House panel issues subpoena in Philadelphia VA probe (Stars & Stripes)
A House committee voted Thursday to issue a subpoena of the Department of Veterans Affairs for personnel and complaint files at its Philadelphia office, part of an expanding probe into mishandling of veterans’ disability and pensions claims. Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs committee, said his panel has repeatedly asked for the information since last December with limited success from VA Secretary Robert McDonald and other officials as it digs into allegations of leadership misconduct and whistleblower retaliation. It was only the third time in the committee’s history that lawmakers resorted to a subpoena, a sign of continuing impatience with a department still struggling after last year’s health scandal involving the Phoenix VA medical center. The last time subpoenas were issued was last May, when the committee demanded documents in that Phoenix scandal relating to lengthy wait times and falsified records. “I have not come to this moment lightly,” Miller said. “There is no doubt that there are serious issues plaguing the operations of the Philadelphia regional office, and we can no longer afford to allow the VA to stonewall legitimate requests for information about that or about any other VA facility.” Miller said that after repeated requests the VA responded late Wednesday with three discs containing documents, but that they remained incomplete with large portions redacted.
Senate issues subpoena to VA inspector general over Tomah documents (The Washington Times)
U.S. Senator Ron Johnson says he has subpoenaed the Department of Veterans Affairs’ Office of the Inspector General for information on an embattled medical center in Tomah. Johnson said in a statement Thursday he sent for the documents on behalf of the Homeland Security and Governmental Affairs Committee as it investigates reports of opiate overprescribing and retaliatory behavior at the hospital. The facility is at the center of multiple probes. The VA, the VA Office of the Inspector General and the Drug Enforcement Administration have investigations in effect. The VA in March reported that patients at the hospital were more likely than those at other hospitals to receive high doses of painkillers. The report also said there was an atmosphere of fear among staff that affected patient care.
Wisconsin DA rips VA over drug-dealing probe (Gannett Media)
Sheboygan County District Attorney Joe DeCecco is accusing the Department of Veterans Affairs of lax oversight after investigators tipped off the VA in 2013 that a veteran was potentially defrauding the government and selling opiates he was prescribed by the VA. Nathan Escoto was convicted of possession and conspiracy to distribute hundreds of oxycodone pills and 22 pounds of marijuana after he shipped them from his California home to an informant in Sheboygan in October 2013. DeCecco said during the investigation that ensnared Escoto, Wisconsin and California investigators learned that Escoto was a wounded combat veteran who received VA assistance to make his home and vehicle disabled-accessible, and a wheelchair. He said Escoto was also prescribed 600 oxycodone pills per month. When he was apprehended, authorities discovered neither his home nor vehicle was modified and the wheelchair was buried behind other items in his garage. The investigators notified VA officials, but in February – 17 months later — officials with the agency’s inspector general told DeCecco the investigation was ongoing and could take another year. “While they initially appeared concerned and likely to investigate, that investigation appears to have stalled,” DeCecco said in a letter he wrote to VA Secretary General Robert McDonald. He called Escoto’s opiate prescription rate “a ridiculous amount” and accused the VA of “enabling” his drug dealing and dropping the ball on ensuring other veterans aren’t doing the same, including in Tomah, where at least one veteran has died from mixed-drug toxicity as an inpatient at the VA facility there. “The lack of supervision by the Veterans Administration in cases like these of ludicrous amounts of prescribed opiate medications not only casts that agency in a bad light but unfairly reflects on those veterans who truly need that type of medication and assistance,” DeCecco said.
