Veterans for Common Sense et al v. Nicholson et al

Filing 48

Attachment 2
Declaration of Paul Sullivan in Support of 46 Memorandum in Opposition to Defendants' Motion for Protective Order to Stay Discovery filed byVeterans United for Truth, Inc, Veterans for Common Sense. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C)(Related document(s) 46 ) (Sprenkel, Stacey) (Filed on 11/27/2007)

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Veterans for Common Sense et al v. Nicholson et al Doc. 48 Att. 2 VA Facility Specific OIF/OEF Veterans Coded with Potential PTSD Through 2nd Qt FY 2007 I. Background: The Government Accountability Office (GAO) asked VA to enumerate the total number of OIF/OEF veterans who were diagnosed with PTSD by VISN and VAMC using VA inpatient and outpatient records. The GAO also asked for this information to be aggregated with Vet Center utilization data. VHA prepared an initial report in October 2004 showing healthcare utilization during FY 2004. This tenth report covers the VA healthcare data from FY2002 through 2nd Qt FY 2007. II. Data Sources: OIF/OEF veteran roster: Since October 2003, the Department of Defense (DOD) Defense Manpower Data Center (DMDC) has sent the Department of Veterans Affairs (VA) Environmental Epidemiology Service (EES) a periodically updated personnel roster of troops who participated in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), and who had separated from active duty and become eligible for VA benefits. The roster was originally prepared based on the pay records of individuals, but in more recent months it has been based on a combination of pay records and operational records provided by each branch of service. Based on the latest DMDC file received on April 17, 2007, there are a total of 717,196 unique OIF/OEF veterans (excluding 3,303 who died in theater), who have been separated as of February 2007 from active duty following the deployment. For each veteran, his/her demographic (SSN, name, DOB, gender, education, etc.) and military service-specific data (branch, rank, unit component, deployment dates, etc.) were included in the record. VHA health care utilization records: The roster was checked against VA's inpatient (PTF) and outpatient (OPC) electronic patient records available through March 31, 2007 to determine those who had sought treatment in VA facilities as well as the ICD-9 diagnostic codes used to describe the visits. Thus, the data we used was administrative data and not based on a careful review of each patient record. For the purpose of this report, we searched his/her health care utilization records during FY 2002, 2003, 2004, 2005, 2006 and through FY 2007 2nd Qt ending March 31, 2007, following his/her first deployment in the Iraq or Afghanistan theater. For identification of a potential PTSD patient, we used ICD-9CM, 309.81. The Vet Center counts were based on the data provided to EES on June 13, 2007, by the Readjustment Counseling Service (RCS). The RCS staff matched the same Page 1 of 8 Dockets.Justia.com