Privacy violations rising at VA medical facilities (NPR)
When Anthony McCann opened a thick manila envelope from the Department of Veterans Affairs last year, he expected to find his own medical records inside. Instead, he found over 250 pages of deeply revealing personal information on another veteran’s mental health. “It had everything about him, and I could have done anything with it,” McCann said in an interview. … Employees and contractors at VA medical centers, clinics, pharmacies and benefit centers commit thousands of privacy violations each year and have racked up more than 10,000 such incidents since 2011, a ProPublica analysis of VA data shows. The breaches range from inadvertent mistakes, such as sending documents or prescriptions to the wrong people, to employees’ intentional snooping and theft of data. Not all concern medical treatment; some involve data on benefits and compensation. Many VA facilities and regional networks are chronic offenders, logging dozens of violations year after year. … In an interview Tuesday, a VA official said the department considers patient privacy a top priority and that it fares well in comparison with health providers and insurers in the private sector, some of which have been targets of cyberattacks this year. The VA runs the largest integrated health care system in the nation, with 150 hospitals and hundreds of clinics that collectively serve around 9 million patients annually. “We take any loss of data very seriously,” said John Oswalt, the VA’s associate deputy assistant secretary for privacy and records management. “Over a third of our employees are veterans. … We have a vested interest in protecting the data personally, too.” The VA also released a written statement that said, in part, “Inappropriate access of patient health records, either during or post treatment, is absolutely unacceptable and in violation of privacy laws and regulations, VA policies and procedures, and our principles.” Responsibility to act on privacy violations falls both to the VA itself and to the Office for Civil Rights within the Department of Health and Human Services. That’s the agency charged with enforcing the Health Insurance Portability and Accountability Act, the federal patient privacy law known as HIPAA. The civil rights office has cited the VA more frequently than any other health provider in the nation, yet it has not sanctioned the VA or publicly identified it as the top HIPAA violator. VA facilities were the subject of more than 300 privacy complaints to the Office for Civil Rights from 2011 to 2014. In 220 cases, the VA submitted a corrective-action plan or received “technical assistance” on how to comply with the law.
Veterans fight for power to bring class-action lawsuits over benefits (The Wall Street Journal)
A group of veterans who have each waited more than a year to have disability claims reviewed say they are being denied a right granted to most Americans—the ability to team up and bring class-action lawsuits to fight grievances. The group filed a lawsuit this year in the U.S. Court of Appeals for Veterans Claims seeking prompt decisions by the Department of Veterans Affairs for thousands of veterans waiting for benefits, saying the delays are causing financial and medical hardship. But the veterans’ appeals court, created by Congress in 1988 to hear challenges to initial government decisions on benefit claims, says it isn’t allowed to hear cases that aggregate complaints of many veterans. The stance is counter to remedies available in most state and federal courts, which allow groups of similarly situated people, such as company employees or consumers of a product, to file a single suit aimed at resolving an alleged injustice. Veterans fighting disability decisions must wait for their cases to be taken up one by one. Now, the U.S. Court of Appeals for the Federal Circuit is considering whether that should change to allow class actions in the veterans’ court. The Justice Department, which represents Veterans Affairs, is expected to file its position on the issue with the court in January. A VA spokeswoman declined to comment. The VA has previously said it backs the decision to block class actions. At 2009 and 2011 legislative hearings, agency representatives said such cases would divert the court’s scarce resources and are unnecessary since the court already looks to precedent to rule the same way in cases with similar facts. Underlying the current fight is what critics call an over-congested disability claims system. While the VA has cut its backlog of disability claims to 74,955, an 88% drop from its peak in 2013, the number of veterans appealing initial disability decisions has risen in the past two years. In the 12 months ending in September, veterans initiated 169,068 appeals—an appeal rate of 14.6%, up from 11% the prior year. Going through an appeal takes nearly four years on average. The process can involve several rounds of appeals and allows new evidence at any time, the department says. “Veterans are demoralized while waiting,” said Kimberly Bonner, 42, an Army veteran who began receiving disability benefits last year, 14 years after she began the process. She said it took several rounds of appeals and the help of a corporate law firm to convince the VA she had post-traumatic stress disorder. In a May ruling, one of the veterans’ court’s eight active judges said the court has a “long-standing declaration that it does not have the authority to entertain class actions.” In an oft-cited 1991 decision, it found aggregating claims was “highly unmanageable” and “unnecessary.” Veterans groups say decisions reached on behalf of more than one veteran could set precedent that would streamline the claims process. “It is pure fantasy to pretend that these disabled, indigent veterans” have the ability to take their cases to court individually, according to a filing by Yale Law School’s veterans clinic, which is representing the veterans in the appeal. The clinic also backed the underlying April lawsuit seeking class status. Two of the VA’s former top lawyers are also pushing for the court to hear class actions. “The pool of applicants for benefits is getting bigger and sicker than ever,” the lawyers, Will Gunn and Mary Lou Keener, said in a brief filed in the Federal Circuit appeal.