VA slammed by GAO, IG for inability to effectively oversee veterans’ health care (FierceIT)
The Government Accountability Office placed the Veterans Affairs Department’s healthcare system on a list of high-risk programs for 2015, saying at an April 29 Senate Veterans’ Affairs Committee hearing that the agency needs to address inadequate oversight and ambiguous policies. “Risks to the timeliness, costeffectiveness, quality and safety of veterans’ healthcare, along with other persistent weaknesses GAO and others have identified in recent years, raised serious concerns about VA’s management and oversight of its healthcare system,” said GAO Healthcare Director Debra Draper at the hearing. GAO prepared testimony says VA operates one of the largest healthcare delivery systems in the nation, including 150 medical centers and more than 800 community-based outpatient clinics. Enrollment in the VA healthcare system has grown significantly, increasing from 6.8 to 8.9 million veterans between fiscal years 2002 and 2013, GAO says. Over this same period, Congress has provided steady increases in VA’s healthcare budget, increasing from $23.0 billion to $55.5 billion. At the hearing Draper outlined five major areas that put the VA at risk of failing to provide adequate healthcare to veterans including ambiguous policies and inconsistent processes, inadequate oversight and accountability, information technology challenges, inadequate training for VA staff and unclear resource needs and allocation priorities. John Daigh, the VA’s assistant inspector general, agreed with Draper’s assessment of the Veterans Health Administration. “VHA is at risk of not performing its mission as the result of several intersecting factors,” Deigh said. “VHA has several missions, and too often management decisions compromise the most important mission of providing veterans with quality healthcare.”
VA reaching breaking point as malware attacks rise (Federal Times)
The Department of Veterans Affairs has seen a dramatic uptick in cyberattacks recently, fending off almost 1.2 billion attempts to put malware on its networks in March alone — a trend that has agency cybersecurity officials worried. For perspective, VA reported fielding just under 330 million malware attempts in November, when the agency began issuing monthly information security reports. This represents a 262 percent increase within five months. “The electronic ecosystem is under assault,” VA CIO Stephen Warren said during a monthly call with reporters April 30. “In a [five] month period we’ve quadrupled in the level of threat. If you pull the data on each month, we’re on an exponential growth rate.” VA security systems were able to block or contain all incoming breach attempts in March but that won’t be possible in the future if the current trends continue, Warren said. If these numbers continue to grow at the current rate, Warren estimates the agency will see as many as 5 billion attempts next month. “At some point we will be overwhelmed; at some point the huge volume and the number will basically start breaking things on us,” he said, noting the 1.2 billion attempts in March represent approximately 45 per second. Exactly how many attempts equal critical mass is unclear, Warren said, particularly as VA continues to strengthen and streamline its defenses. “Whether it’s at 5 billion a month — below 5 billion or above 5 billion — we don’t know,” he said. “At a certain point it doesn’t matter how bad they are, there are just so many that they will get through. I’m not sure where the break point is,” but the team at VA is concerned that point might come sooner than later.
What we know about PTSD and Vietnam veterans today (Fort Wayne News-Sentinel)
For the 2.7 million Americans who fought in the Vietnam War, the painful memories of war still linger 40 years later. A recent congressionally mandated study by the Department of Veterans Affairs estimates that more than 283,000 Vietnam veterans still suffer post-traumatic stress disorder from their war experiences in Southeast Asia. That translates to approximately 283,000 male and 400 female Vietnam veterans living today. Dr. James Lowery, PTSD clinical team member for the VA of Northern Indiana, said even though their service may have been 40 or more years ago, often the memories are vivid and real as if they happened only recently. “The nature of the Vietnam War, like all wars, was complex. Because of the topography of the country and the nature of the enemy, in some cases, it was not always clear who was dangerous, or from where the danger might come. This uncertainty led to heightened anxiety in some veterans upon their return,” Lowery said. PTSD can occur after someone goes through a traumatic event like combat, assault or disaster. Unfortunately, it’s a condition that can ravage our nation’s veterans and lead to dysfunctional lives, alcoholism, and suicide. The mental illness also was linked with other health problems such as cardiovascular disease and ailments of the back, knees or other joints. The study found that about 11 percent of Vietnam combat veterans today still deal with the intrusive nightmares and memories and the tendency toward isolation, numbness and anxiety that come with PTSD. About a third also suffer from major depression. These findings suggest that for a notable group of Veterans, PTSD symptoms are chronic and long-lasting and that particular groups of veterans may be at elevated risk of developing PTSD.
