VA chief McDonald: Aging vets straining the system (AZCentral.com)
Department of Veterans Affairs Secretary Robert McDonald said Friday the nation’s VA health care crisis was created primarily by demands of an aging population of Vietnam warriors, and it could resurface as those who served in Iraq and Afghanistan grow older. Speaking to the Association of Health Care Journalists, McDonald suggested that congressional efforts to cut the VA’s proposed budget increase will exacerbate delays in care and stymie reform efforts. He said the VA system was overwhelmed by complex medical needs of an older veteran population, and that problem was compounded by expanded health care benefits and a shortage of doctors and nurses. The upshot: Long waits for appointments and organizational dysfunction that first got exposed last year in the Phoenix VA Health Care System. Nationwide, the number of VA medical claims rose from 2.7 million in 2009 to a projected 5.9 million in 2017, McDonald said, even though the overall number of veterans is declining. He noted that the entire U.S. health care system faces that same dilemma. “Our veteran population — particularly that population who fought during the Vietnam War — is aging,” McDonald said. “And the aging of that population is what created the stress on the system. Sound familiar? The VA is the canary in the coal mine.”
VA wastes millions, but still wants more as vets wait care (The Fiscal Times)
Veterans Affairs Secretary Bob McDonald says his department is so cash-strapped that it’s struggling to accommodate the massive number of veterans seeking treatment from the health system. At the same time, the agency continues spending nearly $25 million a year on hundreds of vacant or underused facilities across the country. Closing or consolidating those facilities could free up millions of dollars that could otherwise be used to pay more doctors and nurses to treat the backlog of patients at medical facilities across the country, according to McDonald. Speaking to reporters at the Association of Health Care Journalists’ annual conference in Santa Clara, California, McDonald suggested that closing or consolidating these buildings could free up some funds to allow the VA to hire at least 200 more registered nurses and pay for 144,000 primary care visits for veterans. “We need to move forward with closing locations that are not economically sustainable and old, outdated buildings that are challenging to maintain and provide little or no value to our customers,” McDonald said. The VA has 336 buildings across the country, covering about 10.5 million square feet, that are either sitting vacant or less than 50 percent occupied, according to McDonald’s early Congressional testimony. The secretary, who took over the troubled department last July, has urged lawmakers to close or consolidate the facilities — but his suggestion hasn’t gained much traction on Capitol Hill. McDonald has spent much of the past year attempting to repair his agency’s tarnished image. Lawmakers remain skeptical, though — especially given the department’s continuing problems. For example, the VA has been under scrutiny for lax oversight of a massive hospital facility in Denver that is years behind schedule and has racked up a $1.7 billion price tag that is still growing — the most expensive construction project in the department’s history. “I feel like I need a bath,” said Rep. Phil Roe (R-TN) said about the facility’s costs during a recent congressional hearing. “This $1 billion could have provided a tremendous amount of health care — examining rooms and ICU’s — not on winning architectural awards. But now we are stuck in the ultimate catch-22 — we don’t want to go ahead, but we can’t quit.”
VA expands veterans’ access to private care (The Hill)
The Department of Veterans Affairs is making a change to its Veterans Choice Program, which will double the number of veterans eligible to seek private care if a VA hospital can’t accommodate them immediately. The program allows veterans to receive private healthcare if they are unable to schedule an appointment at a VA clinic within 40 miles of their home within 30 days. The 40-mile distance was calculated by a straight line, or “as the crow flies.” But in many cases, the clinics where veterans had to seek care turned out to be further than 40 miles away by driving distance. The new change, announced Friday and going into effect immediately, relies on driving distance instead of a straight-line calculation. “VA is pleased to announce the distance calculation change from straight-line to driving distance for the Veterans Choice Program,” VA Secretary Robert McDonald said. “This update to the program will allow more Veterans to access care when and where they want it. “We look forward to continued dialogue with Veterans and our partners to help us ensure continued improvements for Veterans’ access to care.” He added.
