Lawmakers agree to help VA fill a budget gap (The New York Times)
Republican lawmakers said Thursday that they would support legislation allowing the Department of Veterans Affairs to shift money from another program to cover a $2.5 billion budget shortfall that would otherwise threaten medical care for many patients in coming months. Representative Jeff Miller, Republican of Florida and chairman of the House Veterans Affairs Committee, said at a hearing on Thursday that he would work with other lawmakers to help cover the budget gap. The money would come from a new program called the “Choice Card,” which allows certain veterans on waiting lists and in rural areas to choose taxpayer-paid care from private doctors outside the department’s health system. The program has been a priority for Republicans, who say using private doctors will help reduce health care waiting lists for veterans and will inject a measure of competition into an inefficient agency. The shortfall surfaced just months after lawmakers were told that the agency was actually under budget for the fiscal year. But soaring demand for medical care from veterans has exceeded even the most aggressive predictions about how much, and how quickly, the agency would have to grow to put last year’s waiting list scandal behind it. Overall patient demand at the veterans agency has grown more than 10 percent in the past year, and some regions have seen physician workloads grow nearly twice that amount, according to department calculations. While the average wait time for most appointments is only a few days, the number of patients on waiting lists of a month or longer is now 50 percent higher than a year ago. The principal cause of the scandal over delayed care was a significant shortage of doctors, nurses and office space; agency officials have since hired 1,000 physicians and nearly 3,000 nurses, and leased or expanded clinical space by more than a million square feet. Over all, patients had seven million more appointments in the past year — either inside the department’s hospitals and clinics or at outside doctors to which the agency referred them — than a year earlier. The cost pressures also follow recent approval of new treatments for hepatitis C — a serious liver disease affecting 180,000 veterans — that typically costs $60,000 to $100,000 for a full course of treatment that lasts several months.
Wonder drugs blow a $1 billion hole in VA’s budget (The Fiscal Times)
A senior official at the Department of Veterans Affairs testified on Thursday that his agency is not rationing costly new drugs for veterans suffering from the potentially deadly Hepatitis C virus, as some have suspected, but acknowledged that the VA is reeling from the skyrocketing costs of providing the miracle drugs. Deputy Secretary of Veterans Affairs Sloan D. Gibson told the House Committee on Veterans’ Affairs that the agency had to scramble to shift $697 million earlier this year to cover the cost of the new drugs, including Salvaldi and Harvoni, and that the total cost for the fiscal year will be closer to $1.1 billion. Rep. Jeff Miller (R-FL), chairman of the committee, pressed Gibson on whether some seriously ill veterans were being denied the new treatment, even as the VA continues to spend enormous sums on new hospital construction and fully funding an employee bonus pool. Sloan insisted that the VA was doing everything possible to provide the drugs for veterans who need them. “We are not doing any rationing of care today,” Gibson said at the conclusion of a lengthy morning hearing into the agency’s widespread budget problems. “We don’t expect to do any rationing of care with Hepatitis C. The thing that’s allowing us to do that, frankly, is Choice.” Gibson was referring to a new VA program approved by Congress last year that allows veterans to seek private care through the Medicare program if they have trouble arranging an appointment at a VA medical center within 30 days.
Miller to VA: Agency has ‘a management issue far more than … a money issue’ (The Washington Post)
Despite a tense hearing, a House oversight committee said it will give the Department of Veterans Affairs more “flexibility,” to help ease a $2.5 billion budget shortfall the agency said it is facing to treat millions of former troops. Rep. Corrine Brown, D-Fla., said the House should help instead of “pointing fingers and assigning blame.” VA Deputy Secretary Sloan Gibson called his troubled agency’s lack of planning for an anticipated $2.5 billion budget shortfall “inexcusable” during a House Veterans’ Affairs Committee hearing on the cash-strapped department’s request to use funds set up to help lower wait-times. Rep. Jeff Miller (R-Fla.), chairman of the House Veterans’ Affairs Committee, said the current budget woes, “proves to me once again that VA’s current problems reflect a management issue far more than they represent a money issue.” “This Committee cannot help VA solve its problems, if VA refuses to be honest, upfront, and transparent with us and with the American people about the position it is in, the struggles it is facing, and the help that it needs,” Miller said. But he agreed to, “work with my colleagues on the Appropriations Committee to give VA the flexibility it is seeking to use a limited amount of Choice funds for non-VA care and ensure that no veteran suffers as a result of VA’s mismanagement of the generous budget the American taxpayers have provided.” Gibson said that the VA saw a 10.5 percent increase in workload for the 12-month period, which ended in April.