DMDC roster with Vet Center users' records through FY 2007 2nd Qt. . III. Distribution of Veterans by Diagnostic Code and Facility A veteran is counted only once in any facility-specific category. For example, a veteran who received health care from two or more medical centers within the same VISN was counted once for that VISN. Likewise, a veteran who used services across two or more VISN facilities and a Vet Center was counted only once for the overall national total. The number for "Primary" indicates the total number of unique veterans whose primary reason for the inpatient or outpatient visit was for treatment or evaluation of PTSD. The number for "Any" indicates the total number of unique veterans coded with PTSD, whether or not the primary reasons for the inpatient or outpatient visit was for treatment or evaluation of PTSD. Both "Primary" and "Any" categories may include a suspected diagnosis. IV. Summary: Recognizing the limitations of the DMDC deployment roster and the uncertainty of the final diagnostic data based on VHA's electronic patient records, a query of VHA health care utilization databases using the February 2007 DMDC separation roster yielded a total of 45,330 OIF/OEF veterans coded with PTSD at a VA medical center and 13,392 veterans who received Vet Center service for PTSD. Of these, 38,983 were seen only at a VAMC; 7,045 only at a Vet Center; and 6,347 were seen at both facilities. In summary, based on the electronic patient records available through March 31, 2007, a grand total of 52,375 OIF/OEF veterans were seen for potential PTSD at VHA facilities following their return from the Iraq or Afghanistan Theater. Han K. Kang, Dr.P.H. Director, Environmental Epidemiology Service June 2007 Page 2 of 8 Number of unique OIF/OEF veterans with PTSD utilizing VA facilities during FY 2002 2nd Qt FY 2007 VISN-Facility Inpatients Primary2 1-BEDFORD 1-BOSTON 1-MANCHESTER 1-NORTHAMPTON 1-PROVIDENCE 1-TOGUS 1-WEST HAVEN 1-WHITE RIVER JCT VISN 1 2-UPSTATE N.Y. HCS VISN 2 3-BRONX 3-EAST ORANGE 3-MONTROSE VA HUDSON HCS NY 3-N.Y. HARBOR HCS 3-NORTHPORT VISN 3 4-BUTLER 4-CLARKSBURG 4-COATESVILLE 4-ERIE 4-JAMES E VAN ZANDT VAMC 4-LEBANON 4-PHILADELPHIA 4-PITTSBURGH-UNIV DR 4-WILKES BARRE 4-WILMINGTON VISN 4 5-BALTIMORE 5-MARTINSBURG 5-WASHINGTON VIISN 5 9 26 . 28 14 2 6 11 91 41 41 11 11 10 11 7 46 . 6 7 . . 13 17 23 8 . 71 9 11 9 29 Outpatients Primary2 176 558 162 175 328 271 494 219 2269 1175 1175 224 510 173 571 229 1641 83 222 161 138 142 288 553 165 213 122 1955 318 351 483 1120 Total Patients1 Primary2 176 562 162 177 329 271 494 220 2271 1177 1177 225 510 173 573 229 1644 83 222 162 138 142 288 553 173 214 122 1957 318 351 484 1121 Vet Centers4 PTSD 54 284 131 82 124 246 217 140 1278 270 270 35 287 14 235 37 608 . 77 . 84 . 110 112 174 152 169 878 111 92 184 387 Any3 32 73 . 36 41 16 18 17 213 80 80 23 24 17 31 25 112 . 14 15 . 