Univ. of Florida could expel fraternity over harassment of wounded vets (The Gainesville Sun)
Already on a one-year probation for hazing, the Zeta Beta Tau fraternity at the University of Florida has been suspended following reports that its members yelled at and spit on wounded military veterans vacationing in Panama City Beach last weekend. The fraternity has been charged with several offenses as a part of the university’s formal investigation into “allegations of disturbing behavior toward veterans,” officials said in a news release issued Friday afternoon. The university has charged the fraternity with “causing physical or other harm, obscene behavior, public intoxication, theft and property damage.” ZBT is suspended from all activities pending the outcome of a complete investigation. “I am personally offended and disappointed by the behavior that has been described to me,” said David Kratzer, a retired U.S. Army general and UF vice president of student affairs. “This is not representative of our students or of the university.” Since the incident in Panama City Beach was reported, three students have been expelled from the fraternity, with a promise that more disciplinary action will be taken if the fraternity finds out others were responsible. Because the fraternity is already on probation, it faces stiffer penalties if found to be in violation, including expulsion. Veterans attending the biannual Warrior Beach Retreat at the Laketown Wharf Resort said frat members attending a spring social from both UF and Emory University on April 17 tore through the parking lot, ripping flags off veterans’ cars, insulted vets, spat on them, threw beer bottles off the balcony and were stopped short of urinating on a flag.
Agent Orange: 40 years later, veterans, families still learning of its impact (Pennlive.com)
They had one thing in common: They themselves were exposed to Agent Orange and are now suffering debilitating, if not deadly diseases, or they are the widows of men who died as a result of exposure. Others have children or grandchildren who even today bear the deadly impact of exposure to the herbicide. On Saturday evening close to 150 Vietnam-era veterans and their wives, as well as widows of men who served and have died, came together for a town hall meeting designed to educate veterans and their families of the medical and financial resources available to anyone who was exposed to the herbicide or was born with health complications as a result of their father’s exposure. The Agent Orange/Dioxin Town Hall Meeting was sponsored by the Vietnam Veterans of America, Associates of Vietnam Veterans of America, Chapter 542 in Harrisburg, and was facilitated by a panel of experts including representatives from the national Vietnam Veterans of America as well as the Associates of Vietnam Veterans of America. “A lot of veterans that were in Vietnam were sprayed or came into contact and found out years later that illness cropped up,” said Cathy Keister, whose husband, Brett Keister, was exposed to Agent Orange in Vietnam and died of cancer in 2005. “The Vietnam Veterans of America fought for many years for the VA and the U.S. government to recognize these diseases in our veterans. There is medical and financial assistance available, but a lot of our veterans don’t know it.” Organizers said veterans of all wars going back to World War II and Korea down to present-day conflicts were subjected to lethal toxins. Most were not aware of what was being used or what effects their service would have on their health and the health of the offsprings and grandchildren. “There’s a lot of misinformation about Agent Orange and a lot of information out there that a lot of people don’t understand and a lot of veterans still suffering from it who don’t even realize it,” said Mike Groff, who served in Vietnam in 1968 and was exposed to the toxic agent. Groff does not suffer any health maladies as a result.
Philly case file mistakes are the latest troubles for the VA (Military Times)
It’s a different week but the same set of frustrated questions and criticism for Veterans Affairs Department leaders. The latest mini-scandal for the embattled department has focused on problems at its Philadelphia regional office, where the VA inspector general found evidence of misplaced mail, lackluster customer service and poor leadership. Investigators found that at least 31,000 inquiries to the office were ignored for months, despite internal policies mandating responses within a week. They also observed more than 16,000 paper documents that should have been scanned into veterans’ digital benefits files instead sitting ignored in boxes. In a report released April 15, investigators said the findings show an “immediate need to improve the operation and management” of procedures throughout the facility. But just days after the yearlong investigation was released, VA leaders said it will take at least two more months to determine whether any employees will face punishment for wrongdoing there. The report did not name individuals to be disciplined for the failures, and VA Undersecretary for Benefits Allison Hickey told reporters April 20 that an internal review looking at possible reprimands or retraining will not wrap up until the end of June. “If we see things that require accountability actions, if we find any intent to do things that show a lack of integrity, then I’m not afraid to take appropriate accountability action,” Hickey said. She said VA leaders wanted to begin that work earlier, but were asked by the inspector general’s office not to move ahead until its review of the Philadelphia system’s problems was complete. That reasoning did little to calm congressional outrage over what many lawmakers see as a lack of accountability throughout the department.
