VA looks to revamp private care for vets in ambitious plan (The Washington Post)
The Department of Veterans Affairs will unveil a wide-reaching plan to Congress Wednesday to merge its unwieldy networks of private doctors, an acknowledgement that the government cannot address a surging demand from veterans for medical care alone. The goal of the New Veterans Choice Program, which would combine seven of the agency’s existing private health-care programs into a single system, is to eliminate gaps in care created by a tangled bureaucracy that has inadvertently impeded rather than broadened veterans’ access to care. “All of these programs have been layered on top of each other without someone saying, ‘How do we rationalize them?’” VA Secretary Robert McDonald said in an interview. “We want an integrated network,” he said. “We want the very best providers connected with us. This is a big deal, and it will be a big improvement over what we have now.” VA officials are scheduled to lay out the overhaul Wednesday at hearing before the House Veterans Affairs Committee. The proposed overhaul of the system that allows veterans to use private doctors at government expense if they live too far from a VA hospital or need a specialist is the agency’s latest effort to recover from a scandal over patient wait times. VA is struggling to serve an influx of veterans returning from the wars in Iraq and Afghanistan and an aging Vietnam-era population needing more care. … To expand access, VA hopes to set up one system with a single set of rules that streamlines the system of who gets referred to outside care and to which doctors. Officials also hope to improve the claims, billing and reimbursement systems for doctors, which is so complex that it turns some good practitioners away. VA would also improve its own medical recordkeeping. The plan has a new focus on how competent doctors are, following a growing movement in the health-care field to measure the quality of care. So veterans would be given a list of doctors to choose and their ratings by health plans. The overhaul needs approval from Congress, which passed legislation last summer that directed VA to come up with a plan to consolidate outside medical care programs. The consolidation would be costly. VA estimates spending between $1.2 billion and $2.4 billion to redesign the system in each of the first three years, according to the proposal. Expanded access to emergency services and urgent care would cost an additional $2 billion a year.
Senators question VA’s watchdog nominee (USA Today)
Senators got their first chance to question President Obama’s nominee to be inspector general at the Department of Veterans Affairs Tuesday, and most asked how he could possibly fix the agency beset by scandals, from construction cost overruns to falsification of appointment schedules. Michael Missal, the Washington lawyer nominated by the president last month, assured senators that if confirmed, he would be an independent and aggressive watchdog and wouldn’t hesitate to inform Congress — and the public — when the VA is failing. “I expect to have a highly communicative office,” Missal said at a hearing of the Senate Veterans’ Affairs Committee. He was also asked about a USA TODAY report earlier this year that revealed the previous inspector general completed more than 140 investigations of veteran health care without issuing public reports, including in cases of veteran harm and death. Also not released was a report completed in March last year about alarmingly high opiate prescription rates at a VA in Tomah, Wis., where a veteran died five months later from “mixed drug toxicity” as an inpatient after another opiate was added to the 14 drugs he was already prescribed. “My preference would be to err on the side of disclosure as opposed to nondisclosure,” Missal said. “I agree that transparency is a really critical issue and it’s one to increase the trust and confidence that people will have in the office of inspector general.” The previous head of the office, deputy inspector general Richard Griffin, stepped down abruptly in July after months of criticism about his office’s investigations from Capitol Hill and from whistleblowers at the VA. Under federal law, the inspector general is responsible for rooting out and exposing fraud and abuse at the agency. But critics asserted that some of Griffin’s probes were not thorough enough, that his office was too secretive and cozy with VA officials and that investigations regularly targeted whistleblowers rather than the problems they were reporting. Missal, who specializes in government enforcement and internal investigations at law firm K&L Gates, said he hopes to change those perceptions, particularly among whistleblowers.
