VA’s own internal probe finds impunity of agency leaders at scandal-ridden hospital (Stars and Stripes)
Investigators at the Department of Veterans Affairs found that two senior managers retaliated against whistleblowers who reported dangers to patient care and financial mismanagement at the Phoenix hospital at the center of a nationwide scandal over falsified waiting lists. But 15 months after the internal probes were finished and sent to Secretary Robert McDonald recommending that the managers be disciplined or fired, VA has done neither – keeping one official on paid leave at home and leaving the other on the job. Darren Deering, a physician who is chief of staff at Phoenix VA Health Care System, was scheduled to testify Monday at a Senate field hearing in Gilbert, Ariz., but his appearance was hastily canceled after lawmakers learned of the probe, which has not been made public. The Washington Post obtained a copy. The lengthy, detailed investigations of Deering and Lance Robinson, the hospital’s associate director, provide a window onto an issue that’s only starting to get the attention of senior leaders in government: Supervisors who punish whistleblowers for reporting wrongdoing rarely are punished themselves. At VA, members of Congress in both parties have begun clamoring for more accountability for retaliators after last year’s coverup of long wait times for veterans needing medical care, which was brought to light by whistleblowers. In the case of Deering and Robinson, an internal team created after the scandal called the Office of Accountability Review found that they moved to sideline and ostracize the emergency room director in Phoenix and banish a public affairs officer to a basement after both made disclosures that were protected by law. VA, under pressure from the federal agency that represents whistleblowers, reached confidential settlements with Katherine Mitchell and Paula Pedene last year for the harassment they suffered. But the agency has not moved to punish the top brass who caused it. After Mitchell blew the whistle on critical understaffing, poor patient care, mismanagement of patient wait lists, nursing errors and inadequate training in the Phoenix hospital’s emergency room, Deering placed her on administrative leave and demoted her from her post as head of the emergency room, according to the report. Her previously stellar performance ratings plummeted. “Dr. Deering acknowledged that his decision to reassign Dr. Mitchell was based, at least in part on his desire to remove her from the ‘malignant situation’ in the [emergency department],” the report said. “. . . the unavoidable fact is that the ‘malignant situation’ developed as a result of Dr. Mitchell’s disclosures. Rather than seeking to improve the ED environment by addressing [her] concerns, Dr. Deering chose to involuntarily reassign her.” The report, issued in September 2014, recommended that “appropriate administrative action should be initiated” for Deering and others who retaliated. It also said supervisors and managers should receive training in whistleblower protection. The review panel’s investigation of Robinson also substantiated that he retaliated against Pedene, the public affairs officer in Phoenix. Pedene, who is legally blind, made numerous disclosures beginning in 2010 about financial mismanagement at the medical center. VA’s inspector general substantiated many of them the following year. But then her bosses, Robinson chief among them, took away her job duties and banished her to work in a basement library. In its report on Oct. 30, 2014, the review panel recommended “appropriate administrative action” against Robinson and then-hospital chief Sharon Helman, who was fired for other misconduct the following month. Robinson has been on administrative leave based on allegations of misconduct since May 2014, receiving full pay, benefits, vacation and credit toward his pension. Robinson did not respond to a phone message left Tuesday with a family member. Deering did not respond to a request for comment left through a VA official. VA officials have said they are hamstrung by criminal investigators looking into broader misconduct in the wait-times scandal in both cases, and have been barred from interviewing the managers. But Deputy Secretary Sloan Gibson told House lawmakers last week that the agency is moving forward and “wrapping up” Robinson’s case. “We’ve waited too long, and we’re not going to do it again,” Gibson said of the agency’s delays in disciplinary action against wrongdoers in general. … The long inaction is drawing sharp criticism from Arizona’s U.S. senators, who wrote a letter to McDonald Monday urging him to fire Deering “to continue restoring the trust that was broken at the Phoenix VA Health Care System and to demonstrate that retaliation against whistleblowers at the VA will not be tolerated.”
