DoD, VA vow interoperability between new health IT systems (Federal Times)
One of the central priorities of the Department of Defense’s multibillion-dollar Defense Health Management System Modernization (DHMSM) contract awarded last week is a requirement that any new electronic health records management system be interoperable with the one used by the Veterans Affairs Department. After the two agencies failed to agree on a single health records management system back in 2013, it was determined that the DoD system would work with VA’s Veterans Health Information Systems and Technology Architecture (VistA). VA is currently working on the fourth generation of VistA, which isn’t set to be completed until 2018. Whatever the next version of VistA looks like, officials from VA and DoD are confident the two systems will work together to provide seamless care to soldiers, whether active-duty or retired. “Interoperability is not a new idea between DoD and VA,” said Sloan Gibson, VA deputy secretary, during a health IT summit sponsored by AFCEA on July 31. Gibson noted the two departments regularly share data over their networks through a number of applications. Despite that, “We have a massive and comprehensive effort underway between VA and DoD” to ensure the systems are interoperable, he said. Defense Health Agency CIO David Bowen agreed, stating that VA and DoD share data daily on procedures, check-ups, benefits and more. “We are 100 percent committed to being interoperable with the VA,” Bowen said. “We’ve defined what that means, we have managed our systems so that where we are basically speaking a different language we have developed standards to translate data back and forth.”
The U.S. declared war on veteran homelessness — and it actually could win (NPR)
Under the deafening highway noise of the Pontchartrain Expressway in central city New Orleans, Ronald Engberson, 54, beds down for the night. Engberson got out of the Marines in 1979, plagued even back then by problems with drugs and alcohol. He says that’s mostly the reason he’s been homeless the past 10 years. “My longest stretch sober was 14 months,” he says. “Being out there on the streets, it’s tough.” About 50,000 vets are homeless in America. In 2009, then-Veterans Affairs Secretary Eric Shinseki declared that all of them would have housing by this year. At the time, even inside the VA that goal was considered aspirational at best. But last year, cities across the country said it was looking achievable. New Orleans was the first to declare, in January, that the city had done it. So if New Orleans has zero homeless vets, why was there a Marine sleeping under the expressway? It’s called “functional zero,” according to Melissa Haley, director of supportive services at Volunteers of America in New Orleans. “Homelessness is a continuous process. There’s a veteran right now who is in a home who could very well be homeless tomorrow,” she says. “Functional zero is defined as having a process and the resources in place where we can immediately house a veteran.” So if a vet loses a job today, misses the rent and gets evicted in New Orleans, the city can get him or her housed within a month. Haley says it’s often faster; they got Marine Corps veteran Ronald Engberson housed in one day. A Volunteers of America caseworker, DaVaughn Phillips, met Engberson under the expressway and started asking him questions from a survey. When he heard Engberson’s name, he looked down at a list on his clipboard. “Mr. Engberson, we’ve been looking for you!” Phillips said. “When you said Ronald Engberson, I’m almost about to get up and shout!” Nonprofits, the New Orleans VA and the mayor’s office now coordinate to keep one constantly updated list of homeless veterans. Because Engberson was on the list, his military record had already been confirmed, and Phillips could get him into an apartment. The next morning Phillips met Engberson by the expressway overpass and took him to a modest, clean apartment. First thing Engberson did was shave off his ragged beard.
VA to establish Camp Lejeune presumptive conditions (VetsHQ)
In a huge victory for Marine veterans and their families, the Department of Veterans Affairs (VA) announced it will begin the process of establishing Camp Lejeune presumptive service connections for certain diseases resulting from exposure to toxic groundwater over a 30-year period at the North Carolina base. In an August 3, 2015 statement, the VA said it is currently reviewing kidney cancer, angiosarcoma of the liver, and acute myelogenous leukemia for “potential presumptive service connection.” “The diseases … are known to be related to long-term exposure to the chemicals that were in the water at Lejeune from the 1950s through 1987,” the VA statement said. “The chemicals are Benzene, Vinyl Chloride, Trichloroethylene and Perchloroethylene, which are known as volatile organic compounds, used in industrial solvents and components of fuels. ATSDR and VA representatives will meet at ATSDR offices on August 19 to begin discussions on establishing these presumptions.” The VA’s announcement is being hailed as a huge victory for Marines and their families who were stationed on the base at any point between 1953 and 1987.
