By Sandra Basu
WASHINGTON—VA pushed back against congressional bills under consideration last month that would create new pilot programs related to dog therapy.
“We do not believe that creating yet another program would add significant value. VA is already helping veterans to obtain service dogs when that best supports their recovery,” said VHA Acting Assistant Deputy Under Secretary for Health for Patient Care Services Harold Kudler, MD, who noted that DoD and VA already have similar pilot programs in place.
Kudler made his comments at a recent House Committee on Veterans Affairs Subcommittee on Health hearing on two bills related to dog therapy that were reintroduced from previous congressional sessions.
HR 2327, the Puppies Assisting Wounded Servicemembers (PAWS) Act, would direct the VA to carry out a five-year pilot program to provide grants to select organizations that pair veterans suffering from severe post-traumatic stress disorder (PTSD) with service dogs. To be eligible for the pilot, the veteran must have completed traditional therapies for PTSD and remain symptomatic.
“By propagating a yet-unproven therapy, the bill may result in unintended and negative consequences for the veterans who would be participating in this unsubstantiated treatment regime,” Kudler said in a written statement. “Also the pilot program would be duplicative of an existing VA research study on the effectiveness of service dogs and emotional support dogs for veterans with PTSD.”HR 2225 would require VA to pilot a program in which eligible veterans learn how to train service dogs. As part of the pilot, VA would have to collect data on the effectiveness and mental health outcomes for those veterans participating. Kudler explained that, “although anecdotal evidence has been offered to show the benefits of participating in such a dog training therapy program, there is no published scientific evidence to date that shows that such a program benefits PTSD patients specifically or that such a resource-intensive program is any better than therapies known to be effective in alleviating PTSD symptoms.”
He also said that “the pilot program would be duplicative of a DoD study of this same therapy program at the Uniformed Services University of Health Sciences.”
Currently, blind and visually-impaired veterans have access to service dogs through VA, but the agency has maintained that not enough clinical research yet exists to know if such a program could help treat PTSD.
Further, research to determine whether veterans with PTSD can benefit from service dogs has been fraught with challenges.
While a VA study was initially launched in 2011, the study was halted after two service dogs bit children in veterans’ homes. The study was suspended again before restarting due to problems with the health and training of some of the dogs.
“A delay for a study of this importance for this amount of time is simply unacceptable,” Rep. Stephen Lynch (D-MA) said last year at hearing on the issue held by the House Committee on Oversight and Government Reform Subcommittee on National Security.
Noting that the study results were still years away, VA Secretary David Shulkin, MD, told a House committee earlier this year, however, that he was “not willing to wait because there are people out there today that are suffering.”
At the recent legislative hearing, Keronica Richardson, assistant director of Women and Minority Veterans Outreach for the American Legion National Security Division, said her organization supports the bills.
“PTSD has become an epidemic, and the VA has estimated that between 11 and 20% of veterans who served in Afghanistan or Iraq have PTSD. While the VA continues to stall with their dog-based therapy studies, veterans are being denied alternative forms of treatment,” Richardson said.
Meanwhile, AMVETS voiced its support of HR 2225. When it comes to the PAWS Act, AMVETS National Legislative Policy Advisor Amy Webb said in a statement that while AMVETS supports passage of the bill, “it is with the stipulation that great care, consult, and oversight occur when awarding a contract to an organization that trains the service dogs; in choosing veterans who are able to manage the continued care and training the dog will require; in closely following those who are part of the pilot program; and in setting expectations for how quickly the veteran can obtain a dog.”
On the other hand, the Blind Veterans Association expressed concerns and questions with both bills in a written statement. When it comes to the PAWS Act, the group explained in a statement that “the rush to get people paired with dogs as quickly as possible, in hopes of mitigating their disability’s negative impact on quality of life is laudable,” but that they hope that “this will not be done at the expense of careful and thorough training for both the dogs and their recipients.”
“To compromise here could add significantly to, rather than relieve, an individual’s stress. It can and has also caused injuries to veterans, dogs, and members of the public who inadvertently get caught up in situations involving misbehaving, frightened or aggressive dogs,” BVA director of Government Relations Melanie Brunson said in a statement.
Brunson further explained that BVA has “received numerous reports over the past couple of years of incidents involving apparently untrained, or poorly trained dogs on VA property who act aggressively toward VA employees, veterans who accidentally get too close to the dog, or the service dogs of veterans with disabilities.”
A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.
When Terrence O’Neil, MD, retired as chief of nephrology at the James H. Quillen VAMC in Johnson City in December 2016, he left in his wake decades of work treating kidney disease—nearly 35 years in the Air Force and DoD, plus 11 more at VA.