Combat-related lung diseases lack diagnosis guidelines, researchers say (Military Times)
Evidence is mounting that veterans are suffering from pulmonary disorders related to deployment to the Middle East, but little is being done to diagnose and treat these illnesses, say researchers who are proposing new guidance for treating affected troops. Thousands of Iraq and Afghanistan vets have respiratory problems that affect their daily lives, but few of them — or their doctors — know enough about war-related lung conditions to seek care or diagnose a disorder, says Dr. Anthony Szema, an assistant professor at Hofstra University School of Medicine and adjunct professor at Stony Brook University in New York. “Despite the fact we have been doing this research for a handful of years, no one knows about the incidence of lung disease in the military,” Szema said. In an article published online Tuesday in the American Journal of Men’s Health, Szema and colleagues argue that deployment-related lung conditions, which they call “Iraq/Afghanistan War-Lung Injury,” are found in thousands of troops and veterans, the result of one or more environmental or combat-related factors within the U.S. Central Command area of operations. Reported symptoms range from wheezing and chronic cough to asthma, low blood oxygen levels and debilitating fatigue related to an inability to take deep breaths. With so many affected, more research and outreach is needed to make sure former troops are seeking and receiving treatment, researchers say. “The soldiers don’t really know about these conditions or have heard of the VA’s burn pit registry, and doctors — even pulmonologists — aren’t familiar with these exposures,” Szema said. The researchers examined recent findings from the Veterans Affairs Airborne Hazards and Open Burn Pit Registry as well as information provided by 38 veterans to the advocacy group Burn Pits 360 to gauge the effectiveness of current questionnaires in determining pervasiveness of lung disorders in post-9/11 veterans. They found that both registries lack questions needed to identify veterans with combat-related lung disorders, pinpoint the causes or determine how many are suffering. … But researchers note that other factors besides burn pits may be responsible for lung injury, such as fine particles of metal or bacteria found in the region’s soil and inhaled along with dust generated by sandstorms, blasts and the combat environment in general. In earlier studies, Szema found that a higher number of service members who deployed to the region developed asthma, and he found titanium and other heavy metals in troops’ lungs. Retired Navy Capt. Mark Lyles, a former Navy environmental researcher, found that fine microparticles of dust in Iraq and Kuwait contain metals that have been linked to illnesses such as neurological disorders and cancer, along with more than 140 kinds of bacteria and disease-spreading fungi. But research into combat-related lung conditions remains controversial. The Defense Department and VA have maintained that the risk of long-term health problems related to exposure to dust and burn pits is relatively low. And in 2011, the Institute of Medicine, the medical arm of the National Academy of Sciences, found insufficient evidence to determine whether open-air burn pits were directly responsible for the disorders and diseases being reported by some U.S. troops. However, the IOM did say that particulate matter and metals in Iraq and Afghanistan dust may have contributed to long-term health consequences, but noted that limitations on the available data make it impossible to link the two.
Virginia programs for veterans face legislative scrutiny and concerns (Richmond Times-Dispatch)
A Virginia state program to direct military veterans to mental health services and family support is relying on staff that may not be properly trained or certified to manage behavioral health care, according to a new legislative report that raises major questions about initiatives Gov. Terry McAuliffe is trying to expand. The Joint Legislative Audit and Review Commission took specific aim Monday at the Virginia Veteran and Family Support program, created in 2008 as the Virginia Wounded Warrior Program to coordinate care for military veterans returning from battlefronts in the war on terrorism with brain injuries, post-traumatic stress, and serious depression. The program’s staff — 35 people spread across the state in local and regional community services boards — “are providing some services they may not be qualified to perform,” the report states, citing evidence that employees are expected to provide case management services without the training required by law. “There is some risk that individuals with mental health conditions who are served by unqualified or inadequately trained case managers will not be directed to the appropriate mental health services,” states the report, which recommends that the state determine if the program’s staff should meet licensing requirements and minimum qualifications for the work. John L. Newby II, who became commissioner of the Department of Veterans Services more than a year ago, said his agency has been working with state mental health and community services board officials to devise a plan for reorganizing the program by the time the General Assembly convenes on Jan. 13. Newby said the program is delivered by employees under the control of community services boards, which deliver mental health services under performance contracts with the state. “At the end of the day, we cannot deliver the services in a unified way under the current structure,” he told legislators on the commission, the General Assembly’s watchdog agency. But JLARC Director Hal Greer and key legislators on the panel cautioned against rushing to fix a program that could require much more time to restructure effectively through a proposed gubernatorial work group that would report its findings by Nov. 1. “I’m not sure a month is enough time to figure this one out,” Greer said. The wounded-warrior program is not the only target of the 102-page report, which praised improvements in state assistance in approving benefits for veterans, but also urged the department to do a better job of monitoring wait times at over-extended offices, particularly one in Richmond that is handling three times the median state workload. Generally, the JLARC study urged the department to do a better job of communicating its services to veterans, establishing clear policies for the programs it runs, and measuring their results. “It was a very sobering report,” said House Appropriations Chairman S. Chris Jones, R-Suffolk, in an interview Monday.
