VA acknowledges link between vet’s illness, base chemicals on Okinawa (Military.com)
More than three decades after coming into contact with 100 barrels of a mysterious substance on a Marine Corps base in Japan, a Keene, N.H., city councilor and state representative finally has some closure. In 1981, Kris E. Roberts was a facilities maintenance officer at Marine Corps Air Station Futenma in Okinawa, Japan. As a first lieutenant in charge of maintaining the base with 50 Okinawans and the 35 U.S. soldiers working under him, Roberts was assigned to look into some unusually high chemical readings in the water coming off the base. He and his men did some digging, and found barrels of a substance that Roberts thinks was Agent Orange, one of the herbicides used by the U.S. military during the Vietnam War to kill the foliage that North Vietnamese troops used for cover. More than 100 barrels lay neatly in the ground, rusty and leaking fluid, Roberts said. “We dug, and it was more and more and more,” he said. Now Roberts, a candidate for mayor in Keene, is the first veteran the U.S. government has acknowledged came into contact with hazardous chemicals on Futenma, he said Wednesday. In a ruling this month, the U.S. Department of Veterans Affairs’ appeals board told Roberts that the prostate cancer he was diagnosed with in 2006 was due to “exposure to hazardous chemicals.” Roberts, now 61, said he experienced several medical issues, including strokes and blackouts, when he returned from Okinawa.
Medical errors up at VA hospitals, but they’re doing less to figure out why (The Washington Post)
Hospitals across the country are under growing pressure to reduce preventable medical mistakes, the errors that can cause real harm and even death to patients. But the Department of Veterans Affairs, which runs a massive system of hospitals and clinics that cared for 5.8 million veterans last year, is doing less, not more, to identify what went wrong to make sure it doesn’t happen again. A report out late Friday from the Government Accountability Office found that the number of investigations of adverse events — the formal term for medical errors —plunged 18 percent from fiscal 2010 to fiscal 2014. The examinations shrank just as medical errors grew 7 percent over these years, a jump that roughly coincided with 14 percent growth in the number of veterans getting medical care through VA’s system. Auditors said it was hard for them to know whether the decline in investigations (called root cause analyses) means that fewer errors are being reported, or that these mistakes, while on the rise, are not serious enough to warrant scrutiny. But the reason for the caution is itself disconcerting: VA officials apparently have no idea why they are doing fewer investigations of medical errors. They told auditors that they haven’t looked into the decline or even whether hospitals are turning to another system. The National Center for Patient Safety, the office in the Veterans Health Administration responsible for monitoring investigations of medical errors, “has limited awareness of what hospitals are doing to address the root causes of adverse events,” the report concluded. Patient safety officials are “not aware of the extent to which these processes are used, the types of events being reviewed, or the changes resulting from them,” GAO wrote. It added that “the lack of complete information may result in missed opportunities to identify needed system-wide patient safety improvements.” Auditors said the lack of analysis is “inconsistent” with federal standards on internal controls, which require agencies to look at significant changes in data.
VA touts progress in face of reform challenges (The Washington Times)
The VA is still struggling to right its image after last year’s waitlist scandal, but veterans gathered at the American Legion’s convention this weekend said they see a department picking itself up and already on the path to recovery. Legion members said they’re particularly eager to see the new leadership show it has learned from the scandal that led to their installment after having seen dozens of veterans die while awaiting care, having appointments denied and being shunted onto secret waitlists. “Look, you’ve got to learn to crawl before you can walk, before you can fly, right? The VA is just learning to crawl, and the American public wants them to fly,” said Dave Hazelwood, who served in both Vietnam and Korea. “You can’t do that without going in between.” Mr. Hazelwood, who has had chemotherapy and wrist surgery at the VA clinic in Wichita, Kansas, over the last decade, said the quality of care has steadily improved. “Some things work, some things don’t,” he said. “Only 1 percent of this country are veterans, but even 50 percent of the 1 percent is a heck of a lot of people. Some fall through the cracks, right?” Dr. David Shulkin, the VA’s new undersecretary for health, told the legionnaires that the VA is the best health system in the country — though he acknowledged he inherited many problems, including the wait-time crisis, a $3 billion shortfall in funding this year and an increasing number of patients signing up to use the VA. Dr. Shulkin said those problems had been “building for a long time,” but said the Veterans Health Administration, which he heads, is doing many things right. “I’m going to be very, very focused on telling good things of the VA. Nobody’s been doing that. We’ve only been hearing bad things, and we need to focus on good things as well,” he said. Still, the challenges are big: 35 percent of VA medical centers do not have a permanent CEO, meaning there’s nobody to do long-term planning. And hospitals are inconsistent, meaning the quality of the same procedures can vary dramatically from clinic to clinic.
