Oakland VA files reveal heartbreak, delays (San Jose Mercury News)
There was nothing special about the metal, gray file cabinet. But for Rustyann Brown, it represented heartbreak and shattered trust. Stuffed inside were the silent pleas of more than 13,000 veterans and surviving spouses, some dating back to the mid-1990s, begging for VA assistance — help she believes never came for an untold number of them. Instead, those compensation and disability claims from Northern California veterans had been stashed away and forgotten at the Oakland regional benefits office, according to Brown and other whistleblowers. “The VA didn’t do the right thing,” said Brown, 61, of San Leandro. “It didn’t even try to do the right thing. So many of them died waiting. The thought of what happened to those veterans will keep me up at night the rest of my life.” Brown is one of five employees who came forward with allegations that Oakland mismanaged thousands of claims. She contends the files deliberately were shunted aside to manipulate Oakland’s statistics of backlogged claims. And by speaking out, she is pulling back the curtain on a regional office that already had a poor reputation in the VA benefits system. The latest blow was a VA Office of Inspector General report last month that said Oakland managers conceded 13,184 claims were improperly stored in the file cabinet, including 2,155 requiring further review. Although investigators couldn’t verify that count due to “poor record keeping practices,” it concluded “veterans did not receive consideration for benefits to which they may have been entitled.” But on March 4, Allison Hickey, the VA under secretary for benefits, told a congressional subcommittee that the file cabinet only held duplicates of processed claims. “None are missing,” Hickey said. “There was no malfeasance. No intention to hide anything.” Rep. Doug LaMalfa, R-Oroville, compares the evolving explanations to dog-ate-my-homework excuses. “It’s like grade-school math — show us your work,” LaMalfa said. “We want to know what happened to all of those 13,000 files because those are 13,000 lives. This is not the whole story.” Telling this story has extracted a toll on Brown, who took early retirement last September to escape what she describes as a hostile work environment. Today, she wonders if anyone will ever be held accountable despite the whistle-blowers’ best efforts. “I just wanted to help veterans,” she said. “These are my people.”
Thousands in Florida potential victims of Camp Lejeune water contamination (Orlando Sentinel)
Christina Peach’s parents welcomed a seemingly healthy baby into the world in 1975 at the Naval Regional Medical Center in Camp Lejeune, the North Carolina base where her father was stationed as a Marine sergeant. Seven years later, a chemical consulting company found that water from the emergency-room sink contained 1,400 parts per billion of trichloroethylene — 280 times its regulatory limit for drinking water today — which “has been reported to produce liver and kidney damage and central nervous system disturbances in humans,” according to a memo from Grainger Laboratories in 1982. Peach, 39, who now lives in Mount Dora, believes the water she was exposed to in utero and as an infant is responsible for the kidney cancer she developed last year and for her father’s premature death. Doctors discovered the mass growing on her right kidney when she got a CT scan for appendicitis in January 2014. Her father, Michael Hightower, 61, died 10 months later from lung cancer that had spread to his brain, bladder and bones, she said. “The devastation of this tragedy is still being experienced today,” she wrote on a fundraising page for her father’s cremation and funeral costs. “These Marines and their families dedicated themselves to this country and are now losing their lives to cancer and other life-threatening health issues.” A law passed by Congress in 2012 is designed to help relatives of Marines who lived on the base between 1953 and 1987 and were potentially exposed to the contaminated water. The law promises to reimburse out-of-pocket medical expenses not covered by insurance for people who developed one of 15 conditions, including cancer, female infertility and neurobehavioral effects. The water contained volatile organic compounds and other cancer-causing chemicals from an off-base dry-cleaning company, leaking underground storage tanks, industrial-area spills and waste-disposal sites. In Florida, 19,965 people — veterans, family members and civil workers — are registered with the Marine Corps as potential victims of the Camp Lejeune water contamination, the largest number in any state besides North Carolina. But Peach, who said she lived in a duplex in a nearby fishing village, is not eligible for benefits because she did not reside at Camp Lejeune for at least 30 days, as the 2012 law requires. Still, she argues, all of her mom’s prenatal care took place at the base hospital, she drank the water mixed with her baby formula, visited the base cafeteria and drank water her dad brought home.