Vets who accept separation pay can’t receive VA compensation (Task & Purpose)
After 31-year-old Marine veteran Tim Foster received a 50% disability rating from the Department of Veterans Affairs in January, he was shocked to discover the compensation benefits would be withheld until May 2016. The reason, Foster explained to Task & Purpose, is that he received $30,000 in involuntary separation pay from the Marine Corps when he was forced out in August 2014, due to personnel cuts. Foster said he accepted the separation pay, not realizing he would have to pay it back if he filed for disability. And he isn’t alone. In the last five years, the VA withheld more than $401 million in disability compensation from 24,988 veterans, with $261 million scheduled to be withheld from future benefits, according to Meagan Lutz, a spokesperson for the VA. The reason for this is due to 10 USC 1174, a federal law precluding duplication of benefits. The law requires that the VA recoup military separation benefits paid by the Department of Defense in cases where a veteran is subsequently awarded VA compensation, explained Terry Jemison, another spokesperson for the VA, in an email to Task & Purpose. VA disability benefits can be withheld if a veteran receives readjustment pay, non-disability severance pay, separation pay, reservist involuntary separation pay, special separation benefits, voluntary separation pay, or disability severance pay. The VA is required to withhold some or all of a veteran’s monthly compensation until this recoupment is complete. The process can take years, and for some veterans, like Foster, their benefits are still being withheld long after they’ve spent their separation pay. … “It doesn’t make any sense at all,” said Foster, who compared it to receiving a severance package after being laid off from a company, only to have social security require you to pay that money back. “Separation pay and disability pay come from two separate pots of money and they’re two totally separate things.” As for the $30,000 in separation pay that he received? It’s long gone, said Foster, who explained that it went toward moving, housing, and living expenses. “If I didn’t have to pay back that separation pay, I’d at least have something,” said Foster.
Change in law ends reserve tuition program (Military Times)
Students already enrolled in courses through the Reserve Educational Assistance Program will see no disruption in their tuition payments — but they’ll have to turn out the lights after classes end. That’s because REAP officials won’t be accepting new enrollments. The 2016 Defense Authorization Act signed into law in before Thanksgiving ended the program, leaving only a four-year window for current participants to finish their degree programs. REAP was created to provide education benefits to National Guard and reserve members who spent time on active duty but were not eligible for traditional GI Bill offerings. Nearly 14,000 veterans used REAP funds to attend college classes in fiscal 2014, at a cost of $56 million. But the program is considered redundant now in light of the Post-9/11 GI Bill, which offers education benefits to most troops who spent any time on active duty after September 2001. REAP represented a little more than 1 percent of VA education payouts in fiscal 2014. Individuals who are enrolled and attending classes through the now-defunct program are eligible to continue receiving benefits until Nov. 25, 2019. Officials anticipate that should cover nearly all participants currently working on degrees. Students who received REAP money in the past but were not in classes last semester will see their benefits cut off. VA officials said most of those individuals will be able to use Post-9/11 GI Bill funds instead, but are reaching out to affected students to gauge the potential impact of the changes. “VA is actively working to identify affected veterans who have previously applied for VA benefits to notify them of this change and their potential eligibility for other VA educational assistance programs,” officials said in a statement. They added that would-be new enrollees also can contact VA offices to see if they qualify for other education programs. Additional information on the program change is available on VA’s website.
Insurance for reproductive services leaves some veterans behind (Frederick News Post)
In the 2½ years Kevin Jaye was recovering at Walter Reed National Military Medical Center from injuries he suffered after stepping on an improvised explosive device in Afghanistan in 2012, starting a family was not the first thing on his mind. If Army Sgt. Jaye had been thinking about a family, and had been married then, his military insurance would have covered the cost of the fertility procedures he needs for him and his new wife, Lauren, to make a baby. He lost a leg and a testicle because of the explosion, and now requires sperm extraction and in vitro fertilization to impregnate his wife. In January, he finally went home from the hospital to Hagerstown, and he and Lauren married in August. Waiting until he left the Army to start a family, however, meant losing insurance benefits that pay for the fertility treatments he needs, each round of which can cost $8,000 to $10,000. Insurance covers those costs for active-duty service members whose fertility was compromised by a combat injury. Those benefits do not extend to veterans after they leave active duty. The American Society for Reproductive Medicine, the Society for Assisted Reproductive Technology and the Jayes are lobbying Congress to change the law that affects the insurance coverage. “I think it’s definitely … an oversight,” Kevin Jaye said. The societies and the Jayes aim to see the fertility benefits extended to non-active-duty veterans by the end of the 2016 congressional session. In November, the Society for Reproductive Medicine announced that many of its members would discount the price of fertility services to injured veterans who do not have insurance to pay for the treatments. “This is what we’ve tried to do to solve this problem until Congress will legislate a solution,” said Dr. Jason Bromer, a reproductive endocrinologist at Shady Grove Fertility Center in Frederick. “As a member of the society, I am interested and involved in making this program successful.” … The Department of Veterans Affairs is willing and eager to provide in vitro benefits to wounded combat veterans when IVF would be their only means of conception, Bromer said. But “there is an old law that bans in vitro benefits to veterans,” he said. In part, the matter is caught up in abortion politics, because the fertility treatments may involve fertilizing more than one egg and creating excess embryos. Discarding unused embryos has drawn criticism from anti-abortion advocates. The bill to change the insurance has come up and stalled several times in Congress, but the Jayes are publicizing the situation to get the law changed. … An estimated 1,800 to 2,300 veterans have lost reproductive abilities related to combat injuries, Bromer said. The ASRM has 103 fertility centers agreeing to provide “deeply discounted IVF treatments to wounded combat veterans … in partnership with pharmacies who will provide drugs,” Bromer said. “Hopefully, with what we’ve been doing, that can light a fire under Congress,” Kevin Jaye said.
