Veteran Suicide & Choice Care

As sad and horrific as the story reads (below) on Veteran suicide, it really is nothing compared to actually knowing these folks.
What strikes me as a clinician treating these widows and surviving loved ones is that they are all part of a community.
They hold jobs, with bosses and co-workers and clients. There are in-laws and grandparents,teams and clubs that their Veteran was a part of, banks and pediatricians, siblings, college buddies, kid’s preschool teachers and neighbors  – all impacted by the Veteran’s suicide.
Their suicide reads like a walking advertisement for systemic mental health failure.
By the way, this article was more than three months in the making; well-vetted and sensitive to the interviewees.
I hope military reporter Jeanette Steel receives meaningful journalistic recognition for this important piece (see below).


And from my colleague, Wendy Belding, M.F.T.:

     I am devastated and heartbroken reading this article. I look at these faces and think, "I could have helped."
     As many of you know this past Summer TriWest (the company managing the Choice program for the VA) realized that Licensed Marriage and Family Therapists (LMFTs) were not supposed to be covered by Choice because they (we) are not eligible to be providers on Medicare. So TriWest/Choice completely discontinued any referrals to Licensed Marriage and Family Therapists (LMFTs). TriWest went back to the VA and stated that Marriage and Family Therapists comprise 80% of the providers that they have been referring to. Since then TriWest and the VA have been in contract negotiations trying to figure out a waiver. In the meantime my practice has been short 10 clients (almost all of my referrals have been from the VA since 2010). I could take 10 clients right now from the VA but I won't be able to because the contract negotiations have not been settled. This is true for many of my LMFT colleagues too. Please contact your representative and let them know the importance of Licensed Marriage and Family Therapists providing care for Veterans. We can save lives and we do.
This link will help you find your local political representative
Wendy Belding, LMFT 

*REPOSTING My Blog and E-blast from 4/15/15*

Dear Mr. McDonald, Secretary of Veterans Affairs

     San Diego is rich in skilled clinicians…yet, many Veterans are not aware that we are here, waiting to be of service – and they have a right to our services. 
We can assist any Veteran wading through the morass of VA bureaucracy.  We have a special understanding of the unique obstacles that prevent most Veterans from receiving help. And, while the VA does their best, they know it is not sufficiently meeting the needs of our community. Because of this, several changes have recently been made to accommodate Veterans and families, yet that message has not been made widely known. Veterans Healing welcomes the opportunity to share current and optimal treatment methods, affordable counseling, or simply provide outside resources to those in need.  
Consider this an invitation, Mr. McDonald, to speak with the four of us working on the frontlines. We are your boots on the ground and respectfully, we have some ideas that warrant a good ear. As Licensed Health Care Professionals, serving both Veterans and Active Duty Servicemembers, we are especially aware of the need to improve mental health services. We are also aware (and frustrated!) by the deficiencies that exist. 
We, too, are concerned about the many barriers to care veterans face when seeking mental health services. The VA does so much to help veterans, including reimbursing for psychotherapy conducted by community therapists. Unfortunately, the process by which the VA attempts to coordinate such services is flawed and in turns acts as a barrier to care.
While mental health is hard for anyone to access, it is even harder for our Servicemember. As highly trained, Licensed, and pre-vetted NON-VA Providers - we work independent of the VA to alleviate their backlog - we are more than ready, willing and able to provide the counseling that our Veterans require and desire. 
Our suggestions: 
              Streamline the claim submission and re-imbursement morass that prohibits clinicians that are expertly-trained in military culture from wanting to accept your referrals. The delays and numerous phone calls to get paid on a Veteran that we have successfully treated leads to your therapist attrition. Reimburse us quickly. We cannot afford to stay in business with outstanding invoices that trickle into month-long delays. We will not quibble about our pay. Never once have I heard a colleague complain about our actual re-imbursement fee - we accept that mental health is not a get-rich field. But, pay us, please…
              Waive electronic filing fees for small businesses. We are one-man/woman operations; counselors providing therapy, not large conglomerates. It’s already a given that our re-imbursement fee is more than fair. We service this population because we have the passion for it.
              Consult with your sister-provider TriCare, which does a brilliant job managing claims and services for thousands of military families. Their portal is simple and payment comes within 10 days.  We are literally owed thousands of dollars in submitted unpaid claims.
              At present, when a problem occurs with a claim the provider is not paid and receives no notification that (a) they are not getting paid or (b) there was a problem. Instead, notify us directly and immediately. Tracking down our lost or missing claims is morally defeating and cost-prohibitive.  We will (shamefully) have to reject your next referral in order to sustain a cost-efficient practice. We have learned to only accept one or two referrals at a time as we know they require excessive follow-up (if we get paid, ever!), which then results in the VA having to re-absorb their patient care.
              Provide an online portal for providers to submit claims like every other large insurance carrier offers. The existing portal is unwieldy.
              Allow claims to be faxed with medical notes. Currently, no faxed claims are permitted, whatsoever, and the hard copy of claims is sent to a different location than the (unnecessary but required) medical notes. How do they possible ever meet? They often do not.

     Mr. McDonald, I invite you to lunch. Our treat!
     Christina Neumeyer