GAO report: VA provides inconsistent treatment to veterans with depression (Hartford Courant)
The U.S. Department of Veterans Affairs provides inconsistent treatment to veterans with depression and may be underestimating the number of vets who suffer from the condition, according to a government watchdog agency. The VA also needs to do a better job monitoring veterans who are prescribed antidepressants and in tracking suicides, according to a new report by the U.S. Government Accountability Office. The GAO analyzed VA data from the 2009 through 2013 fiscal years and found inconsistencies in the way veterans were treated and medical records were kept. It also found that the VA’s own clinical guidelines were not always followed. VA officials did not respond to requests for comment about the report. The GAO is an independent, nonpartisan watchdog agency that works for Congress and investigates how the federal government spends taxpayer dollars. According to the GAO, from 2009 through 2013 about 10 percent of veterans – or 532,222 individuals – who sought health-care services through the VA were diagnosed with major depressive disorder. Symptoms include depressed mood, loss of interest or other conditions that last for two weeks or more and affect the patient’s ability to function. But those figures may not accurately reflect the prevalence of depression among veterans, according to the GAO, because a sample of veterans’ medical records found diagnostic coding discrepancies in more than one third of the cases.
The Army is building an algorithm to prevent suicide (FiveThirtyEight.com)
Researchers have created — and are still honing — a model to predict who might commit suicide. That model relies on sophisticated algorithms and a massive amount of data, and it’s blossoming at a surprising institution: the Army. The Army is constructing a high-tech weapon to fight suicide because it’s losing the battle against it. In 2012, more soldiers committed suicide than died while fighting in Afghanistan: 349 suicides compared to 295 combat deaths. That’s a symptom of a military suicide rate that has been on the rise since 2005, far outpacing the general population’s rate. An algorithm can help, but it can’t do everything. That’s where clinicians come in; they can tailor treatment regimens for people with suicidal tendencies. Right now, though, these conversations are happening without a predictive algorithm, if they’re happening at all. “In a way we’re stating the obvious; that mental health problems are associated with suicide risk. That in and of itself is not news, but we’ve turned it into a quantitative algorithm,” said Michael Schoenbaum, who was part of the initial group and is a senior adviser for mental health services, epidemiology and economics at the National Institute of Mental Health (NIMH).
Report: Military veterans losing ground on jobs as disability enrollment increases (Stanford University)
U.S. military veterans are more likely to file for disability compensation and less likely to find employment than ever before, according to a Stanford economist. Mark Duggan suggests in a new article that the two trends are connected: The rapid rise in disability compensation enrollment has contributed to disincentives to job entry. The U.S. Department of Veterans Affairs pays benefits to military veterans with medical conditions linked to their service time through the federal disability compensation program. Veterans have historically done better than the general population in getting jobs. But Duggan found that this is no longer true. From 1980-99, veterans were more likely than other workers to have jobs or be looking for jobs. However, that changed around 2000, and veterans are now much more likely to be out of the labor force than other workers. Duggan’s research found that from 1950 through 2000, about 8 to 10 percent of America’s veterans received disability benefits. Today, 18 percent of veterans are enrolled in the program. Disability enrollment has increased, rising from 2.3 million in 2001 to 3.9 million by 2014. This increase occurred despite a 16 percent reduction during that same period in the number of military veterans – from 26.1 million to 22 million.
Veterans exposed to viruses, claim VA avoided responsibility (MSNBC)
John Renegar Jr., wearing a careworn baseball cap emblazed with “101st Airborne”, surveyed his small living room in Smyrna Tennessee and shrugged. “It just makes you think you don’t mean nothin’ to anybody, you know,” the 66 year old Vietnam vet said. “You served a country, but you don’t mean anything to her.” Renegar is referring to his treatment by the Department of Veteran Affairs. He’s one of thousands of veterans to receive a bombshell of a letter in 2009 – warning them that they may have been exposed to life-threatening infections as a result of misconfigured or unclean colonoscopy equipment. He’s also one of a smaller group to subsequently test positive for a serious infection – in his case, chronic hepatitis that will leave him at risk for life-threatening liver damage for the rest of his life. But Renegar was just as shaken by his treatment after the infection – with the V.A. ignoring his concerns, denying his claims, and eventually fighting him in court. Documents obtained by NBC News show he is not alone – in fact, the agency has quietly rejected most of the medical malpractice claims associated with the botched colonoscopies. Reneger said he believes he contracted his case of hepatitis during a colonoscopy at the V.A.’s Alvin C. York Medical Center in Murfreesboro, Tennessee on Oct. 30, 2003. “You know you’ve lived a clean life and hadn’t done any kind of drugs or … been running around on my wife or anything,” he said. “… I don’t know of anywhere else I could have got it.” He was among 6,387 patients deemed at risk after procedures at that facility between April 23, 2003 and Dec. 1, 2008.