Investigations under way at Florida regional VA system (Gainesville Sun)
An investigative board within the North Florida/South Georgia Veterans Health System has begun looking into questions about how outside medical providers are paid as well as complaints of a hostile work environment, a union official said. The VA Office of Inspector General also has gotten involved in the investigation, said union leader Muriel Newman, president of Local 2779 of the American Federation of Government Employees. Newman said the union was notified last week that Thomas Wisnieski, director of the North Florida/South Georgia VA system, was convening an administrative investigative board. Newman said it is her understanding that the investigative board is looking into concerns regarding inappropriate processes used to pay non-VA medical providers who have seen VA patients through the Veterans Choice Program. The union was told the investigation pertains to VA management, not bargaining-unit employees, although some union members would be interviewed as part of the inquiry, Newman said.
N.M. vets receiving benefits, care faster, VA says (Albuquerque Journal)
The heads of the agencies that provide health care and disability benefits for thousands of New Mexico veterans say they are making progress in reducing wait times for medical appointments and speeding up decisions on disability claims despite myriad challenges. Andrew Welch, director of the New Mexico VA Health Care System, and Chris Norton, regional director for the Veterans Benefits Administration, said they and their staffs have made notable improvements in the past two years and that veterans are beginning to see the results. Cynthia Archuleta, who assists Veterans of Foreign Wars members with disability claims, said her clients are telling her they have seen improvements over the past couple of years. “The veterans who I talk to who have had issues with the VA in the past have since come forward and told me that things have significantly changed” for the better, Archuleta said. “For the most part, they’re happy. Nothing is perfect, but they’re definitely seeing a change. They’ve noticed, for example, that if someone isn’t able to help them at the moment, they’re referred to someone else within 10 to 15 minutes, and that person is able to help them.” Said Norton, “Two years ago, it was taking us well over a year to make a decision on a veteran’s claim” for disability benefits. “We’ve cut the amount of time it takes to make a decision about in half.” Last month, it was taking his office an average of 130 days to reach a decision – or about five days longer than the VBA’s stated goal. The regional office has also whittled down its claims backlog, he said. “Two years ago, we had about 3,000 veterans waiting more than 125 days. Today, we have about 950, and when we finish our fiscal year (at the end of September) that will be down to about 350 – and we’ll continue to chip away at that backlog,” Norton said.
Pilot killed in crash was helping wounded veterans (Military Times)
A pilot who died in a small plane crash in the desert northeast of Los Angeles was giving free glider rides to wounded military veterans. Sixty-seven-year-old Channing Morse of San Diego died Thursday when his small plane crashed in a field in Llano in the Antelope Valley. The area is near a glider flight training school. Morse was a volunteer with the Wounded Warrior Project. His sister says Morse’s tow plane had just released a glider when his Piper PA-25 crashed. Morse was an experimental test pilot and U.S. Air Force Academy graduate.
Legionnaires’ disease cases climb at Illinois veterans home (St. Louis Post-Dispatch)
Officials say the number of residents with Legionnaires’ disease at a western Illinois veterans’ home climbed five more to 28, including two people who died last week. The Quincy Herald-Whig reported Saturday the number jumped from the 23 cases made public Friday when the deaths were reported. Illinois Department of Public Health officials say the deceased residents had underlying medical conditions. Legionnaires’ disease is a severe form of pneumonia, with lung inflammation usually caused by infection. It’s not transmitted from person to person, with most people getting it from inhaling the Legionella bacteria. Illinois Veterans Home spokesman Ryan Yantis says residents are being monitored and anyone with symptoms will be treated as if they have it until lab results show otherwise.