Half of critical positions open at some VA hospitals (USA Today)
About one in three jobs are vacant at nine of the nation’s regional Veterans Affairs health care systems, leaving veterans waiting weeks to get care. Nationally, one in six positions — nearly 41,000 — for critical intake workers, doctors, nurses and assistants were unfilled as of mid July, in part due to complex hiring procedures and poor recruitment, according to critics of the nation’s network of 139 hospitals and clinics that treat veterans. The vacancy data obtained by USA TODAY through the Freedom of Information Act offers the first look at how serious staffing issues are at some VA hospitals and clinics. It also shows that at many locations, unfilled jobs are driving up appointment wait times. USA TODAY’s analysis found that even a 1% increase in job vacancies contributes to more appointments being pushed past a month-long wait. Some of the highest vacancy rates are for psychologists. In 13 regional health care systems, 40 to 64% of psychologist positions are vacant. Nationally, about 21% of such positions are vacant. “It is unacceptable,” said Sen. Jon Tester, D-Montana, a member of the Senate Veterans Affairs committee. “This is a problem under bright sunlight now, and it needs to be fixed.” In Fayetteville, N.C., 59 of its 187 physician positions were open in mid July, and the hospital and its outpatient clinics had only half of the psychologists needed to be at full staff. Overall, a third of medical jobs within that system are vacant. A quarter of patients with pending appointments are waiting more than a month past their requested appointment time. “This is something we’ve been dealing with for more than a year,” said Fayetteville spokesman Jeffrey Melvin, referring to the long wait times. “A lot of that stems from lack of space, lack of providers.” Melvin said Fayetteville had a hard time recruiting medical professionals to move to the area. And the hospital has high turnover because many employees are spouses of military members at nearby Fort Bragg, and leave when their partners are transferred to other bases. Fayetteville is one of nine facilities with clinical employee vacancy rates over 30%. The others are the West Texas Healthcare System in Big Spring, Texas; Roseburg, Ore.; Long Beach, Calif.; Walla Walla, Wash.; Memphis; Reno; Togus, Maine, and Montgomery, Ala.
VA considered rationing hepatitis C drugs for sick veterans (The Washington Examiner)
Department of Veterans Affairs officials mulled a plan to ration expensive medications after asking Congress for $500 million to pay for the same drugs. Although the VA knew since at least January it was facing an enormous budget shortfall due to the rising cost of the medications, agency officials led Congress to believe it was a sudden development that required swift action, asking for the additional funding only weeks before the budget holes would have forced them to close hospitals around the country. Emails and internal memos obtained by the Washington Examiner indicate the VA proceeded with a plan to withhold the hepatitis C drugs from certain veterans even after receiving congressional permission to raid a controversial agency program for the required funding. “It’s another instance of the VA telling Congress, the Veterans Committee and others about how, if we give them money, it would be spent, and then it’s a different plan once we give them the money,” Sen. Jerry Moran told the Examiner. “If the VA tells us there’s a crisis and tells us to respond to that crisis, I would expect them to use the money as they told us they would,” said the Kansas Republican, who is a member of the Senate Committee on Veterans’ Affairs. “A question would be, then how are you spending the money if you are refusing to treat all the veterans that are suffering from this condition?” Moran said. Sloan Gibson, deputy VA secretary, testified in June that the agency faces more than $1 billion in costs from the drug this year. “We don’t expect to do any rationing of care with Hepatitis C,” Gibson told the House Veterans’ Affairs Committee on June 25, when he asked Congress to give the agency $500 million to cover the cost of the drugs. But the VA had seemingly already made progress on an internal plan to ration the medication at the time of Gibson’s testimony. The agency’s top budget official refused to acknowledge early warnings of the budget shortfall when other VA employees raised the issue with her in January. “Please stop the discussion on the funds at this time,” wrote Kathleen Turco, the VA’s chief financial officer, in response to internal concerns that the demand for hepatitis C medication would deplete funds in 2015.
