Veterans news update for May 6

Veterans news update for May 6

Veterans news updateEx-VA cardiologist blasts agency watchdog over Chicago probe (USA Today)
A former cardiologist with the Department of Veterans Affairs is accusing the agency’s chief watchdog of conducting only a limited probe of allegations that care at a VA hospital outside Chicago is grossly mismanaged, leaving veterans at continued risk of harm or death. Dr. Lisa Nee said the VA inspector general completed an investigation of the Hines, Ill., VA hospital last year that failed to determine why doctors were performing unnecessary cardiac procedures on veterans — whether doctors were doing the procedures and falsifying other records to secure bonuses, or if delays in reading echocardiograms left heart conditions untreated to the point where veterans died or worsened to inoperable. “Their investigation was for show, that’s how I would put it,” said Nee, who worked at Hines from 2011 to 2013. “It was something that they could write a report on and check a box, but it wasn’t a true investigation.” Nee, 48, took her concerns to the U.S. Office of Special Counsel, which reviews whistleblower claims. The OSC determined last fall that they had merit and directed VA Secretary Robert McDonald to investigate Hines further. Nee joins a growing chorus of critics of interim Inspector General Richard Griffin, who has been under fire for failing to issue public reports before closing 140 veteran health care investigations since 2006, including a probe last year that found unusually high opiate prescription rates at a VA facility in Tomah, Wis. Five months after the case was closed without a public report, 35-year-old Marine Corps veteran Jason Simcakoski died from mixed drug toxicity as an inpatient at Tomah. A spokeswoman for Griffin defended the probe of cardiology at the Hines VA, saying the OSC did not have all the facts when it made its determination. Spokeswoman Catherine Gromek said the investigation was thorough, involved 10 outside cardiologists, and concluded in a public report in April 2014 that doctors had in fact performed unnecessary procedures, including two bypass surgeries. “Our report has led to significant changes in the provision of cardiology and cardiac surgeries to veterans at this facility,” she said. Gromek confirmed inspectors did not look into why the unnecessary procedures were performed. She said that is up to the facility to figure out. And she said the investigators didn’t examine whether patients were harmed by the echocardiogram delays because they believed VA officials were aware of the problem and taking care of it. She said investigators didn’t examine whether doctors falsified data because they had insufficient information at the time.

Free pain meds for veterans cost taxpayers big bucks (CBS News)
A CBS News investigation has found American troops and veterans are being prescribed dubious drugs that cost taxpayers hundreds of millions dollars. The growing practice of selling the drugs has caused a big, expensive problem for Major General Richard Thomas, who oversees TRICARE, the military health benefit system. In the last year, TRICARE spending on compounded prescriptions surged from $42 million a month to more than $300 million. “We’re on track this year to spend over $2 billion unless we get our hands around this,” said Thomas. “It’s just been astronomical, an explosion of the charges in a relatively short period of time.” Virtually all the spending is for products the DOD believes are of dubious clinical benefit, like pain and scar creams. The cost to taxpayers can be $15,000 for a month supply. Major Thomas told us he hasn’t been able to find anything in the creams that justify their expense. The creams are marketed directly to military personnel at “free lunch” events hosted outside the gates of Fort Sam Houston in San Antonio. “There’s no free lunch here,” said Thomas. “These individuals, their patriotism is directly tied to their paycheck. They’re not helping these soldiers.” Dozens of websites advertise the creams as custom-made cure-alls for service members’ pain and wounds with little or no cost. One company — Healing 4 Heroes — makes it simple: just fill out an online form and submit your request. A CBS News producer posing as a potential sales rep met the owner of Healing 4 Heroes, Deanna Dutting, at a restaurant in Florida. During the meeting Dutting shared the pitch she makes to service members and veterans. “Here’s these amazing creams, they’re completely free. All you got to do is type in your TRICARE number online and submit it,” explained Dutting. Dutting said a doctor then calls the patient and writes a prescription. A one month supply of scar and pain creams, plus a dietary supplement costs taxpayers around $25,000. “If you want to feel bad or do your own research, you can do just like the rest of us did, but we got over it real quick once we started making our money, you know what I mean?” said Dutting. Dutting told us she only collects three percent, most of the money goes to Patient Care America, a compounding pharmacy in Florida that makes the creams and supplements. The pharmacy is making millions, according to Deanna. Patient Care America CEO Patrick Smith declined our request for an interview but provided CBS News with a video statement in which he told us pain creams offer military personnel an alternative to addicting painkillers.

