December 8 Veterans News

December 8 Veterans News

VetsHQ News UpdateGroups demand information on Camp Lejeune disability claims (Military Times)
The approval rate for disability claims filed with the Veterans Affairs Department for illnesses related to poisonous drinking water at Camp Lejeune, North Carolina, has dropped by two-thirds since VA implemented a third-party review process to provide medical opinions on related diagnoses. The Camp Lejeune subject matter expert program requires a VA-appointed physician to review the medical files of former troops who lived on base from 1953 to 1987 and are seeking compensation for illnesses possibly related to drinking contaminated water there. But since the program was introduced in 2012, claims approvals have dropped from 25 percent to 8 percent, prompting critics to question the independence and training of the VA’s 22 to 30-some experts, whom the department has not identified. Veterans advocacy groups have filed a Freedom of Information Act request for records about the subject matter expert program, seeking information on the identities, training and education of those experts. Former Marine and Yale Law School student Rory Minnis, who is helping with the FOIA process, said VA has “largely ignored demands for basic information on the policies, procedures and qualifications of these experts.” “The subject matter expert program has been billed as a means to provide consistency of Camp Lejeune claims and to help develop VA’s institutional knowledge. What the VA did not tell the veterans is what they meant by consistency is consistent denials,” Minnis said during an announcement about the FOIA at Yale on Monday. Nearly a million people, including troops, family members and civilian employees, may have been exposed to volatile organic compounds and other cancer-causing agents, such as benzene and vinyl chloride, in the drinking water at the coastal Marine Corps base, starting roughly in 1953 and continuing at least until 1987, when the water treatment facilities supplying the contaminated water were closed. The Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 required VA to treat veterans who were stationed at Camp Lejeune and have one of 15 related illnesses at no cost. The bill required VA to reimburse affected family members for health services for the named illnesses as well. Disability claims for exposure-related illnesses, however, are decided on a case-by-case basis. A process is underway at VA to designate three illnesses as presumed to be connected to serving at Camp Lejeune during the designated timeframe, including kidney cancer, angiosarcoma of the liver and acute myelogenous leukemia. But for now, all Camp Lejeune disability claims are reviewed by subject matter experts who provide an opinion on whether they believe the claimant’s illness is related. The veteran never meets with the subject matter expert nor does he or she receive a copy of the expert opinion. VA officials say that the medical opinions crafted by subject matter experts are just “one piece among many of evidence” that are considered when deciding a claim. … But Jerry Ensminger, founder of the Camp Lejeune family advocacy group The Few, the Proud, the Forgotten, said VA adjudicators placed too much weight on the subject matter experts’ opinions, and VA has never provided an example of a claims adjudicator overriding an expert opinion. “These people are refuting what the veterans’ own doctors are saying,” Ensminger said. “They are making life and death decisions that affect peoples’ lives. Veterans have a right to know who these people are and what their qualifications are.” He and others also say that clinicians in the program have based their opinions on outdated or incorrect science, including one who argued that the cleaning solvent trichloroethylene does not cause cancer. … Studies dating to at least 2010 indicate that TCE is linked strongly to kidney cancer. More than 10,000 disability claims have been filed at VA related to Camp Lejeune water toxicity, according to Minnis.

Defying stereotypes, number of incarcerated veterans in U.S. drops (NPR)
The number of military veterans in the country’s jails and prisons continues to drop, a new report from the Bureau of Justice Statistics shows. It’s the first government report that includes significant numbers of veterans of the wars in Iraq and Afghanistan — and the findings defy stereotypes that returning war veterans are prone to crime. The data show that veterans are less likely to be behind bars than nonveterans. The study tracked an estimated 181,500 incarcerated veterans in 2011-2012, 99 percent of whom were male. During that period, veterans made up 8 percent of inmates in local jails and in state and federal prisons, excluding military facilities. The Bureau of Justice Statistics began tracking the number of incarcerated veterans after the Vietnam War. In 1978, about 24 percent of prisoners were veterans. That number has fallen steadily since then, as the military switched from the draft to an all-volunteer force. In 1998, veterans had nearly the same incarceration rates as those who never served, and the number has been declining ever since. Those veterans in prisons and jails reported higher rates than civilians of mental health issues such as post-traumatic stress disorder. Less than a third of veterans behind bars actually saw combat, but those who did also reported higher rates of mental health issues, according to the report. On average, veterans doing time are almost 12 years older than nonveterans and are less likely to have multiple previous offenses. The decline in the veterans prison population tracks national demographics. Across the country, the number of veterans is shrinking fast as the millions of vets from World War II and Korea reach their 80s and 90s, and Vietnam vets reach their 70s. Advocates for veterans also credit the lower incarceration rate partly to increased services for returning veterans. For example, most states now have “veterans courts,” where veterans can get treatment for PTSD and drug abuse in lieu of jail time for certain crimes.