Plan to use GI Bill for business grants draws criticism (Military Times)
Some veterans advocates are pushing back against plans to use GI Bill benefits to pay for would-be entrepreneurs’ small-business grants, arguing the move confuses the purpose of the education program. Last month, the Senate Small Business Committee advanced a measure to create a three-year pilot program allowing 250 veterans to use their GI Bill funds as a business start-up grant, rather than for college tuition. The concept has been floated on Capitol Hill several times since the Post-9/11 GI Bill was launched in 2009. But it has grown in popularity in recent months, and this week was included in presidential hopeful Jeb Bush’s veterans reform platform. In a statement, bill sponsor Sen. Jerry Moran, R-Kan., called the idea a “common sense” move to give veterans “more flexibility and choice in their benefits to achieve their goals.” The legislation is supported by several veterans groups, including the National Guard Association of the United States, the American Legion, and Iraq and Afghanistan Veterans of America, which have praised it as another way to ease troops’ transitions from military to civilian life. But Student Veterans of America and the Veterans of Foreign Wars have come out as vocal opponents of the idea, calling it a potentially problematic erosion of a clearly defined program. “The GI Bill is an education benefit,” said Will Hubbard, SVA’s vice president of government affairs. “This is like using a VA home loan program to pay for medical bills instead of a mortgage. That’s not what this benefit was intended for.” In the last six years, VA has paid out nearly $54 billion in Post-9/11 GI Bill benefits to 1.4 million veterans and dependents. The program has proved wildly successful but also has drawn attention because of its cost. Hubbard said he supports expanding small-business programs for veterans, but not by equating them to college degrees or pulling money from the education benefit.
Watchdog: VA employees waste time on social media (The Washington Examiner)
The Department of Veterans Affairs’ Office of Inspector General released a report this week that said tens of thousands of VA officials inappropriately signed up for Yammer, and used the communications tool to get in fights with each other, set up silly chat rooms, and even point out helpful movie reviews to each other. Even worse, the inspector general said Yammer was never formally approved as a communications tool, and that it allowed some VA officials to share personal information on a non-secure platform. The IG summarized its report by saying the use of a “VA Yammer” account has led to numerous wasted hours of work for officials at an agency that has been under near-constant criticism for failing to ensure veterans have access to health care. “VA Yammer was not only an unapproved web-based collaboration tool, it was a misuse of VA time and resources when VA employees used it, due to it not being properly approved,” he said. “Further, the frequent use of Yammer, to include the instant messaging tool, could cause congestion, delay, or disruption of service and degrade the performance of VA’s network.” “Moreover, we found several posts that contained VA sensitive data and numerous posts in which users posted or uploaded unprofessional, non-VA related personal, and/or disparaging content that showed a broad actual and potential misuse of time and resources by VA Yammer users,” it said. The report said that while the VA has a procedure for adopting new technologies and social media, officials started using Yammer in 2012 without any formal approval. Soon after, there were more than 25,000 active users of Yammer at the VA, and another 25,000 or so who had signed up but were not yet active. But no one was managing the system, which led to several examples in which employees were confused about how they were accidentally spamming other workers to join. Many others used Yammer as a fun social site, leading to wasted time at work. The IG report said some users posed pictures of their T-shirts, while another posted a video link to the 1986 movie “Ferris Bueller’s Day Off.”
