VA to outsource care for 180,000 vets with hepatitis C (AZCentral.com)
The Department of Veterans Affairs is moving to outsource care nationwide for up to 180,000 veterans who have hepatitis C, a serious blood and liver condition treated with expensive new drugs that are costing the government billions of dollars. The VA has spent weeks developing a dramatic and controversial transition as patient loads have surged and funding has run out. Those efforts were not disclosed until records were released this week to The Arizona Republic. Instructions on how to carry out the program show that the sickest veterans generally will get top priority for treatment. However, patients who have less than a year to live or who suffer “severe irreversible cognitive impairment” will not be eligible for treatment. That provision, and the mass shifting of patients, drew immediate criticism from veterans advocates. Tom Berger, executive director of a health council established by Vietnam Veterans of America, ripped the VA for launching a “faulty plan” and blasted the idea of medical teams deciding which patients will be denied antiviral remedies. “They’ve set up what I would call, in Sarah Palin’s words, ‘death panels.’ … Maybe rationalization panels is a better term,” Berger said. The maneuver also caused a furor among experts inside the Veterans Health Administration, some of whom disassociated themselves from the plan and warned about ethical compromises. According to e-mails obtained by The Republic, about 200 specialists sent a letter in April to Secretary Robert McDonald expressing their “dismay at this unacceptable development.” “… To halt hepatitis C treatment at VHA facilities now would be unconscionable,” they wrote. “We can and must end the epidemic. Once we have treated every veteran with hepatitis C, the costs will go away. … Give us the ammunition, and we will win this war.” Hepatitis C patients today are treated with a breakthrough medication, sofosbuvir, approved in late 2013 under the brand names Sovaldi and later as Harvoni. In combination with other drugs, sofosbuvir cures the HCV infection in about nine of 10 patients while reducing risks of cirrhosis and liver cancer. However, the pills reportedly cost about $1,000 each retail, or $600 per dose to the VA at a discount. A typical treatment regimen of 12 to 24 weeks costs $50,000 to $100,000. The price tag to serve VA patients could exceed $10 billion. Despite the cost and controversy, sofosbuvir is widely regarded as a modern medical victory: Records show the VA has cured nearly as many HCV patients in the past 15 months as during the previous 15 years. Healed patients not only mean fewer deaths but reduced medical costs over the long haul. In the short term, however, success has spawned a six-fold increase in demand for treatment by veterans, creating a huge funding gap.
Senate defense bill strips VA authority over construction projects (The Denver Post)
Following the revelation of massive problems at the VA hospital project in Aurora, the U.S. Senate on Thursday agreed to legislation that would prohibit the agency from managing construction projects that cost more than $100 million. Instead, the Army Corps of Engineers would be put in charge of those projects as part of a measure co-sponsored by Colorado Sens. Michael Bennet and Cory Gardner. “Through their incompetence, delays, and complete lack of accountability, the VA has proven that it is unfit to manage its own major construction,” said Gardner, a Republican, in a statement. “It’s time to get the VA out of the construction business and get the responsibility for completing these critical projects into the hands of more competent agencies.” The Bennet-Gardner amendment was added to a broader defense bill and — given Congress’ current distrust of the U.S. Department of Veterans Affairs — it’s likely that the VA legislation ultimately will become law in some form. Legislators have been outraged by cost overruns at the Aurora facility, which skyrocketed to an estimated $1.73 billion this year. A major cause of the price hike is widespread VA mismanagement of the project. The agency is conducting an investigation to examine what went wrong. “This is a major reform to the VA’s construction management system — one that we hope will save taxpayer dollars and help more efficiently deliver the quality medical facilities our veterans have earned and deserve,” said Bennet of the bill.
