Dear Editor: Dear Tester

This letter is directed towards Montana State Senator John Tester.

Senator Tester,

On April 11, 2024, you wrote to Mr. Duane Gill, Director of the Montana VA HCS, regarding pain management for Montana Veterans. The facility's response, dated May 14, 2024, was on par with a fifth-grade book report. The misinformation, simplistic responses, and lack of context are indicative of Montana VA leadership's disdain for oversight and being held accountable.

While there are several inaccuracies in the responses, I will highlight the most egregious. Montana VA leadership has reduced therapies for management of chronic pain, stating to your office, other congressional offices, Veterans, VA staff, and the VA Office of the Medical Inspector that when the Director of Comprehensive Pain and Wellness was hired the facility would implement a plan to resume treating Veterans. The facility has billed this position and that of the Deputy Chief of Staff to Primary Care Teams and Veterans as experts in chronic pain management. Primary Care Teams cannot refer Veterans to these physicians, nor do either of them see Veterans in the clinic.

Montana VA wrote that on May 4th, 2024, there were pain management resources specific to female Veterans at a women's health extravaganza at the Billings CBOC. What they neglected to tell you was facility leadership did not allow employees scheduled to present and meet with Veterans to travel to Billings. Since the event had passed by the time they replied to you, they knew the information provided was false.

You cosponsored the Comprehensive Addiction and Recovery Act (CARA) of 2016 which mandated each VA facility to have a CARA Pain Team. I and others at Montana VA have contacted your state and SVAC staff regarding the Montana VA leadership dismantling this team which is required by legislation you sponsored and signed. There has not been a functioning CARA pain team at Montana VA for well over a year.

All the responses are half-truths at best and are not an accurate representation of what is happening to the Veterans and staff at Montana VA. This highlights the focus of my letter, the complete lack of oversight and accountability at Montana VA. Whether it is congressional offices or Office of the Inspector General investigations, the leadership at Montana VA shuns accountability.

There are no consequences for senior leaders at Montana VA. Multiple employees have filed complaints with the Office of Accountability and Whistleblower Protection. None of these go anywhere. When I filed a complaint, the investigator told me, "This office does not care if the Chief of Staff follows the medical staff bylaws." He went on to say that as far as their office was concerned, the Chief of Staff and other executives could do whatever they wanted. The Miles City Community Living Center was shut down due to three substantiated cases of patient abuse from August 2020 to the fall of 2023. The executive responsible for managing the CLC during this time was not removed. Rather the Chief of Staff created a new administrative position for this person. Public records show this person was compensated over $160,000 in salary for 2023.

Holding Montana VA leadership accountable should not be difficult. VA ICARE Values are codified in federal regulation 38 C.F.R Part 0. The Director's response violates the Integrity and Excellence portion of this federal regulation. You are the founding member of the Senate Transparency Caucus. If you cannot or will not hold the leadership of VA Montana accountable for their actions as the Chairman of the Senate Veterans Affairs Committee, be transparent in telling Veterans, VA staff, and the citizens of Montana as much.

Respectfully,

Erik Vilen, M.D., U.S Army Veteran - Iraq 2003-2004