Money and time needed to bring more doctors to VA (Modern Healthcare)
The effort to recruit and train physicians to tend to the specific and often very locally focused needs of VA patients is slow-going despite its fast-track implementation, according to the Veterans Affairs Department. The Veterans Access, Choice, and Accountability Act of 2014 contained an ambitious provision to create 1,500 new VA-affiliated graduate medical education positions in five years. The legislation aimed to put resident physicians in areas of need with the hopes that they would remain there to practice. A request for proposals was issued last fall for new residency positions that were to start July 1, 2015. Those interested had only a few weeks to apply. More than 200 proposals were accepted, 75% of them in mental health or primary-care specialties, said Dr. Karen Sanders, the VA’s deputy chief academic affiliations officer. Matthew Shick, senior legislative analyst with the Association of American Colleges, called that a “fantastic feat.” “Typically, those RFPs are open for months,” he said. Sanders agreed, saying the initial RFP for the first round of residency positions was only “on the street for four weeks, but we got an amazing, robust response.” To some extent, however, it was too much, too soon, and only 162.9 of those new positions were filled by residents July 1. Sanders said her office has reached out to the facilities that didn’t fill their allotted positions. She was told that all were willing, but they had problems doing so in the time allowed. The first RFP stated that facilities would receive $87,000 a year per resident allocated as “indirect education support.” That figure was lowered to $83,000 in the second RFP, which covers 325 new positions scheduled to start July 1, 2016. That initial RFP also noted that “Programs that incorporate teaching of principles of patient-aligned care teams and integration of residents into PACT models of care delivery will be given priority.” Also, all new GME positions needed to be sponsored by an academic affiliate. The new slots could not be sponsored by a VA facility and expanding existing VA-sponsored residencies was not considered.
Former Navy surgeon general takes reins at VA Maryland health system (The Baltimore Sun)
Dr. Adam M. Robinson Jr. remembers seeing an image of John F. Kennedy’s ambulance rolling toward Bethesda Naval Hospital, where doctors performed the autopsy hours after the president was assassinated. It was a startling scene for Robinson, then an eighth-grade student growing up in Louisville, Ky. For the son of a physician, it was also something of an introduction to the Navy’s medical system. “It was a searing moment,” said Robinson, 64. “I remember that I thought it was this great hospital, with great care.” Robinson was appointed director of the VA Maryland Health Care System this month after a nearly 40-year career with the Navy that included a stint as commander of the hospital where Kennedy’s body was examined in 1963. He would go on to become the Navy’s 36th surgeon general before retiring in 2012. The Bethesda man is now taking over a 3,000-employee medical system that spent much of last year on defense. Federal audits showed that Maryland’s VA medical system, with a $550 million annual budget, was among the slowest in the nation at scheduling first-time visits with primary-care doctors. That revelation came as the Department of Veterans Affairs was reeling from reports of significant delays at its medical facilities nationwide — a scandal that led to the ouster of Secretary Eric K. Shinseki. But Robinson, who previously served as chief of staff of the VA Maryland Health Care System, appears to be making progress and is beginning to advance other priorities, such as ending homelessness among veterans.
Army vet walks 1,500 miles from Texas to DC for VA care (WUSA-Washington)
Amari Williams is a combat war veteran with one cause: to help all veterans get the healthcare they deserve. He fought on the battlefield and now he fights for change in the Department of Veterans Affairs, vowing to sit inside the VA office every day until he gets the help that he needs. With only a backpack, Amari Williams said good-bye to his family, left his home in Killeen, Texas, and started walking to Washington DC on July 27 in hopes of finding help for his ailing body. “After the 10th mile, the first 10 miles it was just me an angry vet,” Williams said. That anger softened with each painful step. His journey took a turn that surprised even him. Williams received support from strangers and other veterans which overwhelmed him. But when he reached Knoxville, Tenn. he thought about giving up. “My feet are swollen. My ankles are swollen. My knees have been killing me since ten feet in. My shoulders are on fire,” Williams said. But he pushed on and thought about the veterans who feel the VA system failed them. Amari spent a year in Iraq and returned home in 2004 a different man. “I killed people for a living. We’ve already gone from hell and back,” Williams said. Williams suffers from PTSD, anxiety, depression, hearing loss and pain throughout his body. For more than a decade, his claim would either be lost or denied. The VA says his condition is not due to his combat in Iraq. So to address the issue head-on he walked nearly 1500 miles in 3 weeks to bring his complaints to the VA. Despite a decade of pent up frustration, when he arrived in DC on Friday he took a moment in awe of the country he had fought for. “I just started crying,” Williams said. Williams spends his days from 8 a.m.-4 p.m. at The Veterans Affairs Benefit Administration office. He hasn’t made much progress. Then, because of WUSA9 cameras, the outreach director at the Veterans Affairs came to talk and try to help Amari Williams. Jason Miller was surprised that Williams had walked half way across the country, even though Williams spent his days tweeting inside the VA office while waiting for answers. Miller said he promised he would do his best to get him help and to give him a chance to do so.