Senators will no longer block confirmation for VA undersecretary (NJ.com)
Three U.S. senators will no longer block the Senate confirmation of Morristown Medical Center President David Shulkin, clearing his way to become undersecretary for health in the federal Department of Veterans Affairs. U.S. Sens. Sherrod Brown (D-Ohio), Jeff Merkley (D-Ore.), and Ron Wyden (D-Ore.) had put Shulkin’s confirmation on hold until Veterans Affairs ruled on whether reservists who had served on C-123 aircraft contaminated with Agent Orange would qualify as veterans with full access to health care and disability benefits. The VA issued its ruling Thursday and said the reservists did qualify as veterans with full benefits. “All service members exposed to Agent Orange residue deserve the same benefits, whether they flew on missions that used the chemical or they worked on planes still contaminated by it years later,” Brown said. The senators had urged Veterans Affairs officials to grant the benefits after an initial denial. Under Senate rules, any member can place a hold on a presidential nominee, thus blocking his or her confirmation. “These veterans who were exposed to Agent Orange during their service on contaminated aircraft were injured serving our country, and we owe them the best care possible,” Merkley said. “Whether they were active duty or reservists, their sacrifices should be recognized. President Obama nominated Shulkin in March to fill a position that has been vacant since May 2014, when Robert Petzel resigned before his scheduled retirement date following reports that extra-long wait times at Phoenix VA hospitals were being covered up as veterans died before they could get appointments.
Houston VA accused of manipulating benefits claims (Chron.com)
An employee at the Houston regional office of the Department of Veterans Affairs manipulated dozens of benefits claims to meet production goals, according to a newly released report from the VA’s Office of the Inspector General. According to the report released Monday, investigators examined 91 claims the employee had worked on in fiscal years 2013 and 2014, and manipulated data on 81 of them, apparently under pressure to meet goals set by management. By changing the data and appearing to meet the goals, the employee earned a $2,648 bonus, the report noted. It urged Houston officials to determine the appropriate discipline against the employee, implement a plan to routinely monitor system controls for pending claims and submit for further review to the OIG more than a dozen claims that officials had been unable to fully investigate. “The inappropriate actions described in this report undermine program effectiveness and impair the data integrity of the VARO’s reported pending workload,” the report stated. Ultimately, the employee returned the money, the report said. The allegations against the employee – brought by senior leadership at the VA’s central office – came five months after another high-profile incident in Houston where a manager was caught manipulating unfinished claims to make them look like they had been completed. “It saddens me, strongly, that somebody would feel under so much pressure they feel they have to go to such extreme measures that they have to remove claims from the VA system,” said John Roberts, executive vice president of the Wounded Warrior Project, a veteran service organization, and himself a former VA employee. “The bottom line is it hurt veterans,” he said. “If not for this investigation, these veterans’ claims may never have been found. They would just have been gone.”
Two Democratic Iraq War vets urge Obama to limit ground troops (The Hill)
Two House Democrats want their colleagues to sign a letter to President Obama urging him to resist calls to escalate U.S. military involvement in the fight against the Islamic State in Iraq and Syria (ISIS). Rep. Ruben Gallego (D-Ariz.), a former Marine, and Rep. Mark Takai (D-Hawaii), an Army National Guard lieutenant colonel — both members of the Armed Services Committee — say the U.S. should not fight the Iraqi military’s battles for them. “We fought in the Iraq War. We recognize the serious threat that ISIL poses to our allies in the region and support U.S. assistance to Iraq in its struggle against this deadly and determined enemy,” a statement by Gallego and Takai said, using an alternative term for ISIS. “However, we also strongly believe that we cannot fight the Iraqi military’s battles for them. That’s why we strenuously oppose calls to significantly escalate the U.S. ground commitment in this conflict,” they said. The letter has 17 signatures so far. Gallego and Takai’s letter comes at a time when other veterans in the House and Senate — mostly Republicans — are calling for an escalation in troop numbers and to allow troops to embed with Iraqi forces. “We write to urge you to reject these misguided appeals,” the Democrats wrote in the letter to the president. The two veterans noted Defense Secretary Ashton Carter’s comments that Iraqi forces lost Ramadi, provincial capital of Anbar, because they lacked the “will to fight.” “America’s history has repeatedly shown that though we can give our allies the arms and expertise to fight our common enemies, we cannot impart the determination necessary to prevail on the battlefield,” they wrote.