VA program helps incarcerated veterans transition back into society (NPR)
When I first met Shaun Tullar, he was locked up in the Vista Detention Facility in San Diego County, Calif. He was being held in what the jail calls the vets pod — a ring of cells for veterans to live together like a military unit. We met in a room that felt like a school classroom, but with military flags on the walls, and guards at the door. Substance abuse landed him here. He says he was “self-medicating” and “made some irresponsible choices.” He had struggled with drugs and alcohol before entering the Marines, and was sober during a seven-month tour in Helmand province in Afghanistan. But he began drinking again after returning to Camp Pendleton in Oceanside, Calif. A little later — just as he left the Marines after a four-year tour — everything fell apart. “One week after I got out, my brother’s helicopter went down in Afghanistan. We joined the same day. … I got a phone call from my sister, found out my brother had died in Afghanistan,” Tullar says. “He was on a CH-53, as a crew chief. … Everyone on the helicopter was killed. And that, I relapsed at that point. And I was not strong in my recovery at that point, and I made some poor decisions.” Those decisions led Tullar to several brushes with the law and eventually left him homeless. He’s like a lot of veterans who landed in prison or jail. They have higher rates of substance abuse — and mental illness — than non-incarcerated veterans. And the Department of Veterans Affairs is looking for a new way to reach them. “We’ve got the tools that can help these veterans get back on track. It’s just a matter of helping make sure they’re linked to the right services as early as possible and that they have the supports they need,” says Sean Clark, national coordinator for Veteran Justice Outreach at the VA. The idea is to catch these vets before they are released. “What we’re trying to do is ensure that when veterans do have contact with the criminal justice system, that there are effectively off-ramps into needed treatment,” Clark says. That’s why each VA medical center in the U.S. has at least one person who has to reach out to vets behind bars. The VA’s not everywhere — but it does have access to nearly half the jails and prisons around the country. When Tullar walked out of jail in September, Joy Villa Vicencio, a veterans justice specialist with the VA, was waiting for him. “And that arrangement was made beforehand, so there’s a lot of moving parts to get someone out of custody into my care, basically, and then taken to wherever they need to go,” she says. In Tullar’s case, that meant going straight into a 28-day inpatient treatment program at Veterans Village in San Diego, which is run by the VA. He’s scheduled to live there for the next year. On top of drug treatment, he’ll also be treated for post-traumatic stress disorder. Eventually, there’s job training. “I don’t feel like this is a low point at all, actually. This is one of the first times since I was 15 years old that I’ve actually been sober on my birthday,” Tullar, who just turned 30, says. Despite his progress, Tullar hadn’t told his sister in Florida that he’d been in jail the past few months. “I don’t want to worry her at this point,” he says. “I’m doing really well. I don’t want to tell her that I went to jail to come back to the realization that I needed to get my life together, but it’s true.” The VA doesn’t have programs like Veterans Village everywhere in the country. And the VA hasn’t done enough research to discover whether this type of outreach actually keeps veterans from ending up back in prison. Tullar thinks that it will. And it’s been a smoother adjustment to civilian life than when he first left the military.

Newly appointed VA regional director opts out of job (AZCentral)
A Department of Veterans Affairs administrator who was assigned to lead the beleaguered Southwest regional health-care system has opted not to take the job at the last minute. A spokeswoman for the VA Southwest Health Care Network, known as VISN 18, said Skye McDougall elected to take a similar assignment in Mississippi just as she was scheduled to take the helm at the regional office based in Gilbert. Last month’s selection of McDougall to oversee Veterans Integrated Service Network 18 drew flak from VA critics because of perceived baggage she would carry into a region that includes Phoenix VA Medical Center, the launch point for a national controversy over the department’s management and medical care for veterans. McDougall, as director of the Desert Pacific Health Care Network covering Southern California, testified in March before the House Committee on Veterans’ Affairs that Los Angeles veterans were waiting just four days for doctor appointments. A subsequent CNN report based on VA data and whistleblower complaints described that statement as “simply not true,” and said metro-LA veterans were waiting an average of 48 days. In an e-mail to The Arizona Republic, McDougall said the controversy played no role in her change of heart. “After careful consideration of the position and the needs of my family, I decided to pursue other opportunities and look forward to leading VISN 16,” she wrote. VISN 18 covers Arizona, New Mexico and, until recently, a portion of west Texas that included El Paso. The VA has announced plans to shut down the Southwest regional administration, subsuming it into the Los Angeles network. No timeline has been announced for that change. In the meanwhile, Kathleen Fogarty will continue as interim head of VISN 18 while also serving as director of the regional VA office based in Kansas City, Mo.

