At Hearing, Tester Pushes VA Officials on Treating Rural Veterans for Substance Use Disorder

Chairman also announced upcoming legislation to improve community care for veterans—including expanded access to substance use disorder and mental health care options

Chairman Jon Tester yesterday led a Senate Veterans’ Affairs Committee hearing where he pressed Department of Veterans Affairs (VA) officials on delivering quality and timely substance use disorder (SUD) care for veterans, especially those living in rural America.  

During the first panel, Tester questioned Dr. Erica Scavella, Assistant Under Secretary for Health for Clinical Services at VA, on actions taken by the Department to meet the needs of rural veterans with substance use disorder. VA Montana, whose VA Medical Center hospital is located at Fort Harrison in Helena, is home to a 24-bed residential treatment program for veterans with mental health conditions and SUD.

“I come from a state that’s pretty darn rural,” said Tester. “What makes VA unique in being able to provide residential care for veterans that have comorbidities like SUD and PTSD? How common is it in rural America that the only choice…is VA for a veteran that has these issues?”

“We are the largest integrated health care system in the United States—we provide comprehensive care for our veterans from primary care, through pain management, general mental health, as well as substance use disorder,” replied Dr. Scavella. “So, we treat the whole patient—and we are able to see that due to the fact that we have an integrated record and can communicate with our colleagues to provide that care.”

She continued, “We do have facilities in Montana, specifically for substance use disorder, and our commitment is from the time of identified need—to make sure that we’re bringing those veterans in—if they need in-patient or residential services to start that referral and get the care provided as soon as possible.”

Continuing his efforts to improve community care for veterans, Tester also announced during his opening statement that he will soon be introducing new legislation: “I have heard numerous issues with veterans not being able to readily access VA’s residential care for mental health and SUD—the RRTP [Residential Rehabilitation Treatment Program]. That’s why I included a provision in my STRONG Veterans Act, enacted last December, to study RRTP wait times and availability, to better inform the development of additional RRTP sites and bed spaces. Building off that effort, I will be introducing legislation very soon to make community care really work for veterans. And that includes being able to access residential SUD and mental health care in the community when it is needed.”

Last Congress, Tester led the Post-9/11 Veterans Mental Health Care Improvement Act, which was signed into law as part of the STRONG Veterans Act in December 2022. Senate Tester secured provisions to study veterans’ access to residential mental health and SUD care and to examine VA treatment options for veterans with co-occurring mental health and substance use disorders.

During the hearing, Tester also pushed the VA witness on the role distance from home plays in the Department’s decision-making for referring veterans to substance use disorder treatment. Scavella confirmed distance from home is taken into consideration, and that they try to provide the soonest care possible, in the best way possible. In instances where it is not possible to provide care through the VA system, they make referrals to the community. The Chairman went on to specifically question Scavella on wait times for residential mental health and SUD care.