White House opposes effort to cut bonus awards for VA employees (The Blaze)
The White House said Wednesday that it opposes a Republican plan to cut bonus payments to Department of Veterans Affairs employees by $60 million in the next fiscal year. Republicans have been aggressively pushing to chop VA bonuses ever since it was revealed last year that the VA was purposefully delaying veterans’ access to health care. In fiscal year 2013, the VA was paying out about $400 million in bonuses, even as the department was failing thousands of veterans and trying to cover up the scandal. The House responded last year by capping bonuses at $360 million, and last week, the House Appropriations Committee proposed a $300 million cap. But the White House said it opposes this cut, and said the proposed cap is about $160 million lower than what it should be. “The administration also objects to the committee’s other reductions to the overall VA request, including $159 million in reductions for employee awards, bonuses, and the president’s proposed 1.3 percent pay raise for federal employees,” the White House said. Democrats have said cutting bonuses would only make it harder for the VA to retain qualified employees, and the White House mirrored that argument.
House passes funding plan for VA in FY2016 (Military Times)
House members on Thursday approved plans for a 2.5 percent hike in Veterans Affairs Department funding next year despite a presidential veto threat over what the White House sees as a $1.4 billion funding shortfall. The VA and military construction budget bill — approved by a 255 to 163 vote, largely along party lines — would set aside $171 billion for the two accounts, with almost a 6 percent increase in discretionary funding for the programs from last year’s levels. The plan would cover $163.2 billion in VA spending next fiscal year, which supporters noted would continue a steady line of raises for the department since the start of the wars in Iraq and Afghanistan. But it comes in $1.4 billion under what the White House had requested for VA spending in fiscal 2016, money that department officials say will stymie construction efforts and reduce some medical care access. On Tuesday, the White House threatened to veto the measure over the shortfall, saying it “fails to fully fund critical priorities.” Administration officials also complained more broadly about larger Republican-backed budget plans that would keep Budget Control Act spending caps in place for federal agencies. VA Secretary Bob McDonald earlier this month said the request cut “will cause veterans to suffer.” In advance of the vote, a host of veterans organizations also protested the move, saying the full White House request is needed to keep department reforms on track, calling the proposal “suffocating the system.”
VA doctors still can’t recommend medical marijuana to veterans (The Huffington Post)
The House of Representatives on Thursday killed a bipartisan amendment that would have increased military veterans’ access to medical marijuana. The amendment to the Military Construction and Veterans Affairs Appropriations bill failed 213-210, with Republicans mostly opposed and most Democrats in favor. The measure would have blocked the Department of Veterans Affairs from spending money enforcing a ban on VA doctors discussing medical marijuana with their patients. A similar amendment narrowly failed on the House floor last year. “While it’s disappointing that the House just voted to continue a senseless rule that prevents doctors from treating military veterans with a medicine proven to work for a number of serious conditions, the fact that we came so close is a good sign of things to come,” said Tom Angell, chairman of Marijuana Majority. Nearly 30 percent of military veterans who served in the Iraq and Afghanistan wars suffer from PTSD and depression, according to a 2012 VA report. Some research has suggested marijuana may help PTSD symptoms, which can include anxiety, flashbacks and depression. A recent study found that PTSD symptoms were significantly reduced in patients who smoked cannabis. Currently, 23 states have legalized marijuana for medical purposes and 13 others have legalized marijuana extracts for specific medical uses. The plant remains illegal under federal law. In a letter this week urging lawmakers to pass the amendment, Dr. E. Deborah Gilman, a recently retired VA physician, said it’s “cruel to deny access to any medication for any patient,” especially for veterans.