Investigation finds VA improperly overpaid nearly $40,000 in mileage reimbursements (Stars and Stripes)
Processing irregularities at three Veterans Affairs medical facilities led to an estimated $37,400 in improper travel reimbursement payments last year, an Inspector General audit found. VA IG reviews at the three facilities — Hudson Valley Health Care System in New York, Hampton VA Medical Center in Hampton, Va. and Lexington VA Medical Center in Lexington, Ky. – determined about 21 percent of Beneficiary Travel Program vouchers inspected included one or more processing errors leading to the overpayments, according to the report released Monday. The Beneficiary Travel Program provides eligible veterans and other beneficiaries mileage reimbursement for travel for medical care including exams, rehabilitation and counseling services. “Generally, errors occurred because the medical facilities did not fully use all … (Beneficiary Travel Program) enhancements and had not developed or implemented formal, routine quality reviews of approved mileage reimbursement vouchers,” the report stated. The audits were launched following separate allegations of issues with the program made between December 2014 and April 2015. The majority of the processing errors found in the random samples the IG examined at the three sites were due to incorrect mileage calculation or approval of appointments that did not qualify for travel reimbursement, the report found. The Hudson Valley facility made the most errors. … “Although individual approved travel reimbursements averaged less than $26 per trip for the facilities within our scope, if program weaknesses identified occur across VA’s facilities nationwide, they have the potential to be significant,” the report stated. The IG recommended the VA review its process for approving travel vouchers and better train its staff to handle reimbursement responsibilities. According to the report, the VA “concurred with … the findings and recommendations and provided an appropriate action plan.”

Opinion: Clinton VA proposal is status quo, not reform (Stars and Stripes)
By Pete Hegseth, CEO of Concerned Veterans for America (CVA): “The situation at the Department of Veterans Affairs continues to deteriorate, with a continuous stream of new reports detailing the department’s corruption, incompetence and dysfunction. Yet despite the mountain of evidence that the VA is failing in its mission of providing for the needs of military veterans, fixing the department’s dysfunctional bureaucracy remains difficult. Why? Because too many in Washington are mired in old ways of thinking that allow the status quo to continue. Case in point: Consider the VA plan issued by Hillary Clinton on Nov. 10. While billed as a “comprehensive” solution to the VA’s problems, the Clinton plan represents little more than a doubling down on the failures of the current system. Which is to say that if you’re satisfied with the VA’s performance under the Obama administration — marked by a toxic mix of scandals, mismanagement, waste and long wait times — then get ready for more of the same under a Clinton administration. In its vagueness, Clinton’s plan is eerily reminiscent of the “reforms” promised by the Obama transition team in 2009. A half-decade later, we know how that turned out. Clinton promises to somehow improve and modernize veterans’ health care by doing more or less exactly what the current VA leadership is trying to do. Lacking clear solutions, the Clinton VA plan relies on a blend of substance-free rhetoric and bureaucratic management-speak. … We should be skeptical about Clinton’s commitment to changing the VA. As recently as October — just weeks before issuing her VA reform plan — she downplayed the department’s problems in an interview with MSNBC. She said criticisms of the VA were exaggerated and partisan, claiming the scandal has “not been as widespread as it has been made out to be.” … Earlier this year, CVA convened a bipartisan task force that published a comprehensive proposal to fix VA health care by prioritizing care to veterans with service-connected injuries, enhancing employee accountability and giving veterans the option to seek private health coverage with VA funds. The task force proposed restructuring the Veterans Health Administration into an independent, government-chartered nonprofit corporation to allow for more flexibility and improved performance. This is hardly the wild-eyed push to “privatization” Clinton and her allies pretend it to be. In fact, it’s an approach endorsed by AMVETS, one of the nation’s largest veterans service organizations. In September, an independent assessment commissioned by the VA also called for a “system-wide reworking” of VA health care and proposed a similar restructuring. … The problem is much larger than the proposal floated by a particular policymaker. The Clinton proposal is emblematic of a type of thinking that has been repeatedly proven wrong. The lesson: Veterans and supporters of VA reform should carefully review and question all policymakers’ proposals for fixing the VA — because it’s clear that much of what is being proposed will not even begin to fix what is broken.”