Newly released reports chronicle harm to veterans (Florida Today)
In Tampa, a Veterans Affairs doctor prescribed drugs at an alarmingly high rate, despite being told by colleagues to stop. In The Villages, VA mental health workers didn’t regularly check patients’ vital signs. And in West Palm Beach, a veteran dependent on a ventilator was treated by staff considered “not competent” to deal with such patients. He was found disconnected from the ventilator and in cardiac arrest, but was revived. The three cases are among those chronicled nationwide in nearly 140 investigative reports dating back to 2005 that the VA’s inspector general released last week. In many cases, the reports on dysfunction and treatment errors at VA facilities show the inspector general, the agency’s chief watchdog, trusted the agency to correct problems on its own. The cases largely involve problems such as missed diagnoses and errors during surgery. In on case, a veteran’s face was set on fire during an operation in Lebanon, Pennsylvania. They also detail administrative challenges. Inspectors said a VA intensive care unit in Tucson, Arizona, was beset by a “cauldron of interpersonal tensions and management difficulties.” A 2013 report indicates investigators were unable to substantiate claims of patient abuse or a “suicide behavior incident” at the West Palm Beach VA’s mental health clinic. But they did find low morale and a “culture of disrespect” that involved staff addressing patients rudely. The reports were released last week in response to a Freedom of Information Act request by USA TODAY. The newspaper earlier reported that the VA inspector general’s office kept secret dozens of complaints against VA hospitals, clinics and other medical facilities over the past decade.

VA secretary has a dire prediction for veterans (ABC-San Diego)
Secretary of Veterans Affairs Bob McDonald, in a speech to members of Paralyzed Veterans of America, said as the population of veterans ages, the more worried he becomes about taking care of them. “In 40 years, we will have the same issues we have now; when Iraq and Afghanistan veterans get older, we’re not going to be there for them. You can’t keep kicking the can down the road,” he said. Meaning if the budget continues to be cut in terms of construction, IT and additional staff, the VA can’t meet the need. “The VA is absolutely essential to veterans, essential to American medicine and it’s essential to the American public,” McDonald said. Some have for a privatization of sorts, or vouchers, into civilian medicine as a means to an end, something McDonald can’t be beneficial to veterans. McDonald, who used to be in charge of Proctor and Gamble, said in business, you can move budget money where it’s needed but said he’s prohibited from doing that in the VA. Anne Robinson, a paralyzed veteran from San Antonio, said, “Cut the red tape. We need Congress, the Senate and the president to let him do what he needs to do.”

Senators push independent review of VA to see if claims mismanagement is systemic (Minneapolis Star Tribune)
Troubled by delays in handling of veterans claims, a bipartisan group of senators is seeking a wide-scale independent review of the Department of Veterans Affairs for mismanagement and changes to improve budgeting and speed up applications. A report being released Wednesday by nine senators acknowledged recent efforts by the VA to reduce disability and pensions claims backlogs but said it wasn’t enough. Pointing to the VA’s worst performers such as the Philadelphia regional office, they were announcing legislation that would require the Government Accountability Office to investigate all 56 regional offices for problems. It was the latest sign of congressional concern that recent findings of mismanagement at the Philadelphia VA — including neglected mail, manipulation of dates to make old claims look new, and alteration of quality reviews — might point to a broader, department-wide problem. “The VA system again finds itself engulfed in another scandal,” said Sen. Dean Heller, R-Nev., co-chair of the Senate’s VA backlog working group. VA offices nationwide are suffering from poor management, he said, proving “it is time for an overhaul of the entire system.” Sen. Bob Casey, D-Pa., the other co-chair, said he too was worried that problems were not isolated to Philadelphia. “It’s simply unacceptable to have a veteran with a disability wait hundreds of days for their claim to be resolved,” he said. The VA says there are 161,000 disability and compensations claims on backlog, defined as pending over 125 days. That’s down from a peak of 611,000 in March 2013. But the VA inspector general has questioned the accuracy of the data. Based on a review of VA records, the Senate report said the 10 worst-performing regional offices as judged by wait times were Baltimore; Jackson, Mississippi; Reno, Nevada; Philadelphia; Los Angeles; Chicago; Oakland, California; Indianapolis; Boston; and St. Petersburg, Florida.

