Veterans news update for April 2

VA forces veteran to get X-ray to prove his leg is missing (Fox News)
The Department of Veterans Affairs wanted to prove that Army veteran Chad Fleming was actually an amputee. So instead of referencing his extensive medical records or simply looking to see that he’s missing his left leg, they insisted that he get an X-ray taken of his artificial limb. “You think that they’d just look at my records and say, ‘You know what? We bought 14 legs, this guy’s an amputee.’ But no,” Fleming told The Blaze. “[The doctor] actually laughed. And I told him, I said, ‘You wonder why the country is in such a deficit? It’s because you’re wasting money taking X-rays of a leg that doesn’t exist.'” “It’s like, ‘Dude, I’m not a starfish. It isn’t going to grow back.'”

Study: No link between combat deployments and suicides (Military Times)
A large study of nearly 4 million U.S. service members and veterans found that deployment to Iraq and Afghanistan is not associated with an increased risk of suicide. Appearing in JAMA Psychiatry online on Wednesday, the study by researchers at the Defense Department’s National Center for Telehealth and Technology, or T2, indicates that although the suicide rate among active-duty personnel has increased since 2001, the rate for those who deployed to a combat zone was roughly the same as for those who did not. Rather, the study found that the military group at highest risk for suicide are those who served in the military for less than a full enlistment. In fact, the suicide rate among those who served less than a year was 2.5 times the active-duty rate, according to the research. And those rates remained extremely high among those who served less than three years. “This is an important finding. It shows those who separated from military service had a 63 percent higher suicide rate overall. … Why are these people at higher risk, we don’t have data to explain it,” said Mark Reger, study lead author and deputy director of T2. But the authors did speculate, based on previous research on why people commit suicide, that problems such as injury, a legal issue or mental health conditions that might force a person out of the military could contribute to suicidal behavior. Or, the transition itself — the loss of identity, difficulty developing a new social support system, issues trying to find meaningful work after service or a sense of feeling like a burden or they don’t fit in to civilian society, could play a role. “Additional research is needed to clarify what the circumstances are surrounding early discharges and how these factors may be related to suicide,” the authors wrote.

Ex-troops with highest suicide risk often don’t qualify for military care (The Los Angeles Times)
The largest study to date of recent military and veteran suicides has identified two high-risk groups of former troops who are generally ineligible for the psychiatric care afforded to all others who served: those forced out of the military for misconduct and those who enlisted but were quickly discharged for other problems. In each of those groups, an average of 46 of every 100,000 former service members committed suicide each year — more than double the rate for veterans with honorable discharges. The findings are likely to spur debate over whether efforts to stem veteran suicides are targeting the right people and to strengthen calls to expand access to benefits and care — especially for those who blame post-traumatic stress disorder or other war-related problems for their misconduct and subsequent dismissals from the military. “The problem is much bigger than the veterans we choose to help,” said Phillip Carter, a senior fellow at the nonpartisan Center for a New American Security who has followed the issue. Many veterans with so-called bad discharges are cast off to local-level mental health services and charities, Carter said. The suicide analysis, published Wednesday in JAMA Psychiatry, included all 3.9 million troops who served between 2001 and 2007. Using military and civilian death records, researchers tracked them until the end of 2009, finding a total of 5,041 suicides.

Phoenix VA treatment program closes after leader blows whistle (AZCentral.com)
Phoenix VA officials shut down a specialized treatment program for veterans just days after its director went public with concerns that suicidal patients are being endangered by inappropriate care at the Phoenix hospital. Medical center leaders insist the move was not retaliatory. They recently told The Arizona Republic that Brandon Coleman, a substance-abuse specialist placed on leave after airing his concerns, will be returning to work soon. Coleman is founder of Motivation for Change, a program at Carl T. Hayden VA Medical Center for convicted drug and alcohol abusers. He and other staffers complained that veterans thinking of suicide were not appropriately monitored at the hospital, especially when they showed up as emergency room walk-ins. During patient backlogs, Coleman said, potentially self-destructive or violent veterans often were allowed to simply walk out, or were monitored by “sitters” who lacked training. Coleman said he subsequently was accused of threatening a fellow employee, and his VA-authorized program was shut down, leaving clients displaced. “This has everything to do with me being a whistle-blower,” he added. Jean Schaefer, a spokeswoman for the Phoenix VA Health Care System, said the decision to put Coleman on leave was not retaliatory, but was required by policy pending an investigation of the allegation against him. Phoenix VA Interim Director Glen Grippen had no choice but to close Motivation for Change because Coleman was the program’s only staffer and the only person familiar with its protocols, Schaefer said. In recent interviews, Grippen and Schaefer told The Republic that concerns about the VA’s handling of potentially suicidal or homicidal veterans are being addressed. They also said the threat investigation has been completed, and Coleman is expected to be back on the job within days doing the same work, but possibly under new supervision in a different location.

