N.H. Task Force Collecting Data for Recommendations on Veterans' Health Care

Nov 2, 2017

Al Montoya, interim director of the Manchester VA, speaks at a meeting of the task force looking at the future of healthcare for NH veterans.
Credit Peter Biello / NHPR

A task force looking at the future of health care for New Hampshire veterans wrapped up a two-day meeting on Wednesday. The task force was created to take the long-view on how veterans get their care from the Manchester VA, which has been embroiled in scandal since the summer. Morning Edition Host Rick Ganley spoke with NHPR's Peter Biello who attended the meetings.

(Editor’s note: this transcript has been edited lightly for clarity.)

So Peter, before we get into what the task force accomplished during this two day meeting, tell us what the committee was doing. Why did it exist?

It exists because of a report that first emerged in July, in the Boston Globe, that detailed whistleblower allegations of failures of leadership at the Manchester VA that that resulted in patient harm. There were cases of patients with myopathy whose conditions got so bad that some veterans ended up in wheelchairs. So as a result of this this report, VA secretary David Shulkin came to New Hampshire to address issues created by this, and by a pipe burst in July at the Manchester VA that ruined a bunch of floors. So Secretary Shulkin came. He appointed a leader in the New England region network to put this committee together to look at the future, to determine what the VA can do to better treat veterans in New Hampshire. So that's what this committee is all about.

And what was the committee looking at specifically?

Well the short answer is options. The longer answer is a little more complex. Over the course of two days, they brought in subject matter experts to comment on what options are available for say, primary care, rehabilitation, geriatric medicine, mental health, and several other areas as well. And they presented options, because this committee is all about looking at options rather than making a decision. So a bunch of the options were some combination of building up the Manchester VA by how much should they build it up, or how much should they rely on private doctors in the community to give veterans their care. And so they're coming up with a list of options, and they're expected to come up with some kind of recommendation. For example, one of the options that they're considering has to do with primary care, and it would involve combining two community based outpatient clinics, also known as CBOCs. They're looking for primary care, possibly combining the one in Somersworth and Portsmouth. But I can't stress enough that this is super early in the process. They haven't made any decisions yet. They are looking at options, collecting data and seeing what might be possible for veterans in New Hampshire.

Yeah, so no changes are forthcoming right now. The committee had a new co-chair at this meeting, Dr. Jennifer Lee. Who is she?

Dr. Jennifer Lee, a senior adviser to the secretary of the VA, she replaced Dr. Michael Mayo-Smith as co-chair of the task force. He's the director of the VA New England Healthcare System. He was the one Secretary Shulkin appointed to put the task force together. But he had to step back because of pressure from the congressional delegation here in New Hampshire. The whistleblowers had been saying that he shares some of the blame for what happened at the Manchester VA, because he knew about some of what was happening but did not act in a way that they felt was sufficient. So VA central office in DC said this committee should be independent of him. But the committee did hear from Dr. Michael Mayo-Smith during these meetings and he will remain an adviser to this committee.

And you've been reporting this week that Manchester VA officials are reporting that the culture change at the VA is underway.

Yes that's one of the things the whistleblowers complained about in July, is that everybody is in silos. Doctors of different disciplines don't necessarily talk to each other as much as they should. So apparently that is changing. Al Montoya, the Manchester VA's interim director, says not only is that changing, but it's also becoming a friendlier place. He does his rounds every morning walking around the medical center. He greets veterans at the door. He says the vibe is really changing. And of course, to be clear culture change, doesn't happen overnight. It's been a problem for the entire VA system, but it seems to be moving in a positive direction in Manchester.

So what's the committee's next move?

Well they're collecting a lot more data. The committee members had really good questions throughout the two day period asking for more data areas that the subject matter experts hadn't considered. So it seems like they're going to touch every corner of the issue here. They've got another meeting coming up on Nov. 13, and they're expected to make their recommendations by January 2018.