No choice for veterans when doctors won’t join VA Choice Program (Roanoke.com)
A Giles County, Va., veteran who lives more than 40 miles from the Salem VA Medical Center could see a doctor closer to home if only he could find one willing to participate in the Veterans Choice Program. Guerry Goode said he’s been told by the VA’s program administrator that only one regional provider has signed on, and that doctor is in Roanoke, which is even farther from his home. Goode suspects that what’s happening in Southwest Virginia is happening all over the country as veterans still can’t quickly access health care. A VA spokeswoman agreed to check into the program this week but then did not respond with information. Veterans Choice was a $10 billion Congressional response to last year’s scandal that found veterans were often waiting far too long to access care at VA facilities. The VA hired third parties to administer the program, through which veterans who can’t get a timely appointment with the VA can secure one with a doctor outside the VA system. It also gives veterans who live more than 40 miles from a VA clinic the option to see doctors closer to home. “The problem now, in my opinion, is they are paying people to do clerical work when what they should be doing is getting information out to providers so they can decide whether this is a good program,” Goode said. In his case, he tried to see his local doctor, a Carilion Clinic member. The local office didn’t know about the program and sought guidance from Carilion, he said. Carilion opted not to become a Veterans Choice provider. “We asked our sites to let us know if there were requests. We have less than five. Right now we’re assuming the Salem VA is doing a good job with access,” said Carolyn Chrisman, Carilion vice president for revenue cycle.
Veteran tells Congress that VA fails at providing maternity care (Military.com)
When combat-wounded veteran Dawn Halfaker learned she was pregnant, she thought that the Department of Veterans Affairs would help coordinate her care and pay related bills. But Halfaker quickly found that the VA was not much help, leaving her on her own to find a provider and pay for services. “If the VA is going to outsource maternity care, it should be seamless and include the full range of services,” she told the House Veterans Affairs Committee on Thursday. Halfaker, an Army military police captain who lost her right arm in an ambush during the Iraq War, testified before Congress on access and quality of VA health care for women. The VA says there are currently more than two million women veterans in the U.S., with about 400,000 using VA health care. With more women in the military serving in roles that exposed them to combat, a greater number have returned from Iraq and Afghanistan with war wounds and injuries. More women reporting military sexual assaults have also begun seeking care for trauma. The result has been greater numbers of women are looking for VA health care. The VA covers maternity care, including primary care, specialty care, mental health care and more. But it provides maternity care though agreements and contracts with community providers. Halfaker said a maternity services coordinator was provided by the VA, but she was left on her own to find a doctor who would work under a VA contract based on Medicare terms. And when subsequent tests along with an echocardiogram and lab work was not paid for by the VA, she ended up fielding dunning letters threatening her credit rating. A $1,700 bill from Children’s Hospital in Washington, D.C., was paid by the VA only after she threatened her VA care coordinator that she would speak to Congress, she said.
Lawmaker: VA should cover all psychiatric drugs (Military Times)
A congressman who also serves as a Navy Reserve psychologist says the Veterans Affairs Department should provide former troops any psychiatric drug they’ve been prescribed successfully, regardless of whether the medication is in the official VA pharmacy formulary. Rep. Tim Murphy, R-Pa., a commander who treats patients at Walter Reed National Military Medical Center in Bethesda, Maryland, has introduced legislation that would require VA pharmacies to stock all antipsychotics and antidepressants prescribed by Defense Department physicians. The House version of the fiscal 2016 defense authorization bill includes a provision that would force DoD and VA to match their pharmacy formularies, offering the same medications for pain management, sleep disorders and mental health issues. But Murphy said his bill would go a step further, ensuring immediate access to the exact same brands and doses prescribed by DoD doctors as well as other psychiatrists. The legislation would require VA to stock the same brands — not generics or variants — and ensure that veterans would not have to wait for medicines already prescribed. “At Walter Reed, we spend a lot of time getting patients stabilized, and when they return home, they are given different drugs,” Murphy said. “These medications are not identical and effectiveness is based on many factors — metabolism, weight, gender, other factors.” Earlier this year, the Military Compensation and Retirement Modernization Commission recommended that VA and DoD match their formularies to ensure continuity of care and decrease stress and hardship on troops as they transfer to veterans status. The White House issued a statement on Thursday saying it agreed to the commission’s recommendations that VA and DoD improve collaboration to benefit transitioning troops.