Veterans face threat of no benefits for long-term care (KVOA-Tucson)
The Aid and Attendance Benefit is a little known program that helps care for vets in their twilight years. But veteran advocates say the Veterans Administration is trying to make it harder for vets to become eligible; a move that could threaten long term care for veterans. The Aid and Attendance Benefit was enacted by Congress, as part of an amendment in 1951 and has been around for nearly 65 years. Veteran Advocate, Robert Dhillon, said the proposed changes would drastically reduce money given out to vets for home care and assisted living. He said he also believes the VA is trying to bypass Congress in an attempt to save money hoping no will take notice. “They basically will not be able to afford the care they deserve and need.” James Anson is a World War II Veteran. He and his wife Charlotte recently applied for the benefit. Now 92, Anson has never applied for veterans benefits, but as residents of an assisted living facility they could now use the help. Dhillon said they fear they will have to find other ways to get by. “The net result will be more benefits will be denied to veterans that really need them,” said Dhillon.  “That in effect is supposed to save the government money but all these people are going to do is go to a different government program.” The existing program allows veterans and their spouses to receive up to $2,800. Advocates argue the VA is trying to bypass Congress and in the process, pass over deserving veterans. James Anson’s daughter, Kristine Anson, said her father is only asking for what he deserves. “He’s alive, he’s here, he just started asking, they’ve used up everything they’ve had to get here,” said Anson.  “They’re just asking for what he fought for.”

VA pharmacist: Bosses said not to drug-test patients (Military Times)
A pharmacist at the Tomah Veterans Affairs Medical Center in Wisconsin said she was discouraged by higher-ups from performing drug tests on patients prescribed opiates, as is recommended by VA guidelines. In a joint U.S. House and Senate committee hearing in Tomah on March 30, Noelle Johnson, a pharmacist who was fired from the facility and now is employed by VA as a pain management specialist in Des Moines, Iowa, said pharmacists were discouraged from testing patients for drug use for fear of what prescribing physicians might learn. If the tests were negative, it might indicate that the patient was not taking the medication, raising questions as to whether they were “diverting” or selling their meds. If the tests were strongly positive, it could suggest overuse or abuse and VA could be held liable “when something unfortunate happened,” Johnson said she was told. “I believe that this is the point of urine drug testing, to substantiate use and misuse of high-risk medications for the safety of veterans and the public,” Johnson said. “What happened to the doctors’ oath of “First Do No Harm?” During three hours of testimony, House Veterans’ Affairs and Senate Homeland Security and Government Affairs committee members heard from families of patients who died at the Tomah VA, former employees who said they warned VA officials about physicians suspected of overmedicating patients but were fired or reprimanded for doing so and VA administrators in charge of investigating wrongdoing at the hospital.

One doctor’s cure for opiate overprescription: diagnose first (Stars & Stripes)
Dr. Heidi Klingbeil has a novel solution to the epidemic of opiate overprescription: Make a diagnosis in the first place. That seemingly obvious step — along with follow-up treatment focusing more on rehabilitation than narcotics — has been the linchpin of a program that has brought her regional VA health care network to the bottom of a list where last place is coveted. They have the lowest rate of opiate prescriptions of any hospital in the VA health care system. “If it sounds simple, the truth is, it is very simple,” Klingbeil said. Her goal is to find a way to best treat patients’ underlying conditions that allows them to retain a high quality of life. Often, that means cutting or reducing opiate intake. Klingbeil rewrote the guidelines for pain management in her New York VA region and as chief of physical medicine and rehabilitation, she implements that policy every day. Her approach in the VA’s Veterans Integrated Service Network 3, which encompasses the Bronx and Manhattan VAs as well as outlying areas, is particularly striking in light of a scandal at the Tomah VA Medical Center in Wisconsin. The hospital, known as “Candy Land” because its doctors were said to have been wantonly handing out opiates, has been under intense scrutiny after a former Marine died of an overdose there. Several Tomah officials, including its chief of staff, have been reassigned or placed on leave, and the case has prompted a re-examination of how the VA approaches chronic pain.

