Beto O'Rourke is a lawmaker from Texas who sits on the House Veteran's Affairs Committee
O'Rourke has run out of patience with Washington and has championed the El Paso VA to make changes on its own
The El Paso clinic's plan: Outsource more routine medical care so it can focus on combat-related situations and mental health
El Paso’s Democratic congressman was fed up with the way his local VA clinic was treating veterans.
The clinic has suffered some of the worst wait times in the country. It was ranked second worst in the country for access to mental health care as of June. It has been ranked near the bottom for patient satisfaction and overall access to care. And several veteran suicides here have disturbingly brought the point home.
Congressman Beto O’Rourke, a lawmaker who sits on the House Veteran’s Affairs Committee, had enough of it. Instead of waiting for the Veterans Administration to fix things, he is pushing his clinic to change.
He has fought for grant money to expand mental health services. He has pushed the local clinic to hire more medical professionals. And in a bold move that could change the way the VA delivers health care to veterans, he is urging the VA to outsource most of its routine medical care to local health care providers outside the VA system.
It’s a solution he brought to the table, he says, because no one at the El Paso VA or even at the VA headquarters in Washington seemed to care.
’I was very frustrated’
“I was very frustrated when it became obvious to me how bad the problem was and how little support we had within the leadership of the VA to transform El Paso,” he said.
O’Rourke has been focused on vets since he arrived in Washington in 2012. He has held town hall meetings every month since first elected. And as far back as 2013, a year before the VA scandal broke, O’Rourke was hearing from veterans in El Paso about terribly long wait times, especially in mental health.
He was hearing about problems with access to care and veteran suicides. O’Rourke says he thought he would get straight answers about the problems from the VA administration in Washington. He was wrong, he says.
“They would tell me, ‘Look, you certainly have some disgruntled, ornery veterans in El Paso. And we have them all over the country. But our numbers tell us confidently that we’re seeing veterans in your community within two weeks,’ ” O’Rourke said in a CNN interview.
That didn’t make sense to the congressman, and it didn’t jive with what he was hearing. So O’Rourke did what few congressmen had bothered to do. He did his own survey of vets in his town. The results showed wait times far exceeded what the VA was reporting, and worse, he was hearing personal stories of veterans committing suicide while waiting for mental health treatment.
Waiting and waiting and waiting
The story of Nicholas D’Amico weighed heavily on him.
Nicholas had just turned 45 in September 2013, when he could no longer bear living. For months, the Army veteran suffering from PTSD had been waiting for an appointment to see a psychiatrist, said his mother, Bonnie D’Amico.
“He’s not alone,” said his mother. “There are many, many men that are in his same boat. We had one psychiatrist, and she wasn’t available all the time. … She wasn’t available to him at all.”
Nicholas had been getting care at the Phoenix VA, but his illness forced him to relocate to be closer to his mother in El Paso.
It would be four months before her son would be able to see a psychiatrist in El Paso, his mother said. Then that appointment got pushed back even more. Nicholas grew angry, more depressed and even violent.
“There are guys that wait a year,” said D’Amico. “This is really – it’s a sin.”
The wait just became too much for her son. Days after his 45th birthday, Nicholas tucked his wallet, house keys and phone into his desert combat hat and left them on a mattress. He drove his jeep to the Trans-Mountain highway above El Paso and drove over a cliff.
“I think some people need to go to jail,” said D’Amico. “They knew what they were doing. They treated these men and women like they were doing them a favor to give them an appointment.”
A new effort to prioritize who gets treatment at the El Paso VA devised by O’Rourke and others comes too late for Bonnie D’Amico. The pain she feels is still almost unbearable. What keeps her going is the hope her son’s tragic end will be a beginning of a better VA.
A new way to handle patients
Under the new program at the El Paso VA clinic, those veterans with noncombat problems, such as more standard medical needs, will be sent outside the VA to community clinics or medical facilities in the area. And the VA instead will now strive to focus squarely on treating combat and military service related health issues.
“That could be a traumatic amputation, a loss of a limb. It could be military sexual trauma, traumatic brain injury, or post-traumatic stress disorder,” said O’Rourke.
“All other conditions that are comparable to what anyone in the civilian population might suffer from, diabetes, a cold, the flu, getting their teeth fixed,” O’Rourke added, “there are competent and excellent doctors who are able to take care of them.”
The program is just getting started, but veterans here seem to think it’s working. They shake hands with O’Rourke as he tours the facility and thank him for trying to improve their medical care.
O’Rourke gives much of the credit to the El Paso’s interim VA director, Gail Graham, whom he says is “unlike many people inside the VA.”
Graham, for her part, has been willing to fight for better care at the El Paso VA. But, like other VA managers across the country, at least publicly she defends VA care.
“I don’t think that the El Paso VA was ever a bad system,” Graham said. “I think there were published rankings where its placement was towards the bottom. But I think the quality of care here has never been in question.”
Including El Paso’s local health care community in serving veterans just makes sense, she said. “This is a very service-oriented community with a large percentage of veterans or veterans’ families,” Graham told CNN. “So I really think that embracing the community collaboration is really one of the big stories here in El Paso.”
Where’s the concern in Washington?
O’Rourke said he has not heard the same kind of concern from some fellow politicians back in Washington, from both sides of the aisle, whom he says have mostly moved on from the scandal, even though it in truth has not gone away.
He has imposed his own eight-year term limit on how long he will stay in the U.S. House of Representatives if he continues to be elected. That has given him freedom to speak freely, even against a Democratic President.
O’Rourke helped pass a $16 billion bill that sent emergency and long-term money to fix the VA’s problems, but he says the money did not end the crisis. It continues, he says, and fears his fellow politicians in Washington have already moved on.
“If Congress had been doing its job, it would’ve taken action much sooner than now. The same goes for the President and his predecessors. I don’t know, from his public comments, that he fully appreciates the severity of the crisis, especially in mental health, at a time when 22 veterans a day are taking their own lives, in many instances, because they could not access much-needed mental health care that they had earned. “
CNN asked officials at the Department of Veterans Affairs for a reaction to O’Rourke’s plan and what’s happening in El Paso, but they declined to comment.