Report: Colleges aren’t reacting to student veteran needs (Military Times)
Traditional four-year schools are on the verge of losing an entire generation of student veterans because of lackluster recruiting and support programs, according to new research. The findings, from the Institute for Veterans and Military Families at Syracuse University, comprise the first in a series of reports designed to challenge higher education officials to find better ways to help students moving from military service to civilian life. “We would like to see a shift in focus and engagement across higher education while there is still an opportunity to step up,” said Mike Haynie, vice chancellor at Syracuse and founder of the institute. “As a community, higher education has, in a lot of ways, been on the sidelines during the last 13 years of war.” The latest study, which surveyed 8,500 troops and veterans, found more than one in five veterans attending college felt uncomfortable sharing their military background on campus. Nearly half said they thought their college staff does not understand the skills and experience they bring as new students. About 71 percent of those surveyed felt the military had prepared them to be better students, and 92 percent saw post-military college classes as key to successful transition to civilian life. But that enthusiasm has been dimmed by constraints of the traditional, four-year college degree program built around the lifestyle of recent high school graduates. “(Veterans) are older than their non-veteran student peers, more likely to be married and have children,” the report states. “Unfortunately, non-traditional students represent a growing, yet long marginalized, population of students … Too few top schools offer degree programs that complement (their) lifestyle demands.” Researchers argue that’s one reason why nearly 40 percent of all GI Bill tuition payments over the last five years have gone to for-profit and online schools, despite concerns about the worth of degrees from many of those institutions.
Florida hospitals: VA owes $134 million in unpaid claims (The Miami Herald)
Florida hospitals are trying to get the Department of Veterans Affairs to pay about $134.4 million in outstanding claims for medical services they provided to veterans who faced long wait times or far distances for care at a VA healthcare facility, according to a survey by the Florida Hospital Association. In the survey, which was conducted in September and October, 95 percent of the 89 FHA member hospitals reported having unpaid claims with the VA, some outstanding for more than two years. Bruce Rueben, FHA president, said the group conducted the survey to provide a House congressional committee with information on the scope of the outstanding VA claims. But the findings, he said, will not stop the hospitals from caring for veterans. “This issue of timely payment is one that will be resolved in time . . . but it is not going to have an impact on access to care for veterans,” Rueben said. Delayed payments to non-VA hospitals continue to be “a major issue,” according to U.S. Rep. Jeff Miller, a Florida Republican and chairman of the Committee on Veterans’ Affairs. The committee held a hearing on the issue in June, when VA officials promised to fix the problem. But the issue persists. In a letter to VA Secretary Robert McDonald dated Nov. 13, Miller warned that delayed payments loomed large over the department’s efforts to transform a healthcare system rocked by scandals over veterans’ long waits for care. “If left unaddressed, this problem threatens to severely inhibit VA’s ability to foster productive partnerships with private-sector health care providers,” Miller wrote in the letter to McDonald. But Mary Kay Hollingsworth, communications manager for the VA’s statewide healthcare network, said in a written statement that the department has been doing a pretty good job of paying Florida hospitals on time. Hollingsworth said that so far this year, the statewide VA healthcare system has referred nearly 100,000 patients to private hospitals and doctors, generating 1.7 million claims. The VA has processed 1.64 million of those claims, or about 95 percent of them, she wrote. In total, Florida hospitals have received about $506 million in claims payments from the VA this year, she wrote.
House passes bill capping 2016 VA Senior Executive bonuses (GovExec)
The House on Monday unanimously passed legislation capping fiscal 2016 bonuses for Veterans Affairs senior executives at $2 million. The measure amends the 2014 Veterans Access, Choice and Accountability Act to specifically limit the total amount of performance awards and bonuses given to top career executives at the department in fiscal 2016. The language in the Choice Act required the department to cap the aggregate amount of award and bonuses doled out to all VA employees at $360 million in each of the fiscal years 2015 through 2024. The VA had nearly 360,000 employees as of June 2015, according to data from the Office of Personnel Management’s Fedscope; of that total, 335 were listed as career senior executives. The provision was inserted into H.R. 1338, which requires the department to study the burial of veterans’ unclaimed remains in national cemeteries run by the National Cemetery Administration. House Veterans’ Affairs Committee Chairman Jeff Miller, R-Fla., praised lawmakers for “reining in VA’s outrageous, everyone-gets-a bonus culture,” calling on the Senate to follow suit. The Senate companion bill to H.R. 1338 was folded into a larger measure aimed at improving VA’s disability compensation claims backlog, which the Senate passed last week. Neither one of those bills contained a provision that would cap senior executive bonuses in fiscal 2016, as H.R. 1338 does. Sen. Dean Heller, R-Nev., unsuccessfully offered an amendment earlier this month to the fiscal 2016 Military Construction-VA spending bill that would have prohibited senior executives at the Veterans Benefits Administration from receiving bonuses.