Obama says “no” to 401(k) retirement plans for troops (The Washington Times)
The president announced on Thursday that he does not support the blended military retirement plan recommended by a commission of experts earlier this year, just one day after House members included it in their fiscal 2016 defense policy bill. President Obama said that while he supports 10 of the 15 recommendations from the Military Compensation and Retirement Modernization Commission, he could not support the proposal to have troops contribute to a 401(k)-like savings plan that would be matched by the government in an effort to offer some retirement benefits to troops who don’t serve 20 years. Defense Secretary Ashton Carter echoed the president’s remarks, saying that the department will continue to analyze the rejected reforms, including the retirement changes, over the coming months. “The choices we face about military compensation are both vexing and critically important,” Mr. Carter said in a statement. “DoD will continue to work closely with the Congress and the commission to achieve the goals we share: ensuring the long-term strength and vitality of our all-volunteer force, and honoring all our servicemembers.” The president said he did support implementing the majority of proposals, including better collaboration between the Defense Department and VA, improved child care and mandatory transition assistance.
Lawmakers cite Phoenix VA in call for better control over agency workers (Cronkite News)
Rep. Kyrsten Sinema, D-Phoenix, joined the House Veterans Affairs Committee chairman Thursday to demand greater authority for the Department of Veterans Affairs to fire and discipline employees in the wake of the agency’s “waitlist scandal.” The VA’s problems began in Phoenix, where it was discovered that employees had doctored patient wait lists to make their own performance look better. Audits subsequently found problems nationwide. “A year ago this month we learned that veterans in the Phoenix VA were kept on secret waiting lists, waiting months before seeing a doctor and not getting the care they needed,” Sinema said Thursday. “These revelations were shocking and sickening,” she said at a news conference backed by dozens of vets and veterans advocates “Some veterans died while waiting for care. That’s absolutely unacceptable and frankly its un-American.” But Sinema and Rep. Jeff Miller, R-Fla., the chairman of the Veterans Affairs Committee, said that since that time, no employees have been fired for waitlist manipulation, and some have continued to be paid while under investigation. “Three executives responsible for the tragedies at the Phoenix VA were placed on administrative leave. Two of those employees are still on paid leave and tomorrow will be one year,” Sinema said. “It is wrong that it takes this long to fire people responsible for the poor treatment of veterans,” she said. “We have to change this system.”
DoD rejects Tricare reform, does not oppose military retirement changes (Military Times)
The Pentagon for the first time has offered a detailed response to a slate of proposed military pay and benefits reforms, flatly rejecting the idea of overhauling the military health care system but giving a cautious green light to fundamentally changing military retirement benefits. After a three-month review, the Defense Department bluntly dismissed the controversial idea of scrapping the Tricare health system in its current form and instead providing military dependents with private-sector health insurance similar to federal civilian employee benefits. On the issue of military retirement, DoD “generally agrees there are merits to a blended retirement” system that would shrink the size of the current pension but create 401(k)-style investment accounts that would for the first time provide a retirement benefit to troops who serve less than 20 years, according to a Pentagon memo obtained by Military Times. But in the 10-page memo sent to the White House this week, the Pentagon stopped short of endorsing the proposed retirement plan, saying it will continue to “carefully consider” the commission’s proposal and promising to “complete a detailed and holistic evaluation” by the end of July. For now, lawmakers on Capitol Hill appear to be putting the retirement reform proposal on a fast track, and the Pentagon’s position signals that it will offer no significant opposition to the changes under consideration. The Pentagon memo to the White House, signed by Defense Secretary Ash Carter and dated April 27, was followed on Thursday by a formal statement from President Obama directed to Congress summarizing the military’s recommendations.