3 19 28 42 18 1 132 29 20 20 66 Any3 194 652 201 185 379 312 541 270 2589 1292 1292 256 558 193 647 268 1845 93 243 174 162 172 319 656 218 254 136 2273 368 377 536 1241 Any3 199 669 201 187 384 314 543 273 2607 1296 1296 260 560 194 650 269 1851 93 244 177 162 172 319 657 237 255 136 2283 372 377 540 1247 Grand Total5 Other 81 445 440 1725 707 416 585 543 4942 2587 2587 102 1713 106 726 106 2753 . 783 . 110 . 365 276 707 1039 540 3820 314 28 849 1191 242 800 289 222 446 453 629 370 3250 1451 1451 280 752 206 792 279 2207 93 287 177 204 172 374 710 374 371 242 2797 426 415 634 1429 SubPTSD 5 20 8 2 1 77 19 713 845 33 33 7 29 . 7 10 53 . . . 15 . 36 1 339 55 14 460 5 1 27 33 Page 3 of 8 Number of unique OIF/OEF veterans with PTSD utilizing VA facilities during FY 2002 2nd Qt FY 2007 (Continued) VISN-Facility Inpatients Primary 6-ASHEVILLE-OTEEN 6-BECKLEY 6-DURHAM 6-FAYETTEVILLE NC 6-HAMPTON 6-RICHMOND 6-SALEM 6-SALISBURY VISN 6 7-ATLANTA 7-AUGUSTA 7-BIRMINGHAM 7-CHARLESTON 7-COLUMBIA SC 7-DUBLIN 7-MONTGOMERY 7-TUSCALOOSA VISN 7 8-BAY PINES 8-MIAMI 8-N FL/S GA HCS 8-ORLANDO FL VAMC 8-SAN JUAN PR 8-TAMPA 8-W PALM BEACH VISN 8 9-HUNTINGTON 9-LEXINGTON-LEESTOWN 9-LOUISVILLE 9-MEMPHIS 9-MOUNTAIN HOME 9-VA MID TENN HCS NASH TN VISN 9 14 . 15 12 8 11 12 23 94 23 17 . 9 9 . 36 11 103 10 9 15 . 14 24 14 85 . 14 14 22 11 34 93 2 Outpatients 3 Total Patients 3 1 Any Primary 136 162 407 608 369 363 158 510 2622 531 355 378 311 542 197 666 422 3297 325 399 662 277 259 734 185 2575 272 260 199 264 309 494 1766 2 Any Primary 136 162 407 611 369 365 161 511 2629 532 356 378 313 544 197 673 423 3304 325 400 663 277 260 735 185 2577 272 262 203 267 310 499 1779 2 Any 3 Vet Centers SubPTSD PTSD . 113 188 76 40 84 26 59 586 150 . 88 177 209 . . . 624 101 429 164 121 145 50 . 1010 116 40 25 58 76 94 409 . 1 18 . 30 6 2 102 159 14 . 6 26 2 . . . 48 9 19 71 17 110 2 . 228 16 5 26 117 1 254 419 4 Grand 5 Total Other . 106 2782 8707 1908 584 3 1467 15557 840 . 1629 3590 1172 . . . 7231 989 1395 2007 671 2635 23 . 7720 614 323 614 1271 171 928 3921 172 226 543 758 429 472 201 627 3273 704 448 540 489 733 231 752 442 4143 420 782 879 393 451 891 207 3642 347 344 255 355 385 671 2309 17 3 32 29 13 34 20 33 176 41 65 20 13 20 3 50 20 221 34 25 45 . 46 74 24 237 3 32 32 39 24 77 205 172 174 441 717 409 403 188 588 2973 586 432 464 377 598 230 743 441 3739 364 449 778 319 390 848 206 3043 293 318 236 321 357 598 2085 172 174 444 721 410 416 192 592 2994 590 448 468 379 601 231 752 442 3762 370 451 784 319 392 868 207 3071 294 323 244 329 358 616 2121 Page 4 of 8 Number of unique OIF/OEF veterans with PTSD utilizing VA facilities during FY 2002 2nd Qt FY 2007 (Continued) VISN-Facility Inpatients Primary 10-CHILLICOTHE 10-CINCINNATI 10-CLEVELAND-WADE PARK 10-COLUMBUS-IOC 10-DAYTON VISN 10 11-ANN ARBOR HCS 11-BATTLE CREEK 11-DETROIT VAMC 11-ILLIANA HCS DANVILLE IL 11-INDIANAPOLIS-10TH ST 11-NORTHERN INDIANA HCS 11-SAGINAW VISN 11 12-HINES 12-ILLIANA HCS DANVILLE IL 12-IRON MOUNTAIN 12-MADISON 12-MILWAUKEE 12-NORTH CHICAGO 12-TOMAH 12-VA CHICAGO HCS VISN 12 15-VA HEARTLAND-E VH MO 15-VAMC HEARTLAND-W KANSAS MO VISN 15 9 8 10 . 10 37 6 22 5 3 14 2 . 51 16 . 1 4 13 7 9 4 52 27 99 126 2 Outpatients 3 Total Patients 3 1 Any 20 20 38 . 