‘Sham’ investigations: Docs, nurses investigated at VA hospitals (Delaware Online)
At least eight nurses and two highly paid doctors are spending their days on the phone, setting up patient appointments in an expensive leased office building in Greenville rather than tending to patients at the Wilmington VA Medical Center, according to the union representing half of the employees. Neurologist Maryann Hooker, president of Local 342 of the American Federation of Government Employees, contends the doctors and nurses are under investigation for matters unrelated to their professional medical practice. She calls the investigations a “sham.” “You don’t want that culture of fear in a health care setting,” said Hooker, a longtime VA employee. “You want openness. You want open discussion. You want clarity, fairness, honesty, integrity. And you want to keep your eye on the mission, which is serving the veteran.” The VA will not officially acknowledge that any investigations are underway at the Wilmington facility, located near Elsmere. It also refused to answer specific questions from The News Journal regarding the employees or the tasks to which they’ve been assigned. According to Hooker, another six health providers at the hospital have been assigned to similar jobs during the past year – and all have either quit, retired or accepted part-time employment. The News Journal interviewed a dozen current or former hospital employees over the past two weeks about the investigations, the transfers and staffing issues. While Hooker has testified before Congress and has a national profile that makes her comfortable publicly outlining problems within the VA, none of the other employees would agree to be named – fearing that doing so would result in disciplinary action or the loss of their jobs. Hooker said that all parties are sworn to secrecy. Workers’ positions involved in the transfers were identified in a recent letter describing the assignments sent by the union to VA Secretary Robert McDonald. They include some of the most senior medical professionals at the hospital: the chiefs of surgical services, pathology and laboratory medicine, and radiology.
Group threatens to sue VA over planned pension change (Military.com)
An organization of attorneys plans to sue the Veterans Affairs Department if the agency follows through on plans to means-test eligibility for pensions intended for low-income veterans. The VA’s aim, detailed in a proposed rules change to the Federal Register, is to link the aid and assistance pension eligibility to a veteran’s net worth in the three years prior to applying for the benefit. VA officials say the system is subject to abuse and cannot be sustained without the change. However, attorneys who represent elderly clients claim the move is contrary to Congress’ intention in establishing the benefit and will hurt veterans. “If they enact these regulations we can expect the National Association of Elder Law Attorneys … and groups that protect veterans will sue under the administrative procedures act,” Robert Anderson, founder of The Elder Law Firm of Anderson Associates in Michigan, told Military.com. An agency or department may only alter a regulation if it is “explicitly authorized by federal statute or implicitly authorized,” according to Anderson. In the case of the VA, that authority from Congress is not there, he said. The elder law association has already compiled its formal comments in opposition to the proposed change, Anderson said. The public comments period ends March 24. The proposed change comes after the VA failed to get legislation passed to allow a three year look-back on net worth.
Board votes to suspend license of embattled VA manager Robin Paul (WRTV-Indianapolis)
An Indiana state board has voted to suspend the license of embattled Veteran’s Affairs manager Robin Paul after she was accused in an email scandal. Paul served as manager at the Roudebush VA Medical Center and was accused of sending an email regarding veteran suicide in Dec. 2014. According to documents linked to the investigation, Paul sent an email with a subject line “Naughty Elf in the STICC” that included four photos of a Christmas elf character. One photo included a note next to the character that read “Out of Xanax please help!” Another photo depicted the elf hanging from a strand of Christmas lights and a caption that read “Caught in the act of suicidal behavior (trying to hang himself from an electrical cord).” The Indiana Behavioral Health and Human Services Board voted Monday to suspend her license, just two weeks after she was placed on administrative leave during the internal investigation Paul’s role as a social worker in the clinic focused on assisting veterans who have recently returned from service.