VA: Two agency officials retired ahead of in-house reprimand (The Denver Post)
Two top Veterans Affairs officials retired from the department this spring just as an investigative board was preparing to lambaste them for their role in the disastrous effort to build a VA hospital in Aurora, Deputy Secretary Sloan Gibson said Thursday at a U.S. House hearing. But now that attorney Phillipa Anderson and construction chief Glenn Haggstrom have left the Department of Veterans Affairs, it is unlikely they will face any punishment for their part in developing the over-budget medical complex. It’s now estimated to cost $1.73 billion. Gibson said the wrongdoing was not criminal in nature and that it’s impossible to take administrative action — such as demotion or suspension — against people who no longer work at the VA. “Once a person is resigned or retired, they are no longer an employee and we have no basis for taking any disciplinary action,” Gibson said in an interview. The admission did not sit well with members of the House Committee on Veterans’ Affairs, which organized the hearing to examine budget problems at the sprawling government agency. “Years-late, bureaucratic knuckle-rapping will not suffice for accountability, especially when the two officials retired unscathed with their full pensions and bonuses,” U.S. Rep. Mike Coffman, R-Aurora, said in a statement. But Gibson said his hands were tied in trying to hold accountable VA employees who both fear retribution and can leave the agency at any point. “People aren’t dummies. They see what’s going on. They see the questions that are being asked,” he said. “(But) they are gone either way, which allows us to move forward.”
It may be soon easier to fire any VA employee, not just top execs (GovExec.com)
A House panel on Thursday approved legislation that would make it easier to fire employees at the Veterans Affairs Department. The 2015 VA Accountability Act, H.R. 1994, sponsored by House Veterans’ Affairs Committee Chairman Jeff Miller, R-Fla., would give the VA secretary much more flexibility to fire corrupt or poor-performing employees, not just top officials. The bill essentially would expand to the entire workforce the authority of the 2014 Veterans Access, Choice and Accountability Act, which made it easier to get rid of senior executives at the department engaged in wrongdoing. The Veterans’ Affairs Subcommittee on Economic Opportunity reported out H.R. 1994 along party lines, after some debate. It now heads to the full committee, where it will likely pass. The legislation would allow the secretary to remove any VA employee based on performance or misconduct; the employee could file an appeal to the Merit Systems Protection Board within seven days of his or her removal. MSPB would have to rule within 45 days of the appeal filing. Due process for most of the federal workforce now requires that agencies notify employees within 30 days of an adverse action (including removal), provide them with seven days to respond and an opportunity to defend themselves. H.R. 1994 also would extend the probationary period for new VA employees from one year to 18 months, and allow the secretary to extend that even further. It would limit the secretary’s authority to fire or demote an employee who is a whistleblower, in an effort to protect those workers from intimidation and retaliation.
Study: Vets report limited use of sun protection while deployed (Fox News)
Despite working multiple hours per day in direct sunlight, U.S. military veterans who were deployed to Iraq and Afghanistan reported limited use of sun protection, found a new study from Vanderbilt University. Analyzing anonymous survey data from 212 veterans from the post-deployment clinic at the Nashville VA Medical Center, researchers found that 77 percent of respondents spent four or more hours per day working in the sun and 63 percent had at least one sunburn during deployment. Only 13 percent of participants reported routinely using sunscreen, while 87 percent reported their sunscreen use as “sporadic” or “sometimes.” “I think we were all somewhat surprised, at first, of how many veterans experience sun burn,” study author Jennifer Powers, assistant professor in the dermatology division at the Vanderbilt School of Medicine, told FoxNews.com, adding that the incidence rate was similar across different skin types and ethnicities. Researchers also found that participants had lower access to sun protection— including hats, sunscreen, sunglasses, and shade structures— than the team anticipated. However, when participants had access to sun protection, they were more likely to use it. Additionally, participants who worked over six hours in the bright sun reported they had lower availability to sun protection. “The study does point out that certainly they’re not using sun protection to the degree we would all like because we know, based on previous historical data, that veterans who have particularly served in very sunny places have higher risks for melanoma later in life,” Powers said.