Part of JP Morgan’s vet hiring program it wishes you’d forget (The Huffington Post)
When JP Morgan saw the unacceptably high level of unemployment among recent veterans, it decided to hire thousands of veterans and form a coalition of companies that wanted to do the same. That’s the story Jamie Dimon, the bank’s chairman and CEO, happily told last week. “They bore an unbelievable price for the rest of us, and something like 200,000 are coming out of the system every year, and for a while they had very high unemployment rates,” he said. JP Morgan, Dimon added, wants “to do our share to bring them back into society and give them jobs.” It’s a great story, but it’s missing a key detail: The program began in 2011, partly as a response to the bank wrongfully foreclosing on military homeowners. “We deeply apologize to our military customers and their families for these mistakes,” Dimon said at the time. “We cannot undo them, but we can take accountability for them, fix them and learn from them. Today we want to begin a new way forward…” That apology came in February 2011, five days after a bank executive was called out in congressional hearings for failing to properly follow the Servicemembers Civil Relief Act, a 1940 law that, among other things, protects members of the military from bankruptcy and foreclosure proceedings. The program was officially launched the following month, with the bank highlighting the fact that unemployment for recent veterans was 3.5 percentage points higher than the national rate, and far higher among young vets. That April, journalist Dawn Kopecki noted, the program was included in a legal settlement with military families who had been overcharged on their mortgages or whose homes had been wrongfully foreclosed.
Boston veterans shelter infested with bed bugs, rats, roaches (Breitbart News)
Per a report by WCVB, the New England Center for Homeless Veterans is not providing those who have served our country the help they really need. “Many, many veterans who really need help do not go there because the conditions are so bad,” said Steve Kelly, an Army veteran who has been renting a room at the center for four years. From the investigation done by WCVB, city records from the past two and a half years show hundreds of calls to Boston police for problems including illegal drugs, assaults and illegal firearms. There have also been over 400 emergency medical calls from the center in the last year, according to the Boston Public Health Commission. An anonymous veteran showed off welts and scars all over his arms and legs, claiming they were from bedbug bites he received from staying in the shelter. “I itch all over. It’s a constant struggle,” he said anonymously, in fear he would not be allowed to stay in the center for speaking out against the conditions. Center CEO Andrew McCawley explained that the center may not be “luxurious,” but it meets the “standards of sanitation.” “If you look at the general condition of our living areas you will see that they’re not luxurious, they’re not palatial, but I think they meet standards of sanitation,” McCawley said. The shelter broke ground in May on a $32 million renovation, which will improve the center’s century-old building and also create 35 new apartments for veterans. It is expected to take a year to complete.
Richmond VA Medical Center cited for 14 safety violations, unsafe workspace (WTVR-Richmond)
The Occupational Safety and Health Administration have issued notices to the Hunter Holmes McGuire Veterans Affairs Medical Center, located in Richmond, Virginia, for 14 safety violations. The safety violations include four willful, two serious, and eight other-than-serious violations. OSHA said on May 6, 2015, they initiated its inspection in response to a complaint alleging inadequate protections for employees exposed to workplace violence hazards while providing patient care. A willful violation is a violation in which the employer either knowingly failed to comply with a legal requirement (purposeful disregard) or acted with plain indifference to employee safety. The willful violations in this case involved the medical center exposing employees to workplace violence and physical assault, failing to train employees on the prevention and management of workplace violence, and failing to properly record workplace injuries and illnesses. A serious violation exists when the workplace hazard could cause an accident or illness that would most likely result in death or serious physical harm, unless the employer did not know or could not have known of the violation. In this case, supervisors and employees were not trained on recordkeeping, resulting in the serious violations. Stanley J. Dutko Jr., OSHA’s area director released a statement about their findings at McGuire: “The safety hazards identified at this facility demonstrate a need for a renewed commitment by the Department of Veterans Affairs to provide a safe workplace for the VA employees who care for our nation’s service members, veterans, their families and survivors,” said Dutko Jr. “All employers, including federal employers, are responsible for evaluating and determining the extent to which employees may be exposed to physical assault or other forms of workplace violence and taking the appropriate actions to eliminate or minimize that exposure. Every employer is responsible for ensuring their workplaces are safe and healthy for all employees.”