VA rebuts Tomah hospital criticism (Military Times)
The VA Inspector General’s office on Thursday strongly refuted congressional criticism of its investigation into prescribing practices at the Tomah Wisconsin VA Medical Center. The IG drafted a vitriolic missive to the Senate Committee on Homeland Security and Governmental Affairs that takes lawmakers to task for not requesting personal briefings on the initial allegations, the investigation and the IG’s findings. Deputy Inspector General Richard Griffin led the release of an 11-page rebuttal with a quote from John Adams: “Facts are stubborn things; and whatever may be our wishes, our inclinations or the dictates of our passion, they cannot alter the state of facts and evidence.” He then ripped into criticism of the investigation, refuting reports that his office hid its results, dismissing testimony from former Tomah employees for lacking personal knowledge of the facts and saying that a staff psychologist who committed suicide in 2009 after he was fired from the medical center was a drug dealer. The response was among 13,949 pages provided to the Senate committee in response to a subpoena issued April 29. In a document summation, Griffin addressed the major concerns surrounding the Tomah scandal, including allegations that providers overprescribed opioids and other painkillers, charges of whistleblower retaliation and a reputation that a “culture of fear” exists among employees at the medical facility.
Pittsburgh VA wants to fire 3 who bound co-worker with tape (KDKA-Pittsburgh)
Officials with the Veterans Affairs Pittsburgh Healthcare System want to fire three people and discipline four others after a worker complained that he was harassed and bound with duct tape. Officials have refused to provide details of the incident, reported last week at the VA’s hospital in Pittsburgh’s Oakland neighborhood. Kathi Dahl, the president of the American Federation of Government Employees union local says the incident occurred in the facilities management department where, she contends, VA officials have been slow to respond to past complaints of bullying. VA Pittsburgh spokesman Donald Manuszewski says at least some of the workers may contest the proposed discipline, because they’re represented by the union. He wouldn’t say who or how many employees could do that. The worker, a plumber, reported the alleged harassment June 11.
Clinton: Stop for-profit colleges from targeting veterans (Time.com)
Hillary Clinton announced on Thursday a new plan intended to stop for-profit colleges from fleecing veterans who use federal G.I. Bill funds to attend school. Speaking before a roundtable with veterans in Reno, Nevada, Clinton focused her remarks on the so-called 90-10 rule. The rule requires for-profit colleges to accept at least 10% of their money from private dollars rather than federal financial aid and loans, with the idea of holding the schools more accountable to the open market. But an unintended loophole in the 90-10 rule means that federal military benefits like the Post-9/11 G.I. Bill can count toward schools’ 10%. That leads for-profit schools to aggressively target veterans in search of federal dollars, often deceptively. Proponents of a new bill say that veterans at many for-profit schools have high dropout rates and leave badly in debt. Clinton would plan to close the loophole. Clinton also said on Thursday she would plan as President to address predatory lending to veterans, healthcare and expanding job options after service. She sang the praises of bipartisan compromise, too. “In a democracy, nobody has all the answers,” Clinton said. “You have to get up everyday and say, ‘I’m willing to work for anyone whose willing to work for the good of America and in particular the good of our veterans.’”
Virginia governor: 743 homeless veterans placed in housing since October 2014 (WVIR-Charlottesville)
Governor Terry McAuliffe announced today that 743 homeless veterans have been placed in housing since October 2014. The 2nd Annual Summit on Ending Veteran Homelessness in Virginia was held yesterday at the State Capitol in Richmond. Federal, state and community stakeholders met to develop strategies for The Next Tactical Mile the continued push to achieve Governor McAuliffe’s goals of ending veteran homelessness by the end of 2015 and ensuring that systems are in place to respond quickly to those experiencing a housing crisis in the future. “We are more effective at identifying and housing our homeless veterans now, and we are continuing to improve our systems to make sure that any Virginia veteran who experiences housing instability in the future will rapidly return to safe and stable housing as quickly as possible,” said Governor McAuliffe. “We are making incredible strides, and the level of coordination among federal, state, and local partners is unprecedented,” said John Harvey, Virginia’s Secretary of Veterans and Defense Affairs. “Yesterday’s summit focused on The Next Tactical Mile toward ending veteran homelessness to ensure that we have the resources, systems and plans in place to meet the Governor’s goals.” State efforts kicked into high gear after Governor McAuliffe signed on to First Lady Michelle Obama’s Mayor’s Challenge to End Veteran Homelessness in June 2014 and committed the Commonwealth to ending veteran homelessness by the end of this year. Eighteen mayors across Virginia have also signed on to this commitment.