Feds: VA official stole cash for stripper sex, gambling (The Detroit News)
A former federal employee admitted embezzling about $150,000 from a Veterans Affairs retail store and blowing the cash on strippers, prostitutes and gambling sprees, the Justice Department said Tuesday. Glenn Alan Bates, 57, of Saline schemed to steal money from a VA retail store — or canteen — he managed in Ann Arbor, according to a criminal complaint filed in federal court. If convicted, he faces up to 10 years in prison. Bates, who was released on $10,000 unsecured bond Tuesday, told investigators he spent some of the cash on a stripper named “Ashley” at an Ohio strip club, according to court records. He said he often spent $500 a night on lap dances — and more. “After visiting the club numerous times, Glenn Alan Bates convinced Ashley to come to his hotel room for sex, for which he paid her,” VA Special Agent Frederick Lane wrote in a court filing. The hotel trysts were frequent and non-exclusive. Bates said he also met with other strippers and prostitutes, according to court records. “Glenn Alan Bates stated he became addicted to the sexual encounters and he stole cash from the canteen to pay for this addiction,” Lane wrote. According to court records, Bates told investigators he spent part of the money at casinos in Indianapolis and Battle Creek. Bates and his court-appointed lawyer, Stacey Studnicki, could not be reached for comment Tuesday. The investigation dates to May 2013 after an audit discovered more than $478,000 missing from the retail store. The store is part of the VA Ann Arbor Healthcare System on Fuller Road. The retail stores are operated by the Veterans Canteen Service, a VA branch catering to veterans who receive military health care benefits. The canteens sell food, clothing and electronics.

Veterans Affairs nominee: ‘The VA needs change’ (Military Times)
Dr. David Shulkin, the Obama administration’s nominee for undersecretary of health at Veterans Affairs, told lawmakers Tuesday he would work to create a VA medical system that would provide veterans superior care while attracting top talent to its ranks. Shulkin, president of the 687-bed Morristown Medical Center and an internist who has served as chief medical officer or CEO of major medical facilities since 1991, said the VA’s failings in the past year – appointment wait times, bloated construction costs, lack of accountability and more – and its fledgling transformation efforts have created a ripe environment for “dramatic change.” “The VA needs change. The VA needs more doctors, more nurses and greater efficiency from its current systems,” Shulkin said during his confirmation hearing before the Senate Veterans’ Affairs Committee. In what was largely an amicable hearing, senators nonetheless quizzed Shulkin on several current VA black marks, including the $1 billion construction overruns at the VA hospital in Denver, veterans sickened by Agent Orange years after serving in Vietnam and the VA Choice program, which doesn’t allow veterans to use the system if they live within 40 miles of a VA health facility, even if the facility doesn’t offer the services they need. Calling the ongoing $1.73 billion construction debacle a “monument to ineptitude in construction,” Sen. Richard Blumenthal, D-Conn., asked Shulkin what he thought of VA’s plan to use a portion of construction money included in a sweeping reform bill last year to complete the project. “I would make sure any solution doesn’t come at the expense of treatment of veterans,” Shulkin said. Shulkin would be the first permanent replacement to the post since Dr. Robert Petzel took early retirement during the heightening scandal at VA last year over appointment wait times.