Researchers: PTSD is factor in troop, veteran violence (Military Times)
New research indicates that post-traumatic stress disorder is a common factor in violent acts committed by troops and veterans, but the same study shows that other factors also are usually in play. That gives mental health and primary care physicians the opportunity to identify those who may be at risk and keep them — and others — safe, a Veterans Affairs Department researcher said June 25. According to research conducted at the University of North Carolina-Chapel Hill School of Medicine on a random sample of 1,000 post-9/11 veterans, one-third reported being involved in an incident of physical aggression the previous year and 11 percent engaged in acts of severe or lethal violence. Researcher Eric Elbogen, an associate professor at the school, found that PTSD is “the risk factor most consistently associated with violence.” But other circumstances — age, history of abuse as a child, financial stress and substance abuse — also contribute, Elbogen said. And by knowing a patient’s history for these factors, doctors can tailor treatments that may reduce the likelihood of patients being involved in violence or running afoul of the law. “When the news media hears a report of a veteran involved in violence, there’s a knee-jerk reaction to blame PTSD,” Elbogen told physicians, military personnel, social workers and other participants in a webinar on PTSD and violence sponsored by the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. PTSD “might be relevant,” said Elbogen, “but it’s important to go below the surface, figure out what about PTSD is relevant,” For example, Elbogen noted, alcohol abuse plays a major role in increasing violent tendencies for those with PTSD. According to the research, veterans with PTSD who don’t abuse alcohol engage in violence at about the same rate as civilians, and the same is true for veterans who abuse alcohol but don’t have PTSD. But alcohol and PTSD combined are a risky union that can increase a patient involvement in violence three-fold, Elbogen said.
Opinion: The VA needs more doctors (America Blog)
By Dr. Mark Thoma, MD: “The Veterans Administration problems worsen, as do the problems of the vets seeking care through the VA. Things were already bad a year ago, with revelations that veterans were waiting an excessive amount of time to get seen (read: months), sometimes being deliberately dropped from waiting lists to artificially “decrease” wait times. VA centers were also not making timely referrals to doctors outside of the VA system, their budget was inadequate, there were too few doctors at the VA, and so on. The VA has made an effort to improve the situation. In the past year many more patients have been seen (or referred to outside doctors, including specialists). However, seeing and/or referring these patients has come at a cost of about $3 billion. The VA is now short of money for this program, and is looking at hiring freezes, layoffs, restrictions on some medications and other money-saving options. It wants to ask Congress to allow it to transfer funds from other budget areas to this program, but doesn’t expect a favorable hearing. Of course, failure to act will negatively feed back into the system, making the problem worse. When this story broke last year, I went to the VA’s primary website, along with VA medical center websites in Arizona, California, Minnesota, Alaska, Georgia, Michigan and some other states. I specifically looked for job postings for physicians. EVERY website was advertising for physicians. Most needed internists and family practice physicians, but a number needed specialists: surgeons, ophthalmologists, OB/Gyns, pediatricians, pulmonary doctors, psychiatrists, cardiologists, etc. It’s not just remote VA hospitals and clinics that need specialists; many located in or near large cities need them, too. In some areas, the VA had completely given up the search for permanent physicians, and was instead advertising for locum tenens doctors. These doctors will sign a short-term contract to go to a site — for example, a clinic somewhere in Arizona — and work for a mutually agreed amount of time, usually between a month and a year. When they leave, the post is open again — maybe for months or years — until another locum takes it.”
For-profit colleges aggressively recruit vets; these Democrats want it to stop (The Washington Post)
When it comes to enrolling veterans and their families, there is only upside for for-profit colleges. Men and women who serve in the military receive federal education funding that has become a stable source of revenue for many of the schools. And that money is exempt from a key federal rule that governs the way for-profit colleges are funded. But a group of Senate Democrats are ready to put an end to that. Sens. Dick Durbin (D-Ill.), Tom Carper (D-Del.) and Richard Blumenthal (D-Conn.) introduced legislation Wednesday to close a loophole in the so-called 90/10 rule, which prohibits for-profit colleges from getting more than 90 percent of their operating revenue from federal student aid funding. Money from the G.I. Bill, which provides veterans and their families with funding for college, does not count toward that threshold despite being federal aid. As a result, lawmakers and consumer advocates say for-profit colleges aggressively recruit members of the military. About 40 percent of G.I. Bill tuition benefits have gone to for-profit schools in the past five years. Corinthian Colleges, the for-profit giant that filed for bankruptcy last month amid allegations of predatory lending and lying to the government about its programs, received $186 million in military tuition funding. “While not every for-profit college is a bad actor, one veteran mistreated is one veteran too many,” Carper said, in a statement. “We need to use common sense here. It doesn’t make sense for taxpayers to send veterans to for-profit schools that can be 100 percent subsidized using taxpayers’ dollars.”
