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Wagner Sends Letter to Secretary Shinseki

May 21, 2014
Press Release

(Washington, DC) Today, Congresswoman Ann Wagner (R-MO) sent a letter to Secretary of Veterans Affairs, Eric Shinseki regarding recent allegations that the St. Louis VA system created an ‘artificial backlog’ for treatment of veterans seeking mental health care.  The letter is in conjunction with the recently announced Veterans Health Administration Nation-wide Access Review.  It provides specific questions to Secretary Shinseki regarding these allegations in the VA St. Louis system relating to mental health care access, and requests full transparency into their system and guidelines pertaining to mental health care scheduling:

May 21, 2014

The Honorable Eric K. Shinseki
Secretary of Veterans Affairs
810 Vermont Ave, NW
Washington, DC 20420

Dear Secretary Shinseki,

In light of recent allegations made regarding availability of mental health services within the VA St. Louis Health Care System, I am writing to urge you to look into these claims as part of your recently announced Veterans Health Administration Nation-wide Access Review.  These allegations, if true, suggest that mental health workers have not been working efficiently, only scheduling appointments for a few hours a day, and as a result are creating an artificial backlog for mental healthcare service.  If our veterans are unable to obtain timely mental health care, it can also potentially contribute to subsequent issues that my constituents have shared with me regarding high veteran suicide rates and under-treatment of pain management plans, resulting in overmedication in some cases.  For these reasons, it is absolutely critical that both veterans already in the system and new veterans returning from wars overseas are granted the treatment and attention they deserve.  

In terms of patient access for our veterans, the issue of productivity with specialty care providers within the VA system is a significant contributor, among many others, to the national scheduling crisis the VA faces when it comes to dealing with excessive wait times.  If federal workers who are being paid by taxpayers are not working efficiently and seeing as many patients as they reasonably can, it negatively affects the health and safety of our veterans while limiting patient access for those who need these important services, like mental health care.  Taking care of the health and well-being of our veterans who have given up so much for us and our country is of the absolute utmost importance to me.

While the VA is in the process of coming up with formal productivity standards for specialty care practices, I believe that there are steps that can be taken in the meantime to address these potential allegations and ensure that there is a system in place to make sure providers are allowing veterans timely access.  I ask that you look at this issue in the St. Louis VA system as part of your audit relating to access and additionally provide my office with the following information:

-    What percent of the mental health full-time-equivalent (FTE) workforce in the St. Louis VA system is providing direct patient care to veterans?
-    What is the status of the St. Louis VA system in implementing productivity and staffing standards for specialty care providers, particularly mental health care?
-    What standards are in place to assure reliable data is obtained regarding timeliness of access for mental health providers, specifically relating to demand for mental health services, treatments and providers; the availability and mix of mental health staffing; provider productivity; and treatment capacity?
-    What benchmarks and measures are available to decision makers for effective planning and service provision at the national, Veterans Integrated Service Network, and facility level in St. Louis in terms of access to VHA mental health care and how do they allow for analysis and comparison to each other?  How does this compare to the private sector?
-    What accountability and reporting provisions are in place to ensure that timely access to VHA mental health care is being attained in the St. Louis VA system and are there any data thresholds or other triggers in place that would prompt a review of process and/or protocol?
-    Please outline the specific steps the VA St. Louis Health Care System has taken following the VA OIG report of April 2012 that found the VHA’s first time access to full evaluations were not accurate or reliable, that follow up appointments for treatment were not scheduled within 14 days, that schedulers did not consistently follow procedures, and that mental health staff vacancies did not allow the VA to meet its goals and properly serve veterans? 

I appreciate and look forward to viewing your response to these inquiries.  In light of this allegation and others being made across the country, it is my duty as a US House Representative to ensure that veterans are receiving the proper care that they deserve.  


Ann Wagner

Member of Congress

CC:      Mr. Marc A. Magill, Acting Director VA St. Louis Health Care System
Chairman Jeff Miller, House Veterans Affairs Committee