Caution flag raised on easing of VA Choice Card usage (Stars & Stripes)
An actuarial firm under contract to the Department of Veterans Affairs estimates that allowing veterans who live more than 40 miles from needed VA health care to use private sector care instead could balloon VA health care costs by as much as $46 billion a year. That blast to the VA budget is a worst-case scenario, the upper range of possible cost growth.  It presumes almost four million veterans eligible for VA care and residing more than 40 miles from a VA medical center decide to drop employer-paid insurance, Tricare, Medicaid or Medicare to rely solely on VA-purchased care from nearby private physicians and hospitals. Some veterans’ groups and VA officials fear Congress is on a course that could make the prized VA health system unaffordable, by exploding reliance on private sector care through the new Choice Card program and further easing its restrictive 40-mile rule. The independent actuarial estimate echoes a $51 billion VA cost projection the Congressional Budget Office gave to Congress last July as House-Senate negotiators finalized the Choice Card program enacted as part of the Veterans Choice, Access and Accountability Act of 2014. Key lawmakers now dismiss the accuracy of the CBO estimate given data from the first several months of Choice showing VA made only 45,000 outside appointments for cardholders, and given a VA request for authority to reprogram some of the $10 billion earmarked for Choice through 2017. The new law says cardholders must be able to access VA health care within 30 days or VA must arrange private sector care if requested.  It also made distance from VA care a qualifying factor.  But given the fearsome CBO cost projection last year, lawmakers shaped the law’s 40-mile rule awkwardly to keep Choice eligibility intentionally tight.

Two Western Pa. veterans’ suicides raise questions (Pittsburgh Tribune-Review)
Marine Corps veteran David J. Cranmer, 28, had plenty going for him: a young daughter, a marriage, a good job. The Iraq war veteran from Brentwood, Pa., certainly had no history of suicidal tendencies when he took his life March 10, about a month after he started taking a powerful antidepressant, said his father, Bob Cranmer, 58. Now the former Allegheny County commissioner is urging a close look at whether mental health drugs prescribed through the Department of Veterans Affairs contribute to high suicide rates among veterans. Federal estimates suggest the total among veterans might reach 22 a day, which would account for around 20 percent of suicides nationwide. Veterans make up about 7 percent of the population. Cranmer called the suicide figures “outrageous.” “I think it warrants looking into,” he said Wednesday, two days after another veteran, Michelle Langhorst, 31, of Plum shot herself in a parking lot at the VA Pittsburgh Healthcare System campus in O’Hara. Her suicide remained under investigation by Allegheny County police and the VA. The county Medical Examiner’s Office said she died at 1:37 p.m. Monday. In a written statement, the VA Pittsburgh system offered “thoughts and condolences” for Langhorst’s family and friends. It said a VA investigation will examine, in part, whether “we could have done (anything) better for this veteran and others who receive care” from the regional health care system. “Due to privacy concerns, we can’t provide many details. We can share that we are reviewing the many aspects of this tragic event and are fully committed to providing our nation’s veterans with the absolute best care and services possible,” the VA said.

Marijuana treatment study for veterans with PTSD back on track (Military.com)
A year after the federal government approved a study for the use of marijuana by veterans in treating post-traumatic stress disorder the work may at last get underway. The National Institute of Drug Abuse on Wednesday informed the Multidisciplinary Association for Psychedelic Studies that it is ready to supply researchers with marijuana needed for the study, Brad Burge, spokesman for MAPS, told Military.com. The study will mark the first federally approved study in which the subjects will be able to ingest the marijuana by smoking it, he said. It will also be “the first whole-plant marijuana study,” meaning the marijuana will not simply be an extract of the cannabis in a manufactured delivery system, such as a pill. NIDA’s decision had been a long time coming, according to Burge, but that delay was only one of the setbacks after the Department of Health and Human Services, the Food and Drug Administration and the Drug Enforcement Agency cleared the way for the research last year. The plan also was sidetracked because it lost the University of Arizona as one of two testing sites when the school fired the lead researcher, Dr. Suzanne Sisley, after the government approved the project. The university did not explain the sudden termination, though reports at the time suggested the school was looking to avoid conflict with Arizona lawmakers opposed to the study.

Female veterans pose homeless challenge for VA (WomensENews.org)
For Penelope McClenan, a 52-year-old disabled veteran, the future is clouded by the most basic of uncertainties: does she have a home to call her own? Over a year ago, on Jan. 29, 2014, a city marshal escorted her out of her apartment. It was her birthday. McClenan is unable to work for medical reasons she ties to the time of her military service, and the HUD-Veterans Affairs Supportive Housing program had been helping to pay her rent for three years. This intensive permanent housing program for homeless veterans has dispatched thousands of caseworkers to connect veterans to housing and medical services, distributing roughly 10,000 vouchers per year. In 2011, the program, which in New York works with the city’s Housing Authority, began sending McClenan’s private landlord in Jamaica, Queens, a substantial portion of her rent each month. But rising rents meant that the subsidy wasn’t enough for this single mother. She began to fall behind on her payments. For three months after the eviction, McClenan slept either in her car or her parents’ house until Adult Protective Services, a city agency, paid the overdue rent and made it possible for her to return to the apartment. Now she is waiting for a decision by the New York City Housing Authority and HUD’s Veterans Affairs Supportive Housing Program (NYCHA/VASH) to continue her rent subsidy. In 2009, the Obama administration committed to ending veteran homelessness by the end of 2015. The Department of Veterans Affairs is planning to spend an unprecedented $1.6 billion to reduce to zero the number of homeless veterans this year.