17 94 Primary 159 245 524 191 171 1254 206 298 141 280 242 132 221 1473 293 . 68 154 354 158 191 221 1381 631 680 1303 2 Any Primary 159 245 524 191 173 1255 207 300 143 280 242 132 221 1475 295 . 68 154 357 160 191 221 1385 632 706 1329 2 Any 3 Vet Centers SubPTSD PTSD Other . 55 43 116 41 255 . 96 102 45 30 57 . 330 66 32 . 33 24 53 . 125 333 130 150 280 . 11 16 11 2 40 . . 15 8 . 11 . 34 24 . . 28 11 9 . 3 75 35 8 43 . 664 1469 151 40 2324 . 115 456 808 408 414 . 2201 141 512 . 7049 101 282 . 521 8606 1733 3965 5698 4 Grand 5 Total 186 268 596 228 203 1431 239 337 206 337 283 169 284 1791 329 . 83 188 418 204 231 266 1643 731 787 1508 189 270 604 228 207 1444 243 341 211 337 283 171 284 1798 338 . 83 195 424 211 234 269 1669 736 829 1553 189 294 620 302 238 1576 243 403 280 356 303 214 284 1992 382 32 83 216 439 242 234 355 1874 810 938 1735 18 30 22 15 22 6 . 109 37 . 1 21 33 17 18 11 131 58 163 220 Page 5 of 8 Number of unique OIF/OEF veterans with PTSD utilizing VA facilities during FY 2002 2nd Qt FY 2007 (Continued) VISN-Facility Inpatients Primary 16-ALEXANDRIA 16-FAYETTEVILLE AR 16-GULF COAST HCS 16-HOUSTON 16-JACKSON 16-LITTLE ROCK 16-MUSKOGEE 16-OKLAHOMA CITY 16-SHREVEPORT 16-SOUTHEAST LA HCS VISN 16 17-DALLAS 17-SAN ANTONIO 17-VA CENTRAL TEXAS HCS VISN 17 18-AMARILLO HCS 18-EL PASO HCS 18-NEW MEXICO HCS 18-NORTHERN ARIZONA HCS 18-PHOENIX 18-SOUTHERN ARIZONA HCS 18-WEST TEXAS HCS VISN 18 19-CHEYENNE 19-DENVER 19-FORT HARRISON 19-GRAND JUNCTION 19-SALT LAKE CITY HTHCARE 19-SHERIDAN VISN 19 9 11 11 14 4 41 2 13 10 3 117 18 27 24 69 . . 17 1 23 29 . 69 . 42 1 . 20 14 70 2 Outpatients 3 Total Patients 3 1 Any Primary 183 224 527 527 142 602 204 338 249 337 3248 573 810 767 2109 146 156 543 125 734 328 119 2081 102 705 284 55 418 105 1615 2 Any Primary 187 224 532 529 143 610 204 341 250 337 3264 576 812 769 2116 146 156 545 125 737 331 119 2084 102 710 284 55 419 107 1621 2 Any 3 Vet Centers SubPTSD PTSD . . 510 78 20 208 106 56 113 71 1162 130 292 214 636 62 22 229 42 90 89 47 581 92 214 213 . 171 . 690 . . 5 6 35 42 19 31 185 123 446 56 67 40 163 59 1 14 11 7 1 3 96 18 3 13 . 33 . 67 4 Grand 5 Total Other . . 1077 260 264 564 17 249 1975 11 4417 579 2026 907 3512 96 937 309 43 914 2324 245 4868 429 3176 662 . 2014 . 6281 243 241 972 625 211 768 309 437 364 426 4451 760 1064 1075 2838 203 187 677 151 858 449 163 2590 179 943 480 69 598 133 2321 27 22 27 22 19 72 9 33 22 5 253 47 45 33 123 2 . 42 1 57 48 2 146 1 64 8 . 38 23 124 235 238 588 574 199 641 232 402 282 374 3665 653 914 934 2455 169 174 581 137 821 394 142 2337 114 823 343 69 483 131 1904 243 241 598 578 203 655 233 413 287 374 3714 661 919 936 2470 170 174 585 137 826 399 142 2347 115 830 344 69 490 133 1919 Page 6 of 8 Number of unique OIF/OEF veterans with PTSD utilizing VA facilities during FY 2002 2nd Qt FY 2007 (Continued) VISN-Facility Inpatients Primary 20-ALASKA HCS & RO 20-BOISE 20-PORTLAND 20-PUGET SOUND HCS 20-S.ORG REHAB WHITE CITY 20-SPOKANE 20-VA ROSEBURG HCS 20-WALLA WALLA VISN 20 21-CENTRAL CALIFORNIA HCS 21-HONOLULU 21-MANILA 21-NCHC MARTINEZ 21-PALO ALTO-PALO ALTO 21-SAN FRANCISCO 21-SIERRA NEVADA HCS VISN 21 22-GREATER LA HCS 22-LOMA LINDA 22-VA LONG BEACH HCS CA 22-VA SAN DIEGO HCS CA 22-VA SOUTHERN NEVADA HCS VISN 22 . 