Vets returning from Iraq, Afghanistan face higher skin cancer risk (MedicalXpress)
Soldiers who served in the glaring desert sunlight of Iraq and Afghanistan returned home with an increased risk of skin cancer, due not only to the desert climate, but also a lack of sun protection, Vanderbilt dermatologist Jennifer Powers, M.D., reports in a study published recently in the Journal of Investigative Dermatology. “The past decade of United States combat missions, including operations in Iraq and Afghanistan, have occurred at a more equatorial latitude than the mean center of the United States population, increasing the potential for ultraviolet irradiance and the development of skin cancer,” Powers said. There were several factors contributing to the increased risk, including not only the desert and more equatorial latitudes, but also the length of sunlight exposure day to day, and, among many service members, a lack of training regarding the dangers of sun exposure and limited access to sunscreen. For the study, Powers and her colleagues analyzed anonymous survey data from 212 veterans regarding sun exposure and protection during their last deployment. Only 13 percent of participants said they routinely used sunscreen, while 87 percent reported their sunscreen use as “sporadic” or “sometimes.” Moreover, only 23 percent of veterans indicated the military had made them very aware of the risks of skin cancer. The authors found that 77 percent of respondents spent four or more hours per day working in bright sun and 63 percent had at least one sunburn during deployment. The authors also assessed the availability of sun protection gear, including sunscreen, shade structures, hats and sunglasses, from which they calculated a Sun Protection Availability Score. They found that working more than six hours in the sun was associated with lower Sun Protection Availability Scores. While military personnel deployed overseas may often have survival priorities other than avoiding sun exposure, Powers notes that the study indicates a potential deficiency for access to sun protection that could translate to long-term health risks.
Veterans issues took center stage before Congressional recess (The Hill)
Commentary: “Veterans’ issues took center stage as Congress’s work drew to an end before leaving town for the August district work period. Early last week, President Obama signed two more veterans bills into law, joining the Clay Hunt Suicide Prevention for American Veterans (SAV) Act signed in February. The Veterans Entrepreneurship Act increases small-business loan access for veterans looking to start small businesses. The second bill, the Veterans Identification Card Act, provides veterans a route to access a Department of Veterans Affairs (VA) federal ID card. Veterans enrolled in VA healthcare already possess a federal VA ID, but for those who do not, these cards will prove veteran status for the purpose of establishing eligibility for a variety of federal and state benefit programs. Just over a year ago, Americans learned of secret VA waitlists, whistleblower retaliation and veteran patients dying while waiting to see a doctor. Despite these revelations, few VA employees have been held accountable for their negligence. The VA Accountability Act (H.R. 1994) will achieve the intended result of creating a VA workforce that is more safe, stable and productive. Holding negligent employees accountable for their actions should not be a partisan issue. While I applaud the House for passing the accountability bill, it’s disappointing that the vote was mostly along party lines, which makes the prospects for Senate passage doubtful. Veterans organizations stand ready to work across the aisles and bring Republicans and Democrats to the table to find a way forward — just like we did for the Clay Hunt SAV Act — to ensure veterans receive the quality healthcare they deserve. On a more positive note, the House and the Senate both passed legislation giving VA Secretary Robert McDonald the budget flexibility needed to improve veteran access to care, finally eliminating the patient backlog and fully reforming the VA. We supported McDonald’s call to increase VA budget flexibility to keep hospital rooms from closing, and in the interest of our veteran members facing urgent healthcare needs, we urge Congress to support this on a bicameral, bipartisan front.”
VA says improvements made in San Diego system (KPBS-San Diego)
San Diego Veterans Affairs officials on Monday said they’ve made improvements for patients. The VA San Diego Healthcare System has seven clinics throughout San Diego County and changes have been made since criticism arose of the health care for veterans. In the past six months, the local agency said it has converted 100 staff parking spaces to patient parking. “We know we have to ensure that veterans who come for care don’t wait to get a parking space,” said Jeff Gering, CEO of the VA San Diego Healthcare System. Gering said the agency is also working on improving service. “We’re in the process of recruiting a new chief of police,” Gering said. “One of the big things we’re looking for is customer service as their top priority — to connect with veterans.” Despite the improvements, Gering said the agency still faces challenges with finding enough doctors to help veterans. “Some of it is a pay issue,” Gering said. “Some of it is just a quality of life workload issue. It can be very stressful seeing patients with serious mental illnesses hour after hour.” The wait time for appealing a VA disability claim is about 199 days in San Diego County. The national average is 400 days.
