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Haley Doctors Grilled On Mental Health Care

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By GRETCHEN PARKER, The Tampa Tribune

Published: December 29, 2007

Updated: 12/29/2007 12:14 am

TAMPA - U.S. Rep. Ginny Brown-Waite grilled a panel of doctors and administrators from James A. Haley VA Medical Center on Friday about how closely they are supervising unlicensed psychologists who treat veterans.

At the same time, she questioned the motivations of a staff psychologist who filed a complaint with the state saying he is concerned that veterans unknowingly are being treated by unlicensed psychologists who are inexperienced and not getting enough supervision.

It was that complaint, from Brian Nussbaum, that brought public attention to the issue; Brown-Waite convened the forum at Haley after reading newspaper reports of it.

Brown-Waite, R-Brooksville, pointed out that Nussbaum was not granted the title of team leader of the Post-Traumatic Stress Disorder clinic when he applied for it.

"Perhaps Dr. Nussbaum felt excluded," she said after the forum, and added there appears to be a "breakdown in communication" within the program at Haley.

When asked whether she has concerns that veterans are not getting top quality mental health care, she said the situation still should be monitored.

She asked most of the questions during the forum, as she sat alongside the Haley doctors and administrators. U.S. Rep. Gus Bilirakis, R-Palm Harbor, posed a couple of queries.

About 70 people attended, including leaders of veterans' service organizations. They were not given a chance to question Haley staff.

The forum put Haley administrators on notice their program is being watched, said Verlin "Buck" Rogers, founder and past president of a local chapter of Korean War Veterans Association.

"I think we opened the eyes of the administrators, and they finally realize they need to listen to the veterans more," Rogers said.

Rogers' chapter had voiced concerns that two longtime staff members, including one who had helped develop the PTSD program, no longer are working there. When they pressed for answers, Rogers said the hospital gave them "lip service."

When talk at the forum turned to the departure of those employees, several in the audience grumbled.

Doctor Queries Panel

Sitting in the audience, Nussbaum was the only one allowed to ask pointed questions of the panel. He said again, as he did in his complaint to the Florida Board of Psychology, that he is concerned there are at least eight unlicensed psychologists treating veterans at Haley. That's out of a staff of 42.

"I'm concerned over the large number of unlicensed staff psychologists being hired," Nussbaum said. "It seemed unlikely that qualified, licensed professionals were unavailable."

He alluded to a secretive atmosphere at Haley. Facing the panel of administrators, he said, "I'm sitting here alone, and that's concerning. Why is that? There are people who have expressed their support. They're afraid they're going to lose their job."

Hiring unlicensed psychologists is legal, but Nussbaum has alleged Haley is skirting the state's requirements by not sufficiently supervising them as they treat patients.

In response, Haley's chief of staff, Edward Cutolo, reviewed two months of notes, taken after sessions with patients, to see if they were properly signed by licensed psychologists, he said Friday. He stacked them on the table, in a column a foot and a half tall, and said 97.5 percent of them were signed.

"How do we make sure we're not flipping to the back page where the signature is? How do we ensure they are really being read?" Brown-Waite asked.

Guaranteeing A Review

VA officials have told her a forthcoming directive will emphasize that session notes must have specific notations from supervisors.

The hospital says its unlicensed psychologists are on track to get their licenses, by completing the required 2,000 hours of supervised work, including two hours a week that are closely supervised and one hour a week that is face-to-face supervision.

Brown-Waite addressed that issue, asking Haley's chief psychologist, Arthur Rosenblatt: "How often is there a face-to-face meeting with the post-doctoral staff that you have?"

Rosenblatt maintained that one-on-one supervision, in person, happens weekly.

Later, Nussbaum contested that, telling the panel, "It's difficult to prove something that is not happening."

Reporter Gretchen Parker can be reached at (813) 259-7562 or gparker@tampatrib.com. Reporter Gretchen Parker can be reached at (813) 259-7562 or gparker@tampatrib.com.

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