Texas Senate passes bill limiting tuition benefits for children of vets (The Houston Chronicle)
The Texas Senate took a step Tuesday toward limiting a program that provides free tuition to veterans and their children in an effort to rein in the ballooning costs of the program. The bill, passed on a 24-7 vote, would adjust residency requirements ruled unconstitutional by a federal judge in a case involving a University of Houston student earlier this year. Veterans would now have to live in Texas for eight years to earn benefits under the Hazlewood Act, which provides tuition and fee exemptions from state public universities for military veterans, their spouses and their children. The bill would also require veterans to serve six years to pass on up to 120 credit hours to their children. And veterans only have a 15-year window to take advantage of the benefits after service under the bill. The move comes as the Hazlewood Act, expanded in 2009 to allow veterans to transfer unused college credits to their children, has become an “unsustainable” financial burden on universities. Thousands more students took advantage of the benefits after the act was expanded, and the cost to colleges and universities soared from $24.7 million to $69.3 million in the first year alone. Costs have continued to rise steadily, with Texas public universities spending $169 million in tuition for Hazlewood benefits in 2014. Lawmakers said Tuesday that the Senate was taking a necessary step to avoid a much harder decision down the road. Earlier this year a federal judge struck down a clause in the act that limits benefits to veterans who enlisted in the military while living in Texas. While there have been varying estimates on how that ruling could expand the program, and the costs that come with it, lawmakers have said that Hazlewood could grow to cost universities as much as $2 billion annually in lost tuition, as the ruling could potentially allow any veteran from anywhere in the U.S. to “stroll” across state lines and take advantage of the program.

California lawmakers push for new VA clinic (McClatchy Washington Bureau)
California lawmakers are still trying to breathe life into a French Camp medical clinic designed to serve veterans living in the Northern San Joaquin Valley and Sierra Nevada foothills. Now, the resuscitation effort is up to the Senate. On Tuesday, Democratic Sen. Dianne Feinstein said she will “continue to push” for California clinics including the one proposed for French Camp. “We need more VA health facilities in the…Valley to help veterans access the health care they have earned and deserve,” Feinstein said. “While we must fix any problems with the VA’s construction process, these important projects must be allowed to advance.” Feinstein’s California colleague, Democratic Sen. Barbara Boxer, also said Tuesday that she supports funding the French Camp project and others that give veterans “access to the health care they need and deserve.” Behind the scenes, lobbyists are pushing, as well. The lobbying firm Carpi & Clay, hired for $80,000 a year by San Joaquin County, includes “funding to construct new VA clinic” among the priorities identified on quarterly disclosure reports. The proposed Department of Veterans Affairs’ community based outpatient clinic would serve an estimated 87,000 veterans, primarily living in San Joaquin, Stanislaus, Calaveras, Tuolumne and Amador counties. Currently, the veterans can travel hours to reach a VA facility and return home.

Former medics find themselves on the bottom rung in civilian field (Stars & Stripes)
In four deployments as an Army combat medic to some of the most dangerous corners of Iraq and Afghanistan, Joe Carney had seen the worst of war — bullet wounds, severed limbs, shrapnel. He saved lives amid bombs and gunfire, his emergency room often a patch of dirt in the desert or a rocky mountainside. None of that mattered when he left the Army three years ago. “I think the services should do a better job because at the end of the day, your last day in the Army, the last day in the Navy, you’re out, no one cares about you,” he said. “What I tell people who are planning to get out is, you have to have a plan.” Like many medics and Navy corpsmen, the U.S. military’s front-line medical professionals, Carney’s skills translated to almost nothing in the civilian world. He grew up watching “M.A.S.H.” and “ER” with his parents and was drawn to emergency medical work as a young boy. That led him to join the Army at 19 and serve as a combat medic for 10 years. Nearly half of that time was spent deployed in war zones. But despite his extensive training, he lacked state licensing certificates and he struggled to find a job at his skill level. He settled on a job as an emergency room technician, where he was allowed to do little beyond administer oxygen and take blood pressure readings. “It was a good reality check,” he said. “You know you’re not in the military no more. The hard part was standing back when you’ve got these trauma situations.” It’s a common story with medics and corpsmen, who have long had difficulty finding civilian medical work that matches their training. “It is an asset that’s being wasted because they’re highly skilled in what they do,” said Dr. Michael Bellino, an emergency physician who mentors Carney at the Capt. James A. Lovell Federal Health Center in North Chicago, Ill. “I’d trust him with taking care of my family.”

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