Small Business Administration encourages ‘vetrepreneurs’ (Pittsburgh Post-Gazette)
Before she delivered a keynote luncheon address Tuesday at the David L. Lawrence Convention Center, the head of the U.S. Small Business Administration popped in to Marty’s Market in the Strip District. “It was a customer call,” said Maria Contreras-Sweet, the SBA’s top administrator. Regina Koetters, owner of the 4-year-old market and cafe that specializes in organic food, is a Naval Reserve officer and Iraq War veteran who exemplifies the type of entrepreneur the SBA tries to support. “She’s teaching people to eat better and is building a supply chain of [locally sourced] products,” Ms. Contreras-Sweet said. “She has used SBA services and is an example of what we can do for veterans.” Ms. Contreras-Sweet was in Pittsburgh to address the National Veterans Small Business Engagement — a three-day event aimed at matching veteran-owned businesses with government agencies and private companies that can help them in bidding on federal contracts. Under legislation passed in 1999, the federal government must aim to award at least 3 percent of all contracts to small businesses owned by service-disabled veterans. Since then, some states and private companies have also established similar goals, said Chris Hale, chief executive of the National Veteran Owned Business Association based in Moon. One in 10 of all small businesses are founded by veterans and about 20 percent of small business employees work for veteran-owned businesses, said Ms. Contreras-Sweet. If they apply for SBA loans, veterans are eligible for some fee waivers and discounts, she said. The SBA also provides specialized training at military installations on entrepreneurship with a focus on securing capital and contracts. On Monday, she was at Heinz Field to present the National Veteran Owned Business Association’s “Vetrepreneur of the Year” award to Gordon Logan, founder of the SportClips Haircuts franchise. Mr. Logan served in the Air Force in Vietnam and launched SportClips in Texas in 1993.
Head of VA benefits office leaving St. Petersburg for Nebraska (Tampa Tribune)
Kerrie Witty, whose tenure as head of the nation’s busiest regional veterans benefits office was marked by success in reducing a claims backlog and criticism over morale issues and claims handling, is leaving for a new job with the Department of Veterans Affairs in Nebraska. “I am very much looking forward to moving to Lincoln and working with the employees of the regional office and other partners and stakeholders,” Witty, director of the St. Petersburg Regional Office, said in an email to the Tribune. In her five years there, Witty said, the St. Petersburg office was able to reduce the backlog of disability claims pending by 90 percent and improve the average time a veteran waits for a claim decision from a high of 252 days to 90 days. At the same time, she said, the quality of decisions improved. “I am very proud of the accomplishments of the employees of the St. Petersburg regional office and was privileged to have been their Director during this time,” she said. In an email to staff Tuesday afternoon, Witty said she lived in Lincoln and worked at the regional office there and looks forward to raising her two children there. She came to St. Petersburg after running the Los Angeles Regional Office. As of July 2014, she was earning an annual salary of $152,536. Witty came to St. Petersburg in 2010. The backlog of veterans waiting for a decision on their benefits claims dropped dramatically after March 2013, from its peak of 36,000 then to 6,510, Witty said in August. During that period, the accuracy of claims increased from 82 percent to 90 percent. Claims are considered backlogged at 125 days. But there have also been problems with staff morale and the care of documents. Among them, according to a review by the VA Office of Inspector General, were a file room overfilled with records, lost and misfiled records, mishandled mail and a three-week delay in processing evidence mail received from the mailroom. So many files on patient claims were stacked in piles that “personnel have encountered difficulties locating files and in moving banks of files,” the Office of Inspector General said. “During our interviews, (regional office) employees stated that lost and misfiled records in the file room were a major issue.”
Over 1,000 turn out for unclaimed Marine vet’s funeral (CNN)
Billy Aldridge, an 80-year-old veteran with no records of any family, had over 1,000 people attend his funeral. Aldridge, a United States Marine Corps veteran, passed away at a nursing facility last month with no family to make burial arrangements, said Legacy Cremation and Funeral Services in Indianapolis. No one stepped forward, so Legacy worked with community partners to give the veteran a dignified burial. Legacy reached out to the public to encourage people, especially veterans, to attend the service and pay respects to Aldridge. When local news station and CNN affiliate WTHR reported the story and posted it on Facebook, the response was overwhelming. Tracey Wiese-Stuard was in Florida when she saw the news and started crying. “Oh my gosh, I know him,” she said. Stuard and her family knew Aldridge for more than three years and spent many holidays together at the American Legion post in Indianapolis before she moved in 2013. “He was a great, kindhearted person that would give his shirt off his back for anybody,” Stuard said Veterans in uniform and public safety officials were among the overflow crowd at the service on Tuesday, according to WTHR.