Veterans on Patrol dropping off warm supplies at homeless camps (Tucson News Now)
On frigid Arizona winter nights when the shelters are packed, some homeless choose to remain out in the cold. According to Lewis Arthur, the founder of the Tucson chapter of Veterans on Patrol, there are more than 140 homeless camps set up throughout the area. The group started out as a mission to look for homeless veterans who had slipped through the cracks, but along the way they found themselves coming to the aid of anyone without a roof over their head. “In Tucson, we’ve found 18 veterans so far that are either not in the system or the VA themselves are looking for them,” Arthur said. The group has a base camp set up on private land at the intersection of 20th and Jacobus Street on the south side. Over time, the area has become a donation drop-off point and a place where many in the community volunteer time and effort. Some bring supplies for the homeless, others take turns providing meals. Every night, a group of volunteers loads up a pick-up truck and visits homeless camps set up all over Tucson to drop off food, clothes and hygiene products. Tuesday night, when temperatures were below freezing, the truck was loaded with blankets and firewood. “We want to make sure everyone has blankets,” Arthur said. “A warm visit and friendly faces sometimes make the difference.” … At a homeless camp located in the Sonoran Desert there was an elaborate set up of tents, lights and deep fire pits “Our homeless are some of the most resilient individuals in America,” Arthur said. April Polansky, a resident of the camp, said she’s been homeless on and off through the years. Polansky said she and her husband fell on hard times when both lost their jobs due to disabilities. They chose not to go to a shelter because they didn’t want to give up their pet dogs. … The Veterans on Patrol volunteers dropped up several cords of firewood and blankets for the group. This time they also came armed with a surprise — warm camouflage jackets, a Christmas present for Polansky and her husband. “This is awesome, it’s awesome”, Polansky said.
Pennsylvania nearing year-end goal for reducing veteran homelessness (PRNewswire)
Governor Tom Wolf and officials from the Pennsylvania Department of Military and Veterans Affairs (DMVA) today announced that as part of the Governor’s challenge to significantly reduce veteran homelessness, 481 homeless veterans in Pennsylvania were placed in permanent housing between Sept. 23 and Nov. 30, 2015. The Governor’s challenge was announced on Sept. 22. “Pennsylvania is making steady progress in housing its homeless veterans. With winter weather and extreme cold temperatures rapidly approaching, it is more important than ever that we locate and assist them,” said Governor Wolf. “While we still must wait for final numbers for December, we know that we are getting closer to meeting our goal of providing 550 veterans with stable housing, as well as access to the programs and services that will help them rebuild their lives, by the end of the year.” The commonwealth’s vast network of state agencies and community partners continue to work diligently to hit functional zero, which means having the process and the resources in place to identify and house any homeless veteran who wants to be assisted. “Together, the city of Lancaster and Lancaster County have already announced that they have the systems in place to successfully meet the needs of homeless veterans in their area and we know other communities are very close to making the same announcement,” said Brig. Gen. Jerry G. Beck Jr., DMVA’s deputy adjutant general for veterans affairs. “Many other cities, including Pittsburgh, have also made huge strides. It’s been rewarding for us to coordinate and rally the efforts of all of the stakeholders in this effort and we will continue to advocate for Pennsylvania’s homeless veterans.” The challenge, officially known as the Mayors Challenge to End Veteran Homelessness, is an initiative of the U.S. Department of Housing and Urban Development (HUD) that was launched in June 2014. It was conceived as a means for local leaders to create and coordinate strategies to curb veteran homelessness. In early 2015, HUD conducted a point-in-time count which identified approximately 1,300 homeless veterans in Pennsylvania. Across the United States, 859 mayors, governors and county executives are currently participating in the challenge.
Ohio Veterans Bonus available for Afghanistan-era vets (Cleveland.com)
The Ohio Department of Veterans Services wants to remind veterans who served in Afghanistan that they are eligible for a bonus from the state. Ohioans who were residents of the state at the time they entered the service, and served in Afghanistan or were deployed to any location outside that nation after Oct. 7, 2001, can apply for money from the Ohio Veterans Bonus program. For veterans of Afghanistan, the bonus is $100 a month, up to a maximum of $1,000. For those who served in other parts of the world, the payment is $50 a month, up to a $500 maximum. Family members of those killed in action or who died from disease as a result of their in-theater service can receive a bonus of $5,000, plus whatever the service member was eligible for, up to $6,500. A veteran who was medically discharged as a result of combat service can get $1,000, plus up to $500 for months of service elsewhere. To apply for the bonus, visit www.veteransbonus.ohio.gov or any County Veterans Service office (see www.dvs.ohio.gov for a map of office locations). Applicants can also call toll-free, 1-877-OHIO VET (1-877-644-6838). As of this month the Ohio Veterans Bonus program has paid 89,771 claims, representing more than $73 million in payments. The bonus is not financed by taxes, but through the sale of bonds approved by Ohio voters through a constitutional amendment.