Vets with PTSD sue Colorado for right to use medical marijuana (Courthouse News Service)
Four war veterans and a victim of sexual assault sued Colorado for refusing to allow medical marijuana to be prescribed for post-traumatic stress disorder — an odd case for a state that allows marijuana to be used for fun. The plaintiffs include an Army sniper who served two tours of duty in Iraq, an 11-year veteran who worked in an explosive ordnance disposal unit in Iraq, an infantryman in an elite unit who suffered traumatic brain injuries in two tours of “heavy combat” in Afghanistan, and a woman who was sexually molested when she was 5. All of them “self-medicated” after their trauma, and were prescribed drugs for PTSD. One tried to kill himself. All of them say medical marijuana has relieved their symptoms more effectively and with fewer side effects than prescription drugs. The defendants – the Colorado Department of Public Health and the Environment, and the Colorado Board of Health – refused by 6-2 vote on July 15 to add PTSD to the list of conditions qualifying for medical marijuana treatment. Colorado’s Chief Medical Officer Dr. Larry Wolk was one of the two votes in favor of medical marijuana for PTSD. Wolk said it should not be necessary for veterans of war to falsely cite physical pain to qualify for a medical marijuana card. “We don’t want people to suffer as a result of not being able to access [cannabis] honestly,” Wolk said. Dr. Christopher Stanley, one of the six “No” votes, said he was struggling with “the science piece,” and did not feel there is enough evidence of the efficacy of medical marijuana to treat PTSD. As attorney C. Adam Foster, with Hoban & Feola, represents the plaintiffs in Denver County Court, several veterans groups and research organizations are trying to fill in the “science piece” that Dr. Stanley cited.
5 finalists in contest to design World War I memorial in D.C. (Military.com)
Five design concepts have emerged in a competition to build a new national World War I Memorial in Washington, with ideas ranging from neoclassical architecture to a portrait collage of the “American family.” A design competition for the project drew 350 entries, and a jury narrowed those to five finalists announced Wednesday, based on their concepts alone, without knowing the names behind the submissions. Organizers sought designs that could be built for roughly $20 million to $25 million. Congress designated a park along Pennsylvania Avenue near the White House to become the first memorial in the capital honoring the 4.7 million veterans of the first world war and the 116,516 American lives lost. It would join the Liberty Memorial and National World War I Museum in Kansas City as the nation’s official tribute. The site, the dilapidated Pershing Park from 1981, currently includes a memorial to John J. Pershing, who led the American Expeditionary Force into Europe in 1917. The Cultural Landscape Foundation said it opposes the demolition of Pershing Park for the new memorial. However, the existing memorial elements would be integrated into a new design, memorial organizers said. The challenge is to capture the war experience of nearly 100 years ago for new generations. “We’re establishing a memorial to a generation of veterans and servicemen and women that are no longer here,” said Edwin Fountain, vice chairman of the memorial commission. “You have to think about who is the audience today and 50 or 100 years from now and how do you speak to that audience?”
California VA official pleads guilty to accepting trips (The Modesto Bee)
An Oakdale, Calif., man pleaded guilty to receipt of a gratuity by a public official, the United States Attorney’s office said. Anthony Castaneda, 45,was working as a contracting official at the Department of Veterans Affairs when he accepted vacation trips from a construction contractor, authorities said. “Castaneda was in a position to influence the award of construction contracts at VA facilities, including the VA hospital at the former Mather Field in Sacramento,” federal officials said in a news release. “In 2010, a construction contractor provided Castaneda with a prepaid vacation package at a theme park worth approximately $2,243.56.” Castaneda and his family went to the theme park for five days in October 2010. Court records also show that Castaneda received a $1,500 vacation package from the same contractor previously, in 2008. The contractor has been charged in a separate case. Castaneda faces up to two years in prison and a $250,000 fine when he is sentenced.
