WASHINGTON (AP) _ Veterans Affairs nominee James Peake says he wants to work quickly to improve mental health care for veterans such as by placing more staff at VA clinics to fight soldiers' resistance to getting treatment for depression.
Hours before a Senate panel was to vote on his nomination Thursday, the former U.S. Army surgeon general indicated in a new 22-page disclosure that he wants to plan better for veterans' health care during wartime and other national crises.
Distancing himself from a practice under former VA Secretary Jim Nicholson, Peake also said he would seek to find other ways to retain senior VA officials than awarding lucrative performance bonuses each year regardless of merit.
The Associated Press earlier this year reported that Nicholson approved a generous package of more than $3.8 million in bonus payments in 2006, citing a need to retain longtime VA executives, despite their roles in crafting a flawed budget that fell $1 billion short and jeopardized health care.
``The bonus program is only one incentive and perhaps not the most important in attracting and retaining the best, brightest and hardest working for government service,'' Peake wrote in the disclosure submitted this week to the Senate Veterans Affairs Committee and obtained by the AP.
``If confirmed, I look forward to working ... to create a measurable, realistic and transparent bonus program for the VA executive leadership,'' he said.
The committee was expected to advance Peake's nomination later Thursday to the full Senate for confirmation as early as this month.
In hearings last week, Peake, a retired lieutenant general who has spent 40 years in military medicine, promised to be an independent advocate for veterans and get needed funding for their care.
``I believe General Peake's heart is in the right place, but this job will take more than just promises,'' said Sen. Patty Murray, D-Wash., a member of the Senate panel.
Responding this week to follow-up questions by the panel, Peake said he will look immediately into the most serious charges leveled against the VA under Nicholson. They included a recent VA inspector general's report that found the agency repeatedly understated wait times for injured veterans seeking all types of medical care.
Peake said stigma that soldiers and veterans face in seeking care for post-traumatic stress disorder and traumatic brain injury was a major barrier. He promised to make that a top issue for the VA in the waning months of the Bush administration.
Only recently, the VA has taken steps to add mental health counselors and 24-hour suicide prevention services at all facilities, after high-profile incidents of veterans committing suicide. In the past, the VA had failed to use all the money for mental health that was allotted to it.
Citing Army figures provided by Murray's staff, USA Today reported Thursday that 77 soldiers killed themselves from Jan. 1 through Nov. 27 and that 32 other deaths are pending final determination as suicides.
Peake, 63, said he would use his experience as Army surgeon general from 2000-2004 as a guide, noting that after the Sept. 11, 2001, attacks he quickly moved to ``proactively'' address the mental health needs of Pentagon workers.
Assembling a team in a ``crisis action mode,'' Peake said he dispatched workers to clinics, areas outside clinics and every office to spread the message that it was normal if workers were feeling emotionally affected by events and needed to talk.
``This was not done in response to someone acting 'crazy,' or having a traumatic response. Rather, it was done proactively,'' he said. ``It worked! It is hard to prove the negative, but after a year, there were no suicides in that group of workers and there were a number of people who had, without fanfare, received longer-term treatment.''
Peake repeatedly declined to respond to senators' questions about the VA's budget process until he received detailed briefings. But Peake promised he would go straight to President Bush if he believed the White House's budget requests were inadequate.
``The ability of the VA to surge should be carefully examined in light, not only of supporting war returning veterans, but in the event of 'war' here at home from terrorism to natural epidemics, to disasters,'' Peake wrote.