Another suicide in a Marine unit battered by loss (Tampa Bay Times)
Tyler Schlagel slipped out of his parents’ house while they were asleep three weeks ago and drove through the wintry darkness to his favorite fishing lake high in the Rockies. Schlagel, a 29-year-old former Marine corporal who was stocking shelves at a sporting goods store, carried with him the eight journals he had filled during tours in Iraq and Afghanistan. He also carried a .40-caliber pistol. Under the bright mountain stars, he kindled a small campfire. When the flames grew high, he threw the journals into the fire, then shot himself in the head. Schlagel’s death Dec. 9 was the 14th suicide in his military unit — the 2nd Battalion, 7th Marine Regiment — since the group returned from a bloody tour in Afghanistan in 2008. Many other members have attempted suicide, one just three days after Schlagel’s death. The suicide rate for the 1,200 Marines who deployed together — most now out of the military — is nearly four times as high as for young male veterans as a whole and 14 times as high as that for all Americans. After a New York Times report in September about the suicides underscored shortcomings in the government’s ability to monitor and treat mental health problems among veterans, members of Congress called for the military and the Department of Veterans Affairs to address the issue. But those efforts have remained halting and incomplete, critics say. A big part of the problem is that the veterans of the unit, like hundreds of thousands of other young veterans, fall between the cracks of the two enormous institutions. The military’s authority stops when troops leave active duty. The VA’s starts only if veterans come in for benefits or medical care and many do not seek that care. There is also little formal tracking of suicides among veterans, so although members of other units say they have high suicide numbers like the 2/7, as the battalion is known among members, the extent of the problem remains unknown. The Marine Corps formed a task force this fall in response to the battalion’s plight, but it has largely focused on how to prevent suicides in future veterans. The VA said in a statement that it could not contact members of the battalion and other war-scarred units because some members may still be in the military and therefore outside the VA’s authority. “I don’t understand — they should at least do something,” Madelyn Gould, an epidemiologist at Columbia University who helped create national guidelines on responding to suicide clusters, said in an interview. Clusters can form in tightknit groups, such as schools or military units, she said, where one death can spur others until suicide becomes what she called “a cultural norm.” She said care providers could intervene to discuss the problem and teach effective ways to respond and cope. But that requires identifying those groups and reaching out to them.
City of Austin plans to house all homeless veterans by 2016 (KXAN)
Earlier this year, Mayor Steve Adler took the challenge of finding homes for an estimated 200 homeless veterans. Adler promised a deadline of Veterans day and missed it. The new goal is to find homes for the veterans by the new year. During this process, the mayor said there are two major obstacles. Affordable housing is hard to find in Austin with occupancy rates through the roof. Also finding landlords willing to take city vouchers and rent their property out for $800 dollars or less a month. Despite the City of Austin’s struggle to house all of the homeless veterans, the Texas Homeless Network said homelessness is down across the state by 17-percent. United States Marine Corps Veteran Gary Robinson started off the year living out of his car. Fast forward 12 months and now Gary just graduated from Austin Community College and started work as an automotive technician. He said his biggest accomplishment was finding a place he can now call home. Adler’s Chief Service Officer, Sly Majid, said “We also helped create the Housing Heroes Fund, which we initially slated to raise $150,000. We’ve raised over $350,000, which we’ve been able to use to provide support for veterans and create greater affordability so they can live and find permanent supportive housing here in Austin.” When we last heard from Mayor Adler 100 veterans still needed homes. This number is down from nearly 250 veterans who needed homes at the beginning of the year, but now have a roof over their heads.