‘Searching for Home,’ a cross-generational look at veterans (The New York Times)
Documentary Review: “The oddest thing about “Searching for Home: Coming Back From War” is how often the military men interviewed talk about having been surprised that real war wasn’t like the movies. They make a Korean War veteran seem like a master of emotional distance and control when he sticks to real-life parallels in a speech about his memories. The director, however, may have guided the more recent veterans to the subject (their answers sound very similar). Eric Christiansen, whose earlier documentary was “Homecoming: A Vietnam Vets Journey,” has organized the new film neatly by topic: what the veterans were like as small children, how they feel about what they saw and did overseas, what it was like coming home, what post-traumatic stress disorder is, how they have adjusted (with support groups, support dogs, psychotherapy, marathon running) and, finally, how they’re seeking a sense of home. “Searching for Home” is strikingly photographed by Mr. Christiansen and is sure to give comfort and support to countless veterans and their families. For others, there is little new insight, although the film does create an instructive tension between admiring bravery and sacrifice and being appalled by war itself.”
Evicted Navy veteran gets housing assistance (Military.com)
A Navy veteran and his wife who feared they would become homeless are living in a hotel with the help of the city and several nonprofits, with others working toward a more permanent solution. Rudolph Nanez and Jessica Youness moved to a hotel Aug. 8. They could no longer afford the rent for their Virginia Beach home and received an eviction notice in June, The Virginian-Pilot reported. The couple had said they contacted dozens of veterans organizations over the past several weeks seeking help. The process has been tedious and frustrating, they said. Several groups are pitching in to keep them off the streets and place them in more permanent housing within a couple of weeks. “Right now, what we’re trying to do as a community that has answered the challenge to house all of our veterans before the end of the year is to identify their level of need so we can match them to the available housing,” Pam Shine, the city’s homeless programs coordinator, said Wednesday. Veterans HomeFront, a Chesapeake-based veterans assistance organization, provided volunteers to move the family’s items into storage Aug. 8; Outreach for Christ, a Virginia Beach ministry program, provided the trucks. United Way paid for the family’s first three days in the hotel, and The Salvation Army paid for three additional days. Supportive Services for Veterans Families, a program of the nonprofit Virginia Beach Community Development Corp., which provides affordable housing to low- and moderate-income people, is continuing to pay for the hotel while a case manager assesses the couple’s situation. Nanez met with the nonprofit’s representatives Aug. 11 and entered its program, which provides case management and housing search and rental assistance for three to nine months, depending on the severity of the case. The case manager is helping Nanez find an affordable place to rent, Shine said.
Wounded vets gather for Valor Games (Chicago Sun-Times)
Ernest Byrd was all set for the archery competition, but for the time being, he was on his cellphone — on hold — trying to get a doctor’s signature so that he wouldn’t find himself homeless. “I’ll bring home the gold for you,” Byrd joked when someone finally came on the line. There were a lot of those types of distractions at the Valor Games Midwest — open to injured, ill and wounded veterans and active-duty service members — being held over three days this week at various locations in the city. Some competitors were testing unwilling bodies. Others were emerging from reclusive lives after devastating injuries. And then there was Byrd, on the phone with his local Veterans Affairs office, trying to get someone to pay attention. “I’m going to have to go in in person,” said a frustrated Byrd, 57, an Army veteran from Hyde Park who suffers from osteoarthritis. What all the participants — about 200 in all — seemed to share as they competed Wednesday at Armour Square Park in the shadow of U.S. Cellular Field in Chicago, was a love of brotherhood and sisterhood. “The camaraderie is unbelievable. It’s priceless,” said Byrd, competing in the over-46 archery contest. “That was the thing I learned in the army — those guys come from all walks of life, all parts of the country. It’s like you’ve known ‘em all your life.” Others took part in events that included cycling, rowing, tennis and powerlifting.