VA touts progress made in Buffalo on claims backlog, appointments (The Buffalo News)
Amid national concern over wait times for medical appointments and claims, Veterans Affairs officials in the Buffalo area on Monday sought to deliver the message that progress has been made to improve services. “We’ve been committed to improve access and service,” said Brian Stiller, director of the VA Western New York Healthcare System. Stiller and others spoke at the Buffalo and Erie County Naval and Military Park for what was billed as “VA National Press Conference Day.” In Buffalo, for instance, officials said that, as of mid-July, 95 percent of more than 35,600 appointments for care had been scheduled within 30 days. Stiller called this a “good record” overall, but acknowledged that it didn’t apply to appointments for all specialties. He also touted efforts to refer certain veterans on waiting lists after 30 days to private physicians. VA officials nationally have publicized a significant decline in the disability claims backlog since it peaked at 611,000 in March 2013. As of this week, the total stood at 140,703, according to Donna Mallia, director in the Buffalo office for Veterans Benefits Administration. In this region, claims pending more than 125 days dropped over the same period from 5,900 to 905, she said. Total claims in terms of days pending decreased from 8,700 to 3,900, she said.
Denver VA officials say they have cut benefits waiting list dramatically (The Denver Post)
Department of Veterans Affairs officials said Monday they have made great progress in reducing the numbers of veterans waiting for benefits decisions. In a news conference at a VA clinic in Golden, Colo., Denver officials presented statistics of success: The number of pending disability claims for Colorado veterans is down to 7,443 after peaking at 13,277 in November 2012. The average time taken to complete a benefit claim has been cut in half, from more than a year to 206 days. By focusing on the oldest claims first, the number of veterans with claims pending one year or longer has been cut by 85 percent in two years. VA officials said that record reflects the most significant transformation in agency history to improve the delivery of benefits to veterans, their families and survivors. Nationally, they report, the backlog of veterans awaiting decisions has been cut from 611,000 in March 2013 to 110,000 this week. Renaye Murphy, the Denver regional director of the Veterans Benefits Administration, said her office staffers, most of whom are veterans, not only achieved a reduction in pending claims but got high marks for accuracy and helping veterans cure home loan defaults. But so far, the regional VA office has not been able “to complete veterans’ appeals as timely as we would like to,” she said.
St. Petersburg VA reducing claims backlog (Tampa Tribune)
The backlog of veterans waiting for a decision on their benefits claims has dropped dramatically since March 2013, said Kerrie Witty, director of the Department of Veterans Affairs St. Petersburg Regional Office. The regional office has reduced the backlog of disability claims from its peak of 36,000 in March 2013 to 6,510, said Witty — an 82 percent reduction “and the lowest its been since we started measuring the backlog in 2007.” During that period, the accuracy of those claims increased from 82 percent to 90 percent. Claims are considered backlogged at 125 days. Witty works in a unique location. The sprawling Bay Pines VA complex is one of the few in the nation that has all three branches of the VA — healthcare, benefits and, with the Bay Pines National Cemetery, cemetery services. She and the directors of the Bay Pines VA Healthcare System and the Bay Pines National Cemetery spoke during a press conference Monday afternoon called by VA central offices to spread the word about what local offices have accomplished and the challenges ahead. Last year, the office, which is the nation’s busiest claims center, was the subject of VA Office of Inspector General inspection that found lost and misplaced files contributing to delays. The office has also come under fire from Congress for firing an employee last year shortly after he compiled a scathing report of office operations. On Monday, Witty highlighted other improvements. The percentage of disability claim decisions completed increased 15 percent this year compared to last, she said. Veterans are waiting an average of 133 fewer days for a claim decision than in March 2013. Current claims are decided, on average, in 119 days, she said. And veterans who file Fully Developed Claims receive decisions in an average of 97 days.
Dayton National Cemetery offering full military funerals (Dayton Daily News)
The Dayton National Cemetery is now offering full military funerals for veterans, as part of the Veterans Affairs National Cemetery Association’s movement to be a more positive presence in the City of Dayton. Daniel Barford, an administrative support assistant at Dayton National Cemetery, said the goal is to “let people know the positive things about the VA.” “We can honor veterans every day with the honor salute, and playing Taps, we do that every service,” Barford said. Nick Hetzer, a cemetery technician and a member of the U.S. Navy Reserve, said the honor squad is comprised of all volunteers who attend every service. Barford said the cemetery averages between five and six services a day. Dennis Adkins, a magistrate on the Montgomery County Court of Common Pleas and chairman of the cemetery’s support committee, said the federal government ranks VA cemeteries by how many funerals they perform each year. The top 20 cemeteries are required to provide full military services. The Dayton National Cemetery is ranked “33rd or 34th,” said Adkins. Only 10 percent of the veterans buried in the cemetery received a full military funeral before the honor squad was started, Adkins said. “We started doing the final salute in 2014, and the honor squad started this year. Now 100 percent of veterans are getting a full military funeral,” Adkins said, even though the cemetery is not ranked in the top 20.