Government names special master for Corinthian student debt (Military Times)
The Education Department appointed a special monitor Thursday to help develop a debt relief program for students who attended the now-defunct Corinthian Colleges — a debt forgiveness plan that could cost billions of dollars. Ted Mitchell, the undersecretary at the department, named Joseph A. Smith as the monitor, calling him “a distinguished advocate for consumers and taxpayers” who will guide a fair and efficient process. Earlier this month, the department announced a plan to make it easier for students who attended Corinthian to seek relief for their federal loans. Corinthian, once one of the largest chains of for-profit colleges, nearly collapsed last year amid fraud allegations, and went bankrupt in May. Smith has served as an independent monitor in other high-profile cases. He oversaw consumer relief obligations in a $13 billion settlement between the government and JPMorgan Chase. About $3.6 billion in federal loans has been given to hundreds of thousands of Corinthian students since 2010, but officials say it’s unlikely that every loan will qualify for relief. The Education Department had accused Corinthian of falsifying job placement data for its graduates and altering grades and attendance records. The department fined Corinthian $30 million in April. On a phone call with reporters, Mitchell said the department has received about 7,000 applications as of this week for debt relief, mostly from Corinthian students. Some applications were received from students from other schools, but Mitchell did not say which ones.
Editorial: Rooting out problems at VA hospitals (Tampa Bay Times)
“When dead rats start falling from the ceiling, that should be a sign. The three large, dead rats that workers found at Tampa’s James A. Haley VA Medical Center last week are bad enough, but there are continuing systemic problems at the Department of Veterans Affairs. Haley needs to step up its pest control, and the federal government needs to step up its efforts to ensure that veterans promptly get the medical care they deserve. Tampa Bay Times reporter William Levesque reported that the medical center had a rodent and insect problem. In addition to three rats falling from the ceiling, the facility was infested with cockroaches. Patients even found cockroaches on their food trays. These conditions should not be tolerated anywhere, particularly in one of the nation’s busiest VA hospitals. But the VA’s issues stretch beyond pest control and are not as easily eradicated. Since attempts to obscure VA hospitals’ appointment delays came to light last summer and then-Secretary of Veterans Affairs Eric Shinseki resigned, the agency has been slowly trying to rebuild its standing. But there are 50 percent more veterans than last year on waiting lists of one month or more, and VA physician workloads have increased by at least 18 percent across the country. That’s moving backward, not forward. Now the VA is seeking more money to address its backlogs, and Congress should respond. Veterans who have risked their lives in service of the nation should expect facilities that are free of rats — and they should not have to wait weeks for an appointment.”
Hiring freeze hits Central Alabama VA (Montgomery Advertiser)
The Central Alabama Veterans Health Care System has stopped hiring medical support staff, part of an attempt by the national Veterans Affairs health system to deal with a $2.6 billion budget shortfall. The hiring freeze affects administrative areas such as human resources, police and customer service, but does not include doctors and nurses who provide health care services directly to veterans. The medical support and compliance portion of the system’s budget will be $5 million short for the remaining three-and-a-half months of the fiscal year, according to a bulletin to CAVHCS employees from interim director Robin Jackson and obtained by the Montgomery Advertiser. That’s part of a $15 million shortfall for medical support and compliance staff at VA health care facilities in the Southeast, according to the bulletin. It also affects the director’s office, senior staff, the business office, and other administrative duties. The freeze does not affect staff who help veterans schedule their doctor appointments, according to a spokesman for the VA’s Southeast Network. “The Central Alabama Veterans Health Care System continues to prioritize the hiring of doctors, nurses and other clinical staff to provide the best possible care to the veterans we serve,” said Amir Farooqi, a spokesman for the network. “This includes prioritization for the hiring of administrative staff that directly support clinical operations such as clerks and schedulers.”
Veterans helping fight wildfires in Alaska (KUSA-Denver)
A group of military veterans is in Alaska to help fight the wildfires that are burning in the state. About a dozen veterans picked up their wildland firefighting gear Thursday ahead of their two week mission in Alaska. They recently became certified wildland firefighters through a new partnership between the Bureau of Land Management and the veteran’s organization Team Rubicon. Through the government-supported training program veterans can be paid as firefighters and sent to emergencies. “This will be their first assignment,” said Beau Kidd, a representative with Team Rubicon. “They just finished up their training recently and they’re getting out the door.” Team Rubicon is an international disaster response organization that combines the skills of veterans with first responders to deploy to disasters across the country. On Thursday 12 firefighter trainees left Colorado for Alaska. “It’s always been a bucket list thing for me, since I was young, I’ve always loved the outdoors and taking care of the environment,” said Veteran Marc Gonzalez of Colorado Springs. “Fighting wildland fires is just something I have always wanted to do. This opportunity came up with Rubicon and I couldn’t say no.” The BLM is also organizing firefighter training sessions in Philadelphia, San Francisco, Seattle and Atlanta. Eventually they hope to have about 400 veterans trained as wildland firefighters.
