VA Cited for Neglecting Follow-Up Treatment for Depressed Vets
The embattled Veterans Affairs Department is once again under scrutiny for potentially violating agency guidelines when treating patients—this time, failing to ensure that veterans with depression are receiving sufficient follow-up care after being prescribed anti-depressant medication.
That’s the conclusion of an investigation by the Government Accountability Office. The GAO reviewed patients being treated for depression at six separate VA medical centers and found that after the veterans received anti-depressants, their doctors did not conduct follow-up appointments within four to six weeks, as the VA requires
Related: VA Wastes Millions, But Still Wants More as Vets Wait for Care
In its review, the GAO said that among all patients whose records were reviewed—almost none of them received check ups with doctors in the required time after they were given anti-depressant medication.
"Given the debilitating effect that depression can have on veterans' quality of life, VA's monitoring of veterans with [depression] is critical to ensuring they receive care that is associated with positive health care outcomes," GAO director of health care Randall Williamson said in congressional testimony this week. He went on to criticize the VA for not following its own guidelines to assure veterans receive sufficient treatment.
“This work illustrates, once again, a continuing pattern of VHA's [Veterans Health Administration] noncompliance with its own policies and established procedures,” Randall Williamson, the GAO's director of health care said in congressional testimony last week.
Separately, the GAP flagged the VA’s Behavioral Health Autopsy Program which is used to collect data on veterans that have committed suicide in order to inform policy decisions, saying it is plagued with inaccuracies.
Auditors said that the system had incorrect dates of death—sometimes off by one day, sometimes off by a whole year. The GAO said this made it nearly impossible to assess what kind of treatment they were provided.
Map of the Day: Navigating the IRS
The Taxpayer Advocate Service – an independent organization within the IRS whose roughly 1,800 employees both assist taxpayers in resolving problems with the tax collection agency and recommend changes aimed at improving the system – released a “subway map” that shows the “the stages of a taxpayer’s journey.” The colorful diagram includes the steps a typical taxpayer takes to prepare and file their tax forms, as well as the many “stations” a tax return can pass through, including processing, audits, appeals and litigation. Not surprisingly, the map is quite complicated. Click here to review a larger version on the taxpayer advocate’s site.
A Surprise Government Spending Slowdown
Economists expected federal spending to boost growth in 2019, but some of the fiscal stimulus provided by the 2018 budget deal has failed to show up this year, according to Kate Davidson of The Wall Street Journal.
Defense spending has come in as expected, but nondefense spending has lagged, and it’s unlikely to catch up to projections even if it accelerates in the coming months. Lower spending on disaster relief, the government shutdown earlier this year, and federal agencies spending less than they have been given by Congress all appear to be playing a role in the spending slowdown, Davidson said.
Number of the Day: $203,500
The Wall Street Journal’s Catherine Lucey reports that acting White House Chief of Staff Mick Mulvaney is making a bit more than his predecessors: “The latest annual report to Congress on White House personnel shows that President Trump’s third chief of staff is getting an annual salary of $203,500, compared with Reince Priebus and John Kelly, each of whom earned $179,700.” The difference is the result of Mulvaney still technically occupying the role of director of the White House Office of Management and Budget, where his salary level is set by law.
The White House told the Journal that if Mulvaney is made permanent chief of staff his salary would be adjusted to the current salary for an assistant to the president, $183,000.
The Census Affects Nearly $1 Trillion in Spending
The 2020 census faces possible delay as the Supreme Court sorts out the legality of a controversial citizenship question added by the Trump administration. Tracy Gordon of the Tax Policy Center notes that in addition to the basic issue of political representation, the decennial population count affects roughly $900 billion in federal spending, ranging from Medicaid assistance funds to Section 8 housing vouchers. Here’s a look at the top 10 programs affected by the census:
Chart of the Day: Offshore Profits Continue to Rise
Brad Setser, a former U.S. Treasury economist now with the Council on Foreign Relations, added another detail to his assessment of the foreign provisions of the Tax Cuts and Jobs Act: “A bit more evidence that Trump's tax reform didn't change incentives to offshore profits: the enormous profits that U.S. firms report in low tax jurisdictions continues to rise,” Setser wrote. “In fact, there was a bit of a jump up over the course of 2018.”