Class-action status upheld in wage lawsuit against Ark. veterans homes (Arkansas News)
A divided Arkansas Supreme Court on Thursday upheld a circuit judge’s decision to grant class-action status to a lawsuit alleging that employees of Arkansas veterans homes were required to work overtime hours without compensation. The suit, filed in June 2013 by a group of nurses and nursing assistants who worked for the Fayetteville Veterans Home and the now-closed Arkansas Veterans Home in Little Rock, alleges that their employer, the Arkansas Department of Veteran Affairs, often required the plaintiffs to work before and after their shifts and through their lunch breaks without overtime pay. The plaintiffs claim that the department automatically deducted 30 minutes per day from their work hours for a lunch break, even if, as they say was often the case, they were not able to take a lunch break because of chronic understaffing. The suit also alleges that the department did not allow the plaintiffs to report all the overtime hours they worked and did not respond to their frequent complaints about the alleged violations. The actions by the department violated the Arkansas Minimum Wage Act, the suit claims. The plaintiffs are seeking damages equal to the amount of overtime pay they claim they were illegally denied during a period beginning three years before the suit was filed and ending on the date the case is resolved. The Arkansas Department of Veteran Affairs has denied the allegations.
Michigan veterans affairs officer admits taking cash (Battle Creek Enquirer)
The former director of the Calhoun County (Mich.) Veterans Affairs office on Thursday pleaded guilty to three high-court misdemeanors. Scott Losey, 45, of Portage, had been charged with the three high-court misdemeanors in May. Three misdemeanors for money and gifts he solicited from veterans and family members were dismissed. At a July 27 sentencing, Losey will be sentenced to probation and a drug treatment program for one of the misdemeanors. There will be a delayed sentence for two of the more serious misdemeanors. Losey can apply to have the other misdemeanor dismissed if he successfully completes probation, but it is not guaranteed. Losey admitted during the plea taking to taking money for services and said he was addicted to prescription drugs. Assistant Prosecutor Tamara Towns and Losey’s attorney, Anatase Markou, attended the plea taking before Calhoun County Circuit Court Judge Conrad Sindt. Losey initially had been charged with embezzlement, which carried a 10-year maximum sentence, but those charges were dismissed after prosecutors evaluated the evidence. He was fired by the county after some family members told Calhoun County Sheriff Department detectives that he at least suggested they give money or gifts for the work he did helping them secure benefits.
IU Maurer School of Law establishes clinic to assist veterans with disability benefits (Indiana.edu)
The Indiana University Maurer School of Law announced today that it has established a Veterans Disability Law Clinic. The first of its kind in the state, the clinic will represent veterans — at no charge — whose applications for disability benefits have been denied and who wish to appeal the decision to a decision review officer or to the Board of Veterans’ Appeals. The clinic will also provide free services to veterans who seek a discharge upgrade or a correction to their military record in order to receive VA benefits. “The process for getting veterans’ disability benefits can be confusing, complex and lengthy,” said Carwina Weng, clinical professor of law and director of the school’s Disability Law Clinic. “We hope that the clinic will help our clients navigate this difficult process so they can receive the benefits they have earned.” Second- and third-year students at the law school will handle client intake and fact-gathering and represent clients at hearings, all under the supervision of a VA-accredited attorney. Their participation will take place within the law school’s Disability Law Clinic. Clinic services will generally be available to all income-eligible veterans residing in Monroe, Brown, Greene, Lawrence, Morgan and Owen counties, but the clinic will accept any eligible client willing to travel to Bloomington. Weng said there are nearly 7,500 veterans in Monroe County alone. The clinic will begin accepting clients on July 1.