4 12 92 . 6 49 2 154 8 1 . . 23 3 3 35 9 26 5 17 6 62 2 Outpatients 3 Total Patients 3 1 Any Primary 73 129 594 868 61 188 227 121 2191 210 190 14 468 429 247 136 1644 719 536 441 632 250 2518 2 Any Primary 73 132 594 887 61 188 254 121 2212 211 190 14 468 435 248 136 1650 720 537 441 633 251 2521 2 Any 3 Vet Centers SubPTSD PTSD 150 77 239 361 32 98 80 . 1037 99 74 . 302 117 81 52 725 246 157 143 228 68 842 21 82 37 52 2 18 24 . 236 1 26 . 44 4 10 3 88 19 12 9 6 12 58 4 Grand 5 Total Other 1069 1547 599 6197 84 1384 1584 . 12464 488 1647 . 1271 1139 163 155 4863 1300 2643 466 4450 497 9356 214 233 844 1208 94 269 319 144 3185 301 255 14 853 569 327 180 2404 981 735 654 888 337 3480 . 15 33 120 . 14 50 2 219 15 4 . . 73 15 12 116 28 52 13 36 17 142 111 169 700 959 72 217 251 144 2539 252 204 14 687 492 275 154 2007 830 641 524 759 295 2962 111 173 702 983 72 221 277 144 2568 258 205 14 687 520 282 155 2042 835 648 526 766 297 2980 Page 7 of 8 Number of unique OIF/OEF veterans with PTSD utilizing VA facilities during FY 2002 2nd Qt FY 2007 VISN-Facility Inpatients Primary 23-FARGO 23-FORT MEADE 23-MINNEAPOLIS 23-SIOUX FALLS 23-ST CLOUD 23-VA NEB-WESTERN IA HCS VISN 23 Unique Counts 1 3 11 3 4 16 38 1480 2 Outpatients 3 Total Patients 3 1 Any Primary 68 109 302 126 176 797 1543 39152 2 Any Primary 68 109 303 127 176 797 1544 39225 2 Any 3 Vet Centers SubPTSD PTSD 79 35 62 80 . 215 471 13392 1 8 52 76 . 29 166 3790 4 Grand 5 Total Other 791 328 1010 1575 . 1998 5702 120014 143 168 411 237 199 998 2091 52375 4 4 50 14 10 48 129 3114 87 142 356 186 196 887 1806 45040 87 143 373 190 199 893 1829 45330 1. The "total patient" counts were generated by matching a cumulative roster of 717,196 unique OIF/OEF veterans, who had been separated from active duty as of February 2007, with VA inpatient (PTF) and outpatient (OPC) databases for FY 2002, 2003, 2004, 2005, 2006, and through 2nd Qt FY 2007. The DOD Defense Manpower Data Center identified and provided the identity of these veterans to the VA Environmental Epidemiology Service on April 17, 2007. The number for "Primary" indicates the total number of unique veterans whose primary reason for the inpatient or outpatient visit was for treatment or evaluation of PTSD. The number for "Any" indicates the total number of unique veterans with PTSD, whether or not the primary reasons for the inpatient or outpatient visit was for treatment or evaluation of PTSD. The Vet Center counts were based on matching the DMDC OIF/OEF roster with Vet Center users' records through 2nd Qt FY 2007. The number for "Grand Total" (n=52,375) indicates the sum of "Any Total Patients" (n=45,330) and "Vet Center PTSD" (n=13,392) after excluding known duplicates (n=6,347). 2. 3. 4. 5. Page 8 of 8

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