Rubio gives Obama ‘F’ on VA issues (The Washington Times)
Sen. Marco Rubio of Florida on Thursday gave President Obama a failing grade on issues related to the embattled Department of Veterans Affairs. “It’s an F — I mean, because the system’s gotten worse, not better,” Mr. Rubio said at a Concerned Veterans for America town hall in New Hampshire, drawing applause. “We’ve replaced the secretary, we’ve had press conferences … and you’ve poured more money into it, and the results — the wait times have gotten longer in some places.” Mr. Rubio, a 2016 GOP presidential candidate, said he thinks when it comes to such issues, “it’s either an ‘A’ or an ‘F.’ “ “It can’t be a ‘C’ or a ‘D’ — I mean, it’s either an ‘A’ or an ‘F,’ ” he said. Mr. Rubio said it’s not a “funding issue” or a “want to” issue, “it is the fact that the model itself may no longer work in a 21st century that is dramatically different from what the world looked like 80 to a 100 years ago in terms of access to private providers and centers of excellence that want to take care of veterans and are open for business that can see you right away and produce a result that’s good or better.” “Again, the key is it is up to the veteran to choose,” he said. “They may be very happy at the VA that they have, they may be very pleased with the services they’re being offered and that should be available to them as well. But putting the veteran in charge – [you] don’t do that, you’re going to continue to have a failing grade no matter who the president is.”
Huckabee: Get government out of veterans’ health care (The Washington Times)
Former Arkansas Gov. Mike Huckabee wants the U.S. to get out of the business of veterans’ health and medical care. The Veterans Health Administration, the part of the embattled Department of Veterans Affairs handling medical care, should be “put out of its misery and most importantly, put it out of the government’s” reach, Mr. Huckabee said Wednesday at a stop in Osceola, Iowa, the Des Moines Register reported. Veterans should instead be given a health care card that provides them with medical services at whatever facility or provider they go to, said Mr. Huckabee, a 2016 GOP presidential candidate and winner of the 2008 caucuses in Iowa. “You say ‘that might be expensive.’ It might be,” he said. “If we have to take down every monument in Washington, D.C., cut them up in pieces and sell them as souvenirs to pay for it, so be it.”
Rangers, NASCAR race organizers give Texas vet afternoon of surprises (NBC-DFW)
When retired Marine Sgt. Jeff Kyle walked through the gates of Globe Life Park Thursday, he thought he was there simply to watch the Texas Rangers play. But the team and representatives from NASCAR’s Brickyard 400 race had other plans for him. “This, everything is a surprise,” said Kyle, who lives in Waco. Once he arrived, Rangers officials told Kyle to warm up because he was going to throw the game’s ceremonial first pitch, which he threw right over home plate. Then as Kyle stood on the mound, the stadium’s public address announcer dropped an even bigger surprise. Kyle had won a nationwide contest to have the Brickyard 400 named after him. “My whole body is shaking,” said Kyle. “I’m overwhelmed. There’s a lot to take in right now and I don’t think it’s all sunk in quite yet.” A friend of Kyle’s nominated him for the “Your Hero’s Name Here” contest, which Brickyard 400 title sponsor, Crown Royal, holds each year to honor heroes in America’s communities. Finalists are selected and the public chooses a winner. “This was a great opportunity for us, with Crown Royal, to really celebrate why we’re free and can race on Sundays,” said Doug Boles, president of Indianapolis Motor Speedway, where the Brickyard 400 takes place. “They don’t do what they do to become heroes. They do what they do because they know it’s the right thing to do.” Boles said Kyle is a deserving winner for multiple reasons. While he was in the military, he was deployed to Iraq twice and served overseas in several other countries. Since retiring, he’s spent his time working with multiple organizations that help disabled veterans. The Jeff Kyle 400 will take place on July 26 at Indianapolis Motor Speedway. Kyle said he’s looking forward to attending his first NASCAR race. Military service runs deep in Kyle’s family. He’s the younger brother of “American Sniper” Chris Kyle.