VA continues to fall short for veterans with mesothelioma (Asbestos.com)
Michael Johnson watched his father, retired U.S. Marine Corps veteran John Johnson, die prematurely almost three years ago from mesothelioma after the VA health care system misdiagnosed and mishandled his case more than once. His biggest point of contention — which ultimately cost his father’s life — is that patients within the VA health care system have no way of knowing there is a mesothelioma specialty center that can provide the care they need and likely extend their lives. “It’s mind-boggling the way the VA works,” Johnson told Asbestos.com. “If my father had been diagnosed correctly, he’d still be here today. He believed in the VA, but it absolutely let him down.” Johnson and his family have made it their mission to help correct a glaring flaw in the system by reaching out to federal VA leaders and pledging financial support to specific cancer centers that treat veterans with mesothelioma. An estimated 3,000 Americans are diagnosed annually with mesothelioma, and approximately one-third of those are veterans, a disproportionate amount that stems from the military’s extensive use of asbestos materials in the 20th century.
Kansas senator vows to push for passage of veterans suicide prevention bill (Topeka Capital-Journal)
Sen. Jerry Moran is vowing to reintroduce legislation aimed at cutting the number of veteran suicides – up to 22 a day – that was blocked in the final days of the Congressional session. Senators fled Washington earlier this week without taking action on the bill after Sen. Tom Coburn, an Oklahoma Republican known for blocking legislation, stopped the bill from moving forward. Coburn, who is leaving the Senate after 10 years, said the bill would do little to prevent suicides because it does not reform the scandal-plagued Department of Veterans Affairs. Moran, a Republican, slammed Coburn’s action late Wednesday. “I was extremely disappointed that the Clay Hunt Suicide Prevention for American Veterans Act was blocked from passage this week in the Senate after it unanimously passed the House. The average suicide rate among veterans is a troubling 22 deaths each day, and the legislation would be instrumental in developing a VA system capable of offering first-rate mental health care services, as well as utilize the expertise of outside organizations to provide support for those struggling with the invisible wounds of war,” Moran said in a statement to The Capital-Journal.
Veterans court judge dismayed at killing spree by client (CBS-Philadelphia)
The judge overseeing Veterans Treatment Court in Montgomery County, Pa. says that community is devastated by the actions of Bradley Stone, the man prosecutors say murdered his ex-wife and five of her relatives earlier this week. Judge William Furber says Stone, 35, was admitted to the court with a second-offense DUI. He says Stone did not have a record of violence and showed no violent tendencies during his time in the program. Furber also says court personnel are at a loss to explain his actions. Those actions, the judge says, do not represent the 32 veterans currently receiving treatment through the court, which he says is critical to ensure their well-being. Furber says the other veterans will receive private counseling in place of their regular Friday court docket this week. He says they have been deeply affected by the tragedy.
High price has VA rationing new hepatitis C drug (Newport News Daily Press)
Sen. Bernie Sanders (I-Vt.) used one of his last hearings as chairman of the Senate Veterans Affairs Committee to review how VA has had to ration a break-through medicine that cures hepatitis C, a liver virus infecting 174,000 veterans, because a course of treatment — 84 pills over 12 weeks — costs VA almost $50,000 per patient. Sanders said the biopharmaceutical company Gilead Sciences Inc., of Foster City, Calif., stands to earn more than $200 billion on a new drug called Sovaldi. When combined with still toxic antiviral medicines including interferon injections, Sovaldi cures hepatitis C at a 90 percent rate, and does so faster and with fewer side effects than past drug regimens. That a cure has been found is good news, Sanders said, especially for veterans who are infected with hepatitis C at three times the rate of the general population. Vietnam War-era vets are hit particularly hard because of battlefield blood exposure, non-sterile vaccination routines, wartime sharing of razors, drug abuse and recruit demographics from the last draft era. What’s disturbing and “astounding,” Sanders said, are pill prices set by Gilead. VA has budgeted $1.3 billion to buy Sovaldi over the next two years to treat mostly patients with advance liver disease or liver cancer, said Michael Valentino, chief consultant for VA Pharmacy Benefits Management Services. There’s money enough for 25,000 to 30,000 patients, he said. If VA had an unlimited drug budget, said Dr. David Ross — the director of HIV, hepatitis C and public health pathogens programs for VA — it would provide Sovaldi at least to half and perhaps two-thirds of the 174,000 vets infected with the virus. Some are better off waiting, Ross explained, because medicines are being developed that, unlike Sovaldi, will not have to be taken in combination with more toxic drugs.