Lawmakers: Funding education for Texas veterans is too high (The Washington Post)
They signed up to fight for their country, and the state of Texas promised to pay for their education. For decades, veterans went to public universities and colleges under the Hazlewood Exemption, which kicks in after federal benefits under the G.I. Bill are exhausted. But the price tag has increased sevenfold since 2009, when legislators in Texas — which has the country’s second-highest population of veterans, 1.7 million — allowed the benefit to be passed on to veterans’ children under a legacy provision. “Everybody’s heart was in the right place when we added all the other beneficiaries,” said Republican state Sen. Kel Seliger, chair of the Senate’s higher education committee. But, he added, “it just got too high of a price tag.” Now, amid rising legacy costs and concern that a federal lawsuit over residency could push the benefit’s annual figure to $2 billion, policymakers are trying to balance state politics and fiscal conservativism with commitments made to veterans during World War II. Of the 10 states with the most veterans, only Illinois and Texas waive all tuition and fees for veterans who meet program requirements, according to a Texas Legislative Budget Board report. And Texas is the only state of the 10 to offer full tuition and fee waivers to children, the report said, a decision made in 2009 in tandem with expanding the benefit to include spouses of veterans who were injured, missing or killed in action. About 39,000 Texas residents used the benefit last fiscal year, at a cost of $169 million, according to the Texas Legislative Budget Board. That’s 576 percent more than before the legacy expansion, when only about 10,000 used the exemption, at a cost of nearly $25 million.
Troubled VA medical center in Tomah gets new leadership (Military Times)
The director of the troubled Veterans Administration Medical Center in Tomah has been reassigned. According to the Office of Congressional and Legislative Affairs, Mario DeSanctis has been reassigned to a position at the Great Lakes Health Care System network office. The Tomah facility came under scrutiny in January when reports of narcotic overprescribing practices and retaliatory behaviors surfaced. The hospital is under investigation by the VA, the VA Office of the Inspector General and the Drug Enforcement Administration. According to the Office of Congressional and Legislative Affairs, the medical center will be under the leadership of Mr. John Rohrer, who is currently associate medical center director at the Madison VA Medical Center. It did not indicate why DeSanctis was transferred. A message left at the office Saturday wasn’t immediately returned.
Post-9/11 vets caucus to focus on wars’ aftermath (Military Times)
The new congressional Post-9/11 Veterans Caucus symbolically launched Thursday, on the 12th anniversary of the start of the Iraq War. But members say they’re less worried about potential new military operations like that and more focused on the lingering impact of the fights of the last decade. “What happens next is often times the question that isn’t answered,” said Rep. Tulsi Gabbard, D-Hawaii, co-chair of the new caucus and an Iraq War veteran. “What are the second-, third-, fourth-order effects of these decisions? “We have firsthand experience with that.” Thirty-one members of the House and Senate served in the military during the post-Sept. 11 era, 26 of whom served in Iraq or Afghanistan. Several were members of the Guard or reserves, and most have had some personal interaction with the Department of Veterans Affairs. Caucus co-chair Rep. Scott Perry, R-Pa. — also an Iraq War veteran — said having friends who are dealing with the wounds of war and the transition from military life brings an important perspective to congressional debates. “We can educate other members who aren’t as familiar,” he said. “The members of this caucus have unique experiences based on what they did or do in the military. They have lived it.” The move comes at a time of belt-tightening for Defense Department budgets and increased criticism of VA operations. Caucus members said they want to keep veterans’ voices at the center of those debates, to prevent number crunching from overwhelming the personal stories of those affected. Caucus members said they plan to work closely with Iraq and Afghanistan Veterans of America and other groups focused on younger veterans’ issues. IAVA CEO Paul Rieckhoff said the group is a critical effort to keep the youngest war veterans in the public eye.
Editorial: VA needs more work to treat veterans properly (Tampa Bay Times)
Nine months after a full-blown crisis rocked the Department of Veterans Affairs, the situation for veterans has improved thanks to new leadership at the department, more money and the continuing glare of media coverage. But the health care system is not where it needs to be to appropriately serve patients. Veterans face new gaps in coverage and a bureaucracy that is still struggling to become more responsive to the growing demand from America’s military families. President Barack Obama made a high-profile visit this month to the agency’s hospital in Phoenix, where reports first surfaced last year of sham waiting lists. He called attention to the improvements the department has made, from cutting wait times for veterans seeking a medical appointment to hiring hundreds of new doctors, nurses and other clinical care staff. The new leadership Obama installed at the agency and the $15 billion Congress provided in supplemental funding have helped create a new sense of urgency within the department and enabled the agency to cut wait times and expand access to medical care providers. Yet the department is still fumbling to reform a bloated bureaucracy, and its mixed record in blending the VA’s traditional health care system with a new network of private care providers poses new challenges. Some veterans are still falling through gaps in coverage, especially in the far-flung areas. Having two tracks of medical providers also creates new opportunities for the VA to dodge accountability on the quality and continuum of care that veterans are receiving. And the referral system continues to create confusion for veterans and providers.
