Veteran services

VA Secretary Robert Wilkie on expanding Colorado Veterans Services not allowing MMJ orders

Ryan Warner: Secretary Wilkie, thank you for being with us.

VA Secretary Robert Wilkie: Thank you for inviting me.

RW: I’d like to start with the VA Medical Center in Aurora. It opened shortly before you took office in 2018 — more than $1 billion over budget, five years behind schedule. There were immediate criticisms that it was too small for the demand, and federal lawmakers were so upset they stripped the VA of authority to handle large projects like this. What are you doing to make sure veterans get the care they need now?

SECRW: Well, the great thing about Colorado is that it’s one of the fastest growing areas of the country when it comes to veterans. In the last year or so, I think our outpatient visits have grown by about 117,000, which means we’re devoting more resources not only to the Denver area, but to eastern Colorado as well. And the other side of the equation is something I’ve been working on for the eight months here. And it is the Mission Act that is the largest and most comprehensive reform program in the history of the Department of Veterans Affairs, especially for veterans in rural Colorado, because it says that if VA cannot not provide a service that a veteran needs in a timely manner, then that veteran has the option to walk out of our VA and get that care.

RW: Of course that means building a new relationship, a new system, new software, and that’s no small feat. I want to bring you this question from the congressman who represents Aurora where the VA regional hospital is located. So it comes from Jason Crow, a Democrat.

Jason Crow: We’ve seen the administration repeatedly suggest the idea of ​​privatizing the Veterans Administration. How will the Secretary implement the new Missions Act regulations while maintaining the integrity of a self-contained, dedicated AV system?

SECRW: Well, the nice thing about veterans is that they vote with their feet. If you look at the satisfaction rate of veterans, we have figures that we have never seen in our history. Our veteran satisfaction rate with VA care is around 89.7%. And I’ll go back to something that happened last year in December when the Annals of Internal Medicine said VA health care is good or better than all health care in any part of the country.

RW: When it’s available.

SECRW: Well, it’s available most of the time. We are not sitting on the sidelines of the larger issues plaguing America’s health care system. America lacks mental health professionals. America is short of primary care physicians. America is short of nurses. The turnover at VA is actually lower than the private sector and for those in Colorado we have same day appointments not only for mental health but also for urgent care and that’s a huge step up before compared to how things have been in recent years.

RW: A review by the US Digital Service is concerned that the software the VA is developing to decide who is eligible for private medical care isn’t working and could negatively affect the health care of some 75,000 veterans a day. That’s according to a ProPublica survey. What is your opinion on this review?

SECRW: Well, I’m going to refute everything in this report. It’s an interesting report that was written without discussing any of the issues with a senior official in Veterans Affairs, including the people who actually manage our information technology systems. For a company that’s supposed to be all about technology, about 90% of that report was about politics, which I think if you look at their charter, they weren’t competent to do that. What I’m still going to rely on is what our veterans tell us and our veterans vote to use VA to go where people understand their culture and understand their language.

RW: I understand that the VA hospital here in Colorado is planning to open a new spinal cord injury unit this year.

SECW: Yes.

RW: Secretary, tell me briefly about the need for this type of care.

SECRW: I am the son of a seriously wounded combat soldier. The VA was originally created by President Lincoln to provide for those injured in battle. Spinal cord injuries, to me, are the saddest aspects of this culture we live in. Denver has been a leader and the University of Colorado has been a partner of Denver VA in establishing new protocols for the treatment of spinal cord injuries.

Denver will be where veterans from the western United States come for treatment. I visited the spinal injury treatment center. There is no such thing. You can’t find things like this at Stanford or Johns Hopkins and it’s absolutely vital considering the type of injuries we see on the modern battlefield. On the modern battlefield, soldiers survive injuries that in my father’s time in Vietnam would have cost their lives, but we still haven’t reached the milestone in terms of spinal injury science. spinal.

RW: And I guess giving people back movement and feeling.

SECRW: Absolutely.

RW: Mm-hmm.

SECRW: Absolutely. Denver will be at the forefront not only in terms of medical facilities but also the rehabilitation facilities, hot water pools, electronic stimulation systems that we have and very proud of what is happening in Denver and we also have a partnership there with the Department of Defense.

RW: Now, another thing that Colorado is known for at the forefront is marijuana.

SECW: Yes.

RW: And in a recent interview, you said opioid prescriptions provided by the VA have dropped 51% in the last year alone.

SECW: Yes.

RW: But at the same time, the VA doesn’t plan to allow medical marijuana prescriptions for veterans despite its track record in treating chronic pain. Is it just a matter of the federal government…

SECRW: Well, it’s federal law and it’s simple. It is very simple. This is federal law. The other thing I’m going to say and I said it in my testimony is that we’re not in the 1960s. We still have no idea of ​​the effects of a type of marijuana more potent than us see in the country and I won’t be able to replace the opioids we’re getting rid of, with a drug that we still have no idea what kind of effects it has on the brain. We are still in the early stages of determining this impact. But as you said, it’s also against federal law and as long as it’s against federal law, it’s up to Congress to change the way we do things.

RW: Recently, the Trump administration has placed a renewed emphasis on combating veteran suicide. The president recently signed an executive order and the VA launched a campaign in seven states, including Colorado, called the Governor’s Challenge.

SECRW: Absolutely.

RW: Just briefly, before I go, how do you think that will make a difference?

SECRW: Well, it’s an honor for me to lead the President’s Task Force on Suicide Prevention. It is one of the great tragedies in America that every day 20 veterans take their lives and 14 of those 20 are outside of the VA. So what this does is not only open up the door in terms of research and a comprehensive health approach that includes a thorough assessment of the mental health status of all of our veterans, but for me, it opens the door when it comes to providing resources to states and localities so that they can help us. Give yourself an example.

RW: With the idea that they’re not all in the VA system, as you said.

SECRW: Absolutely. In the state of Alaska, which is a place where many Americans go to separate themselves from society and there are certainly parts of Colorado that I know because I worked for a big company in Colorado. They have a similar situation. But in Alaska, more than half of veterans are outside the VA.

I went there in October and asked the Federation of Alaska Natives to double the number of VA tribal reps to help us find these veterans. Are we going to get to zero? No, because the majority of those who commit suicide are unfortunately from the Vietnam era. So some of our veterans had issues that started to develop when Lyndon Johnson was president. We can never get to zero, but I think with a whole-of-government approach and a closer relationship with states and localities, we can make a huge dent in this area and I’m very honored that the president allowed me to lead this effort.

RW: We only have a few seconds. There was a report in the Washington Post that you might be in the running to be the next Secretary of Defense.

SECRW: Well, the one thing I’m fighting for is being the best VA secretary I can be and I’ll tell you, I’ve seen this military life from many angles, as the son of a seriously wounded combat soldier, as an officer in both – first the Navy and now the Air Force, and as a top Pentagon leader. This is the world I grew up in. I go where they ask me to serve and I am deeply honored to enter this building each day and carry out what I believe to be the most noble mission of the federal government.

RW: Thank you for being with us, Secretary.

SECRW: Very well, thank you very much.