WRITTEN STATEMENT OF
DOUGLAS H. MITCHELL, JR., MSW, LCSW, ACSW
PRESIDENT, ASSOCIATION OF VA SOCIAL WORKERS
CHAIR, SOCIAL WORK DEPARTMENT
CARL T. HAYDEN VA MEDICAL CENTER
PHOENIX, AZ
BEFORE THE
SENATE VETERANS AFFAIRS COMMITTEE
MAY 16, 2007

Mr. Chairman and members of the committee, good morning. I am here today representing the membership of the Association of VA Social Workers employed by the Veterans Health Administration.

First of all, I am a veteran of the United States Army. I proudly served my country from February 22, 1966 to September 4, 1973.

I also receive my medical care through the Department of Veterans Affairs. I am equally proud to do so. Having received care both outside VA and inside, I feel qualified to state unequivocally that there is no comparison; the VA is second to none.

I have been employed by VA for 22 years. For the past 13 years I have been assigned to the Carl T. Hayden VA Medical Center in Phoenix, AZ as the Assistant Chief of Social Work and for the last ten years as the Chair of the Social Work Department.

During my tenure in Phoenix, I have observed the VA health care system evolve from a rigid, facility centered hospital system with virtually little regard for resource availability to a vibrant, patient-centered system determined to deliver the best quality care in the most efficient manner closer to home. I would like to highlight some specifics concerning experience in the field based upon decisions Dr. Kussman has made.

I believe Dr. Kussman is committed to making the transition from active duty military to veteran status and community life as seamless as possible. In August 2003, Dr. Kussman started the seamless transition program. He placed a VA social worker at the Walter Reed Army Medical Center to help transfer active duty patients to VA medical centers. Within a few months, a second social worker was added. Today, we have 14 social worker liaisons at 10 military hospitals. Dr. Kussman supports the liaisons and knows them by name. In Phoenix, our case managers interact often with these individuals.
• Dr. Kussman is committed to the best quality care possthle for all veterans. But he is particularly concerned with the severely-injured OEF/OIF veterans. The second phase of seamless transition included a case management program to ensure that no veteran falls through the cracks. Every VA medical center has nurse or social worker case managers who follow their patients wherever they go - inpatient to outpatient to the community.

• Although VA has had a system of 4 Traumatic Brain Injury (TBI) Centers since the early 1990's1 Dr. Kussman believed that the severity of the injuries of OEF/OIF veterans required that we provide more comprehensive care. He converted the TBI centers to Poly-trauma Centers to ensure that veterans could receive concurrent treatment for all of their injuries including TRI, amputation, spinal cord injuries, visual impairment, hearing loss, combat stress and PTSD in one location. Further, he developed the Poly-trauma System of Care, which includes the 4 Poly-trauma/TBI Centers and 17 Network sites.
• When the Secretary announced that he wanted to hire 100 patient advocates, Dr. Kussman had a vision for how these new employees could help the most severely-injured OEF/OIF veterans with their transitions. The new transition patient advocates (TPA5) are being assigned to active duty patients while they are still at the military hospital to meet the patient and family and serve as an ombudsman to help them with any problems or concerns and assist them in navigating in both the DoD and VA systems.
• Under Dr. Kussman's guidance, VA developed a computerized veterans tracking system to a) notify the gaining facility of the patient's pending discharge, b) document the patient's status and, c) notify staff as to both the clinical and logistical status.
• Dr. Kussman is a physician who understands and promotes interdisciplinary care. Under his leadership, all clinical team members work together with patients and families on treatment plans and treatment decisions.
• Dr. Kussman also understands the importance of families and supportive services for them. He has been a staunch supporter of the VA Fisher House Program and has ensured that VA medical centers, particularly the Polytraumal TBI Centers, address family needs. He understand that our patients and families are people experiencing multiple life crises and he fully supports a team effort to help patients and families cope with all of the challenges they are facing which include medical, social , psychological and spiritual.

In summation, I strongly believe that:

Dr. Kussman is a hands-on leader in terms of supporting the staff and the patients.
He recognizes that we are re-inventing a health care system to serve a new generation of veterans and his enthusiastic support for innovative ideas has resulted in unprecedented levels of case management and high quality care for a veteran population transitioning from active duty to civilian life.

An immediate local example in Phoenix is that, for more than two years, we have known of the need to evaluate all veterans who have been exposed to blasts, incidents or accidents that could conceivably result in neuropsychological impairment. At Dr. Kussman's direction, a committed team of VA clinical staff developed a CPRS template that screens for medical conditions endemic to the Gulf area as well as TBI. This template automatically triggers specialty consults for further evaluation. This multidisciplinary team consists of Physicians, Nurse Practitioners, Physician Assistants, Information Management, Social Work, Nursing, Speech Pathology, and Mental Health practitioners. It is truly an effort to treat the whole veteran.

Perhaps even more extraordinary is the relationship that has developed between the VBA Regional Office and the VA Medical Center due to Dr. Kussmans leadership. The Phoenix VARO sends personnel to evening groups at our medical center to explain veteran's benefits, initiate claims for service connected disability compensation and to provide access to the complete array of services available through VBA. In previous years, One VA" was a slogan. In Phoenix, it has become the practice.

Finally, and most important to me, Dr. Kussman empowers each of us in VA to do the right thing for our patients.