species of birds, 16 species of fish, five species of amphibians, six species of reptiles, and 67 species of animals. In all, the NPS protects over 600 threatened and endangered species. And all on a shrinking budget and with fewer employees. Our experience was uniformly good.
The Veterans Administration has a budget of over $370 Billion to care for 9.1 Million Veterans out of a total population of 17.9 Million Veterans. The VA has 377,805 employees. They maintain 1,3480 health care facilities, and are supported by over 45,000 non-profits dedicated to helping Veterans.
Veterans report satisfaction with VA Healthcare; Benefits; Support Services; Specialized Care; and Community and Camaraderie. Because of our focus on preventing suicides, it is no surprise that we focus on the VA’s failing grades in the areas of healing brain wounds. The #1 priority in the VA right now is suicide prevention, yet the number of Veteran suicides since 9/11 has exceeded 151,000 and continues to climb. Traumatic Brain Injuries are still underreported and untreated. The yearly suicide rate for Veterans still remains above 17 per day, and families suffer right along with the brain wounded. So much for customer satisfaction.
In much the same way that the VA Office of Inspector General (OIG) performs independent oversight, the Center for Public Integrity (CPI) keeps tabs on scams in the not-for-profit world where billions of donated dollars are at stake. Their reporting on Veteran-help organizations is sobering. They record scams that continue, largely due to lack of oversight or even minimal requirements for how donations should be spent. The nation, in effect, relies on the good will and honesty of not-for-profits.
Kudos are due to the thousands of volunteers and truly dedicated individuals and organizations that minister to Veterans. That said, investigations by CPI revealed organizations spending large sums of donor money on lavish staff events, extravagant conferences, and high executive salaries, rather than directly supporting veterans. This included reports of lavish retreats at luxury hotels and excessive spending on travel and meetings. That, of course, if after all the “standard” overhead at those 45,000 not-for-profits that accumulate to hundreds of millions of dollars. Helping Veterans is a multi-billion dollar industry.
Mismanagement costs and growing insider and outside fraud contribute to VA budget hikes.
In this and every year, the average citizen wants to know about “results” and things as mundane as Return on Investment, Quality of Life of Veterans, and a reduction in the suicide rate among Veterans. It’s hard from the average citizen to know how the VA is doing unless you dig into OIG reports and talk to veterans, as we do, who are refugees from the pill-prescribing and talk therapy culture across the “mental health” bubble in the VA.
It’s easier for citizens to see how well the NPS is doing: visit the parks and experience the flora and fauna. Real bipartisanship is on display: visitors and wildlife coexist in a semi-permanent state of harmony due to a general political climate that accepts the nation’s devotion to national parks and preservation. NPS employees are on report every day, overseen by millions of Americans with a personal stake in the product.
The NPS has a complex and wicked set of problems: decreasing budgets and rising costs; over-tourism; lack of infrastructure; and climate change that threatens ecosystems with floods and wildfires, rising sea levels, blights and infestations. Yet the NPS continues to oversee a superior product to its customers and its charges.
The VA’s #1 priority is to provide timely, quality care to veterans and their families. This is especially true for veterans with brain wounds where the urgency of the opioid and suicide crises continue to afflict a shrinking customer base. Veterans are NOT receiving the care inside the VA that is available to a lucky few who have either the means or the good luck to discover the healing power of Hyperbaric Oxygenation for TBI/PTSD.
Ancillary casualties of the VA’s indolence about diagnosing and treating brain wounds are the Caregivers for the brain-wounded. The RAND Report America’s Military and Veteran Caregivers: Hidden Heroes Emerging from the Shadows, catalogs the myriad sacrifices made by spouses, families, and other Veteran caregivers: “43 percent of military and veteran caregivers to those 60 and under met probable criteria for depression; this is almost four times the rate of non-caregivers. About 20 percent of military and veteran caregivers in this group had thoughts in the past year about taking their own lives. This is also four times the rate of non-caregivers. Thirty-six percent felt that they needed mental health care but did not seek it.”
The Report pinpoints many of the costs that TreatNOW cataloged in Brain Drain two years ago. A key finding in that Report that would dramatically relieve the caregiver population, save money, prevent suicides, and improve the Quality of Life of Veterans states: Continuing with the failed VA pharmacology and talk therapy treatment protocols results in an estimated Veteran re-occurring annual lifetime economic impact of $4.7 Trillion. Over the 40-year lifetime of a TBI Veteran treating versus not treating brain wounds is less than 0.42 percent of the total impact cost to not treat all TBI Veteran.
If rangers in the National Park Service were experiencing among their wildlife populations the equivalent of what DoD and the VA call “the suicide epidemic”, they would not ignore immediately available solutions. They would move heaven and earth to understand the crisis, and find antidotes or vaccines, or any treatments that would save the wildlife. Yet the culture in the VA – their “arrogance of ignorance” – prevents Veterans and their caregivers from knowing about or receiving immediate help available with HBOT and other alternative therapies.
Imagine that. The scenario above mimics the words of former SEN Trent Lott during hearings on treating Veteran Brain wounds: “It’s funny in a sad way that I can get HBOT for my race horses but not for Veterans.” [NOTE: Equine use of hyperbaric oxygen therapy is a well-known and commonly used treatment for ailments, as it is for many other animals.]
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UPDATE: The University of South Florida in Tampa is now accepting applications for its clinical trial, Hyperbaric Oxygen Treatment for Veterans with Traumatic Brain Injury. Treatment with HBOT for veterans and active duty with TBI/PTSD is free, with a stipend for completing participation. No travel or per diem expenses are available.
BLACK BOX WARNING: The VA OIG evaluated allegations related to the care of a patient who died by suicide six days after a mental health appointment at the VA Tuscaloosa Healthcare System (facility).
The OIG substantiated that a mental health nurse practitioner failed to inform the patient of a mirtazapine-related suicide risk, complete required suicide screening, and closely monitor the patient after initiating mirtazapine. Administrative staff did not attempt to schedule the patient’s medication management follow-up appointment within two business days, as required.
The OIG proved that the social worker failed to sufficiently assess suicide risk, conduct lethal means safety counseling, and seek consultation. Facility staff did not arrange the patient’s PTSD treatment and the social worker received inadequate supervision.
The OIG substantiated that staff did not submit a consult for required traumatic brain injury evaluation.
PUBLICATION NOTICE: The Art and Science of Hyperbaric Medicine, Dr Jason Sonners and Dr Joe Dituri, NOW Publishing, 2024. Textbook on the off-label uses of HBOT.
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The TreatNOW Mission is ending service member suicides. Along the way, we have learned that we can end suicidal ideation, help end symptoms of PTSD, get patients off most of their drugs, and heal brain wounds to end the effects of BLAST injury, mild TBI Persistent Post Concussive Syndrome, and polytrauma from AHI and Burn Pits. Diabetic Foot Ulcers have become a major emphasis. www.treatnow.org
Heal Brains. Stop Suicides. Restore Lives. TreatNOW
Information provided by TreatNOW.org does not constitute a medical recommendation. It is intended for informational purposes only, and no claims, either real or implied, are being made.
