Review of VA substance abuse care among spending bill provisions tied to Florida

Healthy orange fruit, left, pictured next to fruit damaged by “greening”
Healthy orange fruit, left, pictured next to fruit damaged by “greening” MCT

The death of a patient at a Miami veterans’ facility could lead to a broader review of similar programs across the country, one of several provisions impacting Florida in a recently passed congressional spending bill.

The spending bill, passed by the House late Thursday and heading to the Senate and a probable presidential signature, also included additional money to help combat citrus greening – a disease ravaging the state’s agricultural industry – and it protected money for Everglades’ restoration projects.

U.S. Rep. Mario Diaz-Balart, a Republican from Miami who next year will chair a key congressional appropriations subcommittee, saw the effort as one that kept the lid on unnecessary spending while freeing up money for things that mattered more.

“By reducing wasteful spending on programs and agencies like the problematic IRS we are able to fund the areas of government that matter most – like helping our veterans, combating citrus greening and continuing the much-needed restoration of the Everglades,” Diaz-Balart said in a statement.

The spending bill reflected a bipartisan measure crafted by House and Senate appropriators to prevent the government from another shutdown. It passed the House on Thursday and included a package of 11 spending bills to finance most government agencies through next September. The Senate now takes up the measure.

As with most spending bills, this one doesn’t simply deal with dollars and cents – it also directs the federal government to undertake particular projects or tasks and report back to Congress the results. The incident at the Miami veterans’ substance abuse program led to one such provision.

The death was highlighted earlier this year by the U.S. Department of Veterans Affairs inspector general, which investigated the unexpected death of a patient in the substance abuse residential rehabilitation treatment unit at the Miami VA Medical Center.

The death was the result of acute cocaine and heroin toxicity and occurred while the unit’s security surveillance camera wasn’t working and while employees of the unit had no view of the unit’s entrance and exits, the inspector general found. While VA rules said staff members should be present at the unit “at all times,” the inspector general reported that “staff were not present at all times as required.”

The inspector general recommended the facility beef up monitoring of patients and put in place consistent contraband search processes.

Tucked into the spending bill’s provisions on the VA was one to see if the problems in Miami were widespread. It requests that the VA’s inspector general “conduct a broader review of the operations and effectiveness of VA substance abuse inpatient rehabilitation programs,” detailing the number of veterans treated and their average length of treatment; the average length of time for VA treatment compared to that of non-VA residential treatment programs; recidivism rates; the level of supervision of patients in VA programs; and how often drug tests are performed. There are 63 such units across the country.

The inspector general is to report back to Congress on its review by August 2015.

The spending bill also targets additional funding for citrus greening, an insect-spread disease that first appeared in Florida in 2005 and rapidly spread to all 32 citrus-growing counties. The disease migrates when infected plants are moved and come into contact with the carrier insect, which can transmit it to other trees.

While it’s not a threat to humans or animals, the disease takes hold in citrus trees and results in green, bitter-tasting fruit, ruining crops meant for sale to consumers or juice makers.

While the U.S. Department of Agriculture and Congress have ramped up spending to understand and combat the disease, it’s still a major threat to citrus growers in Florida – and a potential threat in other citrus states such as California.

The spending bill provides an additional $4.5 million for the Citrus Health Response Program, run by the Agriculture Department. The money is to “help address the damaging effects of citrus greening disease.”

According to Diaz-Balart, the spending bill includes other provisions vital to Florida interests, including additional funding for democracy promotion in Venezuela, Nicaragua, Bolivia and Ecuador; funding for ongoing South Florida Everglades restoration projects, including $65.5 million for construction projects and $19.5 million for operation and maintenance; and $75 million for improvements to the Herbert Hoover Dike that surrounds Lake Okeechobee.