Senators, VA official clash over Colorado hospital at hearing (The Denver Post)
U.S. senators clashed with a top Department of Veterans Affairs official Friday over the costly, half-finished VA hospital in Aurora and demanded a more thorough investigation of what has gone wrong. After a tour of the Aurora facility in the morning and during an afternoon hearing, members of the Senate Veterans’ Affairs Committee pledged to complete the project. At the same time, they stressed the importance of finding who was responsible for the project’s ballooning cost — it is now estimated at $1.73 billion — and making sure the VA never has a comparable construction disaster. Sen. Richard Blumenthal, D-Conn., called for an independent investigation outside the U.S. Department of Veterans Affairs, which is conducting its own review. He suggested the U.S. Department of Justice. “The people responsible for the financial catastrophe here need to be held accountable,” he said after a tour. He said the investigation should examine the project’s “disastrous” cost, delays and design changes. Committee chairman Johnny Isakson, R-Ga., promised the veterans’ hospital will be finished but noted that its new price tag is 427 percent over the VA’s original estimate to Congress. During the hearing at the Aurora Municipal Center, Isakson sharply questioned Sloan Gibson, the VA’s deputy secretary, about the lack of punitive action after four of the agency’s major medical projects ran hundreds of millions of dollars over original estimates. Gibson said those responsible for two key decisions on the Aurora project are no longer in their jobs but could not name anyone who had been fired. Isakson pointed out that Glenn Haggstrom, VA’s construction chief, retired with full benefits after being questioned about cost overruns on the Colorado hospital. Again and again, “we’re told that you can’t fire anybody in the federal government,” Isakson said. “Well, you can fire somebody for cause.” He also questioned why the VA could not find any money from its growing administrative budget to help pay for the hospital. “This is not the time,” Gibson replied, saying the agency had scraped together money this year just to provide hepatitis treatment.
VA spent $5,000 on floor cleaning for Obama’s visit (The Weekly Standard)
A year after news broke of the waiting list scandal at the Veterans Affairs medical facility in Phoenix, Arizona, President Obama finally visited the facility in March. And while they didn’t quite roll out the red carpet for the president, they did clean the floors — and spent $5,000 to do it. A record of the contract is posted at the USASpending.gov website, and included in the details is the description “FLOOR CLEANING SERVICE FOR POTUS VISIT.” The contract posting also indicates that “urgency” required a non-competitive contract award, and “only one source” was investigated to complete the work. News of the planned visit came out just days in advance of the president’s trip. While at the Phoenix medical center, the president held a roundtable discussion where he heard from veterans, and also announced the formation of the MyVA Advisory Committee: “The MyVA Advisory Committee will advise the VA on additional ways the VA can work to improve customer service delivery and veterans’ outcomes. President Obama also charged the new committee with assessing what progress has already been made at the VA to improve veterans’ access to quality medical care.”
Scientists are testing MDMA as a PTSD treatment for veterans (The Verge)
About three years after his discharge from the US Marine Corps, Nicholas Blackston is in an unfamiliar office, starting to feel the effects of an unfamiliar drug: as he watches, an old-fashioned banker’s lamp in the office suddenly bursts into kaleidoscope fractals. While the MDMA Blackston’s been dosed with is usually more associated with raves, glow sticks, and rap lyrics, the chemical also has a second life as a medication used to heal psychological wounds. In some ways, Blackston is an ideal patient for MDMA — and one of a growing number of people with PTSD who are turning to the compound, as The Verge has previously reported. He wasn’t responding to the drugs that are typically prescribed for PTSD, and he has an open mind when it comes to alternative treatments. Blackston is part of a study that’s revived interest in the original use of MDMA: therapy. Before becoming a participant in the study, which was conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS), applicants have to do psychological tests to confirm they have PTSD and show that they’ve been taking prescription drugs that haven’t worked. In the study, participants receive either low-, medium-, or full-dose MDMA — 30mg, 75mg, or 125mg, respectively. Patients who were in groups with lower doses have the option to receive three full doses one month after their second session; Mithoefer says everyone gets three full-dose sessions. Two months after the final session, an independent psychologist measures where the patient is on the Clinician-Administered PTSD Scale (CAPS). The test is conducted again a year later.
VA in tests to make X-rays, other images available to vets online (Military.com)
The Veterans Affairs Department is field testing two new programs to give veterans using VA health care electronic access to additional records, including X-rays and MRIs. The images would be available for download via the “Blue Button” feature on the VA’s My HealtheVet website, though VA also is working on a way for veterans to personally transmit the images to another health care provider, including non-VA doctors, when necessary. “Sometimes the challenge when you have an imaging study done is … transferring those images to the next consult — perhaps it’s outside the VA,” said Kim M. Nazi, management analyst with the Veterans Health Administration’s office of Informatics and Analytics. Currently, patients have to request the images, which are copied to a CD, she told Military.com. The VA also is field testing enabling veterans to download and securely transmit a health summary, again making it easier for a veteran to transfer his or her VA medical information to another doctor, including outside VA, she said. The Blue Button does not provide veterans with every medical or health record the VA has on them, however. So a veteran wanting to take a deeper dive — for example if they planned to file claim appeal or for a rating increase — they would need to request copies of everything from their inpatient/outpatient electronic health record, according to Nazi.