Women veterans with depression 5 times more likely to be unemployed (Healio.com)
Women veterans with depression were almost five times more likely to be unemployed compared with veterans who tested negative for depression, according to data published in Medical Care. “Unemployment was prevalent in this national sample of women veterans,” the researchers wrote. “Shortly after the National Survey of Women Veterans was completed, in January of 2010, the unemployment rate among women veterans was 11.2% vs. 9.4% for male veterans and 8.3% for civilian women.” Alison B. Hamilton, PhD, MPH, of the VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy in the VA Greater Los Angeles Healthcare System, and department of psychiatry and biobehavioral sciences at UCLA, and colleagues conducted a secondary analysis of the National Survey of Women Veterans (n = 1,605). They found that 10% of women veterans were unemployed. Screening positive for depression was a risk factor for unemployment (OR = 4.7; 95% CI, 1.8-12.4), according to data. Those with military service during wartime (OR = 2.9; 95% CI, 1.1-7.3), and service in the regular military compared with those in the National Guards/Reserves only, also had an increased risk (OR = 6.8; 95% CI, 2.2-20.5), according to researchers. “Screening for unemployment and other vulnerabilities among women veterans may also be an important step in ensuring that women veterans are directed to services that will help them to obtain the necessary support to thrive in their post-military lives,” the researchers wrote.
Veteran cites years of pain under VA health care in saying system yet to be fixed (Seattle Times)
When Tim Kuncl shattered his shinbone after falling from the roof of his Puyallup, Wash., home while hanging Christmas lights in 2011, he trusted that his local Veterans Affairs hospital would return him to health. But three-plus years and three surgeries later, the 45-year-old Coast Guard veteran’s confidence in VA health care also has been smashed. “It ruined my life,” said Kuncl, a married father of four. From the get-go, Kuncl’s complicated bone break challenged doctors. Each surgery at the VA Puget Sound Health Care System in Seattle succeeded only in leaving him in escalating pain, Kuncl said. His agony became so intense he could barely control his bladder when he walked. Last fall, after a VA nurse told him that his pain was partly nerve-related — even though X-rays showed problems with surgical hardware — Kuncl finally had had enough. He turned to treatment at a private hospital, where he learned he had few options. Now, with only a stump below one of his knees, Kuncl is recovering from recent amputation surgery while sounding the alarm for other vets. “I don’t want to see what happened to me happen to anyone else,” said Kuncl, a longtime VA volunteer. Often the object of criticism, VA health care remains under fire in the wake of a national controversy that rocked the federal agency last year.
VA’s tardiness on St. Augustine clinic will cost taxpayers (Jacksonville.com)
The administration responsible for the longest wait times among major facilities in the entire Department of Veterans Affairs, and which could not meet a two-year deadline to move its St. Augustine clinic, soon will cost taxpayers more than $64,000 per month because of its tardiness. And if the North Florida/South Georgia VA Health System does not meet a new, six-month deadline, the cost to taxpayers will nearly double. It was actually 3 1/2 years ago that St. Johns County notified the VA that it would have to move its clinic from its current location on U.S. 1, where a new Lowe’s is scheduled to be built. “We do not want you to be overly concerned,” Mary Ann Blount, director of St. Johns County’s land management department, wrote to the VA from on Oct. 12, 2011. “Should the Board approve the agreement, it provides for your department to remain in its present location for a two-year period following a closing.” Closing on the property occurred April 1, 2013, triggering the two-year deadline. More than a year earlier, St. Johns County offered to build a new VA facility 5 miles to the north of its current location at the new Health and Human Services complex near the St. Augustine airport without raising the VA’s lease of $24,843 per month. The VA refused. “The proposed county site located at San Sebastian View will not be considered,” VA contracting officer John Blake wrote in an email to the county in August 2013, a year and a half after St. Johns County’s first outreach. According to the VA, Blake said, the site was within the 100-year floodplain and was not within the “advertised delineated area,” meaning the site was not in the area the VA had targeted. However, St. Johns County contests both points, according to two sources with knowledge of the deal who spoke on the condition of anonymity because a clause in the contract forbids either side from speaking to the media without mutual agreement. The VA is using out-of-date information, the sources said.