Sens. Hillary Rodham Clinton (D-N.Y.), Mike Enzi (R-Wyo.), and Charles Schumer (D-N.Y.) have secured an agreement from the Senate’s Subcommittee for Appropriations for the Department of Veterans Affairs (VA) about key issues affecting mental health in implementation of the Capital Asset Realignment for Enhanced Services (CARES) Plan.

VA psychiatrists and mental health advocates expressed concern that the VA was using a flawed planning model to determine the need for mental health services for the next two decades and that hospitals and other facilities would be closed without sufficient planning (Psychiatric News, November 21).

According to the "Senate Record" for November 17, Clinton said, "We understand that you [Senate managers for the legislation] are committed to pursue language in the Conference Report. . .that would urge that no closures or reduction in long-term care, domiciliary care, and mental health care services would take place until the full analysis is completed. The language would also require the VA to submit updates on their progress in this analysis to the appropriate committees."

Schumer said that the managers had agreed to present language that would "recognize the benefits of and the need to have CARES-related hearings within 30 miles of all facilities facing closure or a reduction in services, as well as the importance of veteran participation at these hearings."

At a meeting on November 12 on mental health issues, VA Undersecretary for Health Robert H. Roswell, M.D., assured APA Medical Director James H. Scully Jr., M.D., and Acting Director of Government Relations Eugene Cassel, J.D., that the VA recognizes that the planning model underestimates future need for mental health services and that adjustments will be made at a later date.

Final recommendations of the CARES Commission are due to VA Secretary Anthony J. Principi sometime this month. ▪