A fix is planned for delayed veterans program in Alaska (newsminer.com)
There won’t be Fairbanks-based staff to answer military veteran’s health care questions as soon as promised, but plans for an Alaska-specific answer to problems with the 2014 Veterans Choice Act haven’t been abandoned. Plans to hire seven Alaska-based employees to answer veterans’ billing and scheduling questions are about six weeks away from completion, Veterans Affairs Undersecretary David Shulkin said last week at the Senate Veterans Affairs Committee. “We are not walking back on this plan. It is taking longer than you or I want, and you’re right to be impatient,” Shulkin said under questioning from U.S. Sen. Dan Sullivan. The senator posted an excerpt of the hearing on his Facebook page in which he expressed his frustration with the Veteran Administration. This summer, Sullivan organized a series of Congressional hearings in Alaska about the Choice Act. The bill was intended to improve access to health care by letting vets get care from any doctor who accepts Medicare. It was created in response to a scandal at the Phoenix Veterans Administration office where officials deliberately distorted statics on wait times to make it look like veterans were getting care on time. But at the Congressional hearings in Alaska this August, many Alaska vets testified that the bill has actually made things worse, at least here in the 49th state. The vets complained of long hold times when they called TriWest Heathcare Alliance, the contractor that’s administering VA health benefits in Alaska and 20 other states. They complained of Outside employees of the contractor who didn’t understand the realities of Alaska’s geography or climate. In October, VA staff announced a pilot program for Alaska that would employ TriWest employees at Alaska VA offices so Alaska veterans don’t have to call Outside phone banks. Sullivan raised his voice at Wednesday’s hearing when he asked why those employees haven’t yet been hired. “On behalf of my veterans I’m pissed,” the senator said, banging his hand on the table. “What the hell is going on?” Shulkin said he remains committed to the Alaska pilot project. He said it took longer than expected because changing a federal contract was a longer process than he anticipated. Alaska inspired other parts of the country to request local “embedded” staff to answer Choice Act questions, Shulkin said. The local staff have already been hired in New Orleans. TriWest plans to have staff in Anchorage, Fairbanks and possibly in Southeast Alaska, TriWest spokeswoman Elaine Labedz said by email. The company is in the process of recruiting Alaska staff, she said.

2 men charged with vandalizing veterans memorial (TimesDaily.com)
Two men who told police they made a “bad decision” when they broke into the Veterans Memorial at Veterans Park in Florence were arrested, authorities said. Police Sgt. Cliff Billingsley said Zachary T. Royce and Bradley Wayne Crosslin were each charged with destruction and desecration of burial grounds, third-degree criminal trespassing and third-degree criminal mischief. All three charges are misdemeanors, but destruction and desecration of burial grounds is a Class A misdemeanor, which carries a punishment of a year in jail and up to a $1,000 fine, if convicted. The two men are accused of climbing over the fence at Veterans Park to get to the Veterans Memorial. Once inside the park, police said the men climbed onto the F-4 Phantom jet on display at the memorial, walked on the wings and urinated on the aircraft. “And they attempted to get the fuselage off, but was unsuccessful,” Billingsley said. “I don’t know why they were trying to do that unless they were trying to get inside the jet.” The incident occurred about 5 a.m. Nov. 24. Randy Chapin, a veteran, American Legion member and curator of the memorial, said the vandals turned a garbage can over, putting it over one of the artillery shells at the memorial, and then used the can’s metal lid to try and break into a door at the memorial. Billingsley said the door to the maintenance room, which is attached to the memorial, was beaten, but the vandals were not able to get inside. “All of this was caught on security video,” he said. Chapin said a cleaning company was called to clean the jet and the memorial. “Plus, we had to clean up around the memorial where they had dumped the garbage, and repair the door they tried to break into.”

Free estate planning assistance to be offered to Virginia’s low-income veterans (The Viriginian-Pilot)
Low-income veterans in Virginia will be able to receive free legal assistance to draft wills, powers-of-attorney and advance medical directives, officials announced Monday. A legal clinic offering those services will be held at Tidewater Community College’s Chesapeake campus March 1. Other clinics will be offered that week in Richmond, Roanoke and Annandale. The legal services will be offered to veterans and their spouses by volunteer attorneys from the Office of the Attorney General and the Virginia State Bar. At a news conference at the MacArthur Memorial in Norfolk, Attorney General Mark Herring said the legal work that will be offered for free typically commands fees of $500 to $1,500. “This is a cost many of our veterans may not be able to afford, especially if they’re older Virginians or students on a fixed income, but that doesn’t make these documents any less important,” he said. Qualifying veterans will get one hour with an attorney on a “first-come, first-served” basis, according to Herring’s office. Officials said they hope to serve more than 100 veterans statewide. There are 780,000 veterans in Virginia. Veterans and their spouses must fill out a questionnaire on Herring’s website or at a Virginia Department of Veterans Services Benefits Office. To qualify, veterans must show that their incomes, assets, expenses and locations do not allow for readily available estate attorney representation. The questionnaire can be found at tinyurl.com/VetsPlanning.

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