VA chips away at health care applications — eligibility backlog still above 500K (Military Times)
Veterans Affairs officials say they are chipping away at a backlog of applications for health care, following an inspector general’s report in September that found 300,000 veterans on the eligibility waiting list were dead. VA Deputy Secretary Sloan Gibson said Wednesday that VA has implemented a plan to improve its health care application system, starting with a review of more than 560,000 pending requests — from the living — including 30,000 from combat veterans who should have automatically qualified but wound up in the system because they didn’t submit income information that was not actually required. Gibson said that since Dec. 11, VA employees reviewed a third of the 30,000 combat veterans’ applications and enrolled about 2,200 patients. It will continue reviewing all combat veterans’ applications and then move on to reviewing applications from every living veteran on the list, he added. “The overarching goals of the Veterans Enrollment Rework Project is to fix the enrollment system and enroll veterans as quickly as we can,” Gibson said during a phone call with reporters Wednesday. A VA OIG report published in September found that the VA health eligibility system contained 847,882 applications but 307,000 on the list had died, according to the Social Security Administration. The review also found that as many as 10,000 applications may have been deleted in the past five years and veterans weren’t notified of the mistake. VA officials said there were many deceased veterans in the system because they cannot be purged unless the death is verified by either a death certificate, a record of death from a VA facility or notification from the National Cemetery Administration. VA does not accept Social Security Administration, Medicare, Defense Department or other government entity notifications as proof of death. Gibson said that after VA reviews applications from living veterans, it will review the applications of deceased veterans to determine whether their delayed applications and lack of access to VA health care contributed to their deaths. “I want to emphasize a sincere apology to veterans and their families. It was not right by the veterans and we were not being good stewards of taxpayer dollars,” Gibson said.
Opinion: Chronic indifference at Veterans Affairs (The Wall Street Journal)
Sen. Jerry Moran & Rep. Jeff Miller: During his Senate confirmation hearing in July 2014 to head the Department of Veterans Affairs, Robert McDonald pledged to “transform” the vast agency. After horrific reports of wait-time manipulation, coverups and even deaths at VA medical facilities across the country, veterans and the American people were calling for honest leadership to restore their trust in the department created to serve them. Transformation wouldn’t be easy, Mr. McDonald said, but it was “essential.” And “those employees that have violated the trust of the nation and of veterans must be, and will be, held accountable.” Sixteen months have passed but the VA’s culture of indifference persists, and the climate of accountability Mr. McDonald promised is nowhere in sight. “Veterans still facing major medical delays at VA hospitals,” read an Oct. 20 CNN article; “VA execs demoted, but get to keep their jobs and fraud money,” reported a Nov. 23 Daily Caller piece. “VA’s own internal probe finds impunity of agency leaders at scandal-ridden hospital,” said a Dec. 16 Washington Post report. It is now clear that the VA’s most-serious problems are rooted in its leaders’ routine and pervasive refusal to seriously discipline those who have engaged in proven incompetence, corruption and malfeasance. Consider:
- After the biggest scandal in VA history, in which 110 VA medical facilities across the country maintained secret lists to hide long waits for care, only three low-level VA employees have been fired for wait-time manipulation. Not one senior-level executive has been fired for the same violation.
- In September the VA’s Office of Inspector General revealed that two VA senior executives inappropriately used their authority to game the agency’s hiring system, allowing them to benefit from more than $400,000 in taxpayer-funded relocation expenses. Instead of recovering the money and firing the two individuals, the VA is planning to give them assistant-director jobs paying more than $100,000 and ignoring calls from Congress and veterans service organizations to recoup the funds on behalf of veterans and taxpayers.
- In December the public learned of two internal VA investigations that found whistleblowers at the Phoenix VA Hospital were retaliated against by two senior managers for reporting dangers to patient care and financial mismanagement. More than a year after investigators recommended to Secretary McDonald that the managers be disciplined, the VA has refused to hold them accountable.
The overwhelming majority of VA employees are honest and hardworking. But by repeatedly declining to take serious action against those engaged in proven mismanagement and corruption, VA leaders are only further eroding the department’s credibility with the veterans it serves. What’s more, the White House and VA are actively opposing congressional efforts to give Secretary McDonald the tools and flexibility he needs to tackle the agency’s accountability crisis head-on. Mr. McDonald refuses to support, and President Obama has issued a veto threat on, the House-passed VA Accountability Act (H.R. 1994). This legislation would give the VA secretary the authority to swiftly fire or demote any employee for poor performance or misconduct while protecting whistleblowers and limiting the agency’s ability to place misbehaving employees on paid leave. Nearly every major veterans service organization, including Veterans of Foreign Wars, the American Legion, Vietnam Veterans of America and Iraq and Afghanistan Veterans of America, supports making it easier for the VA to fire corrupt or incompetent employees. It’s an open question as to why Messrs. McDonald and Obama refuse to stand with these groups in their quest to reform VA’s broken culture. Congress also wants to give the VA the authority it needs to recover questionable bonuses (H.R. 280) and annuities on pensions of VA employees convicted of felonies committed on the job (H.R. 1994 and S. 290). The money these bills are intended to recover could go toward filling the nearly 41,000 open positions for doctors, nurses and other health care professionals at the VA, helping improve the quality and timeliness of care for veterans across the country. The VA has refused to support these bills, which enjoy strong bipartisan support. Sixteen months into Secretary McDonald’s tenure, the VA remains an agency under a specter of scandal—a place where, all too often, employees who have demonstrated incompetence or corruption are let off with a free pass. Until VA leadership makes good on its promise to support real accountability, efforts to reform the department are doomed to fail, and the VA will never be transformed into an organization truly worthy of the veterans it is charged with serving.
Study shows how explosions damage vets’ brains (The News Tribune)
Blasts from explosives have long been known to cause mild traumatic brain injury in combat veterans, but a new study by Seattle experts sheds light on how — and where — lasting harm may occur. Using brain scans from dozens of former soldiers, plus similar research in mice, scientists at the University of Washington and the Veterans Affairs Puget Sound Health Care System have identified the cerebellum — the area of the brain critical for coordinating movement, balance and certain cognitive skills — as particularly vulnerable to repeated blasts. The findings could prompt studies into ways to prevent and treat mild traumatic brain injury, or mTBI, which has been called the “signature injury” of recent wars in Iraq and Afghanistan. An estimated 250,000 to 500,000 members of the U.S. military have been diagnosed with mTBIs across the globe. “What’s interesting is that these types of TBI wouldn’t be on most people’s radar,” said James S. Meabon, an expert in psychiatry and geriatrics at UW and the VA Puget Sound. He’s the lead author of the paper published Wednesday in the journal Translational Science Medicine. “If you’re not getting a moderate to severe type of injury, most people would shrug that off.” More than 40 veterans who participated in the study experienced an average of 21 mild traumatic brain injuries as a result of explosions, with some enduring more than 100 such injuries. The more blasts they were exposed to, the more they showed lower levels of glucose metabolism, a marker of brain activity, in the cerebellum, the study found. Damage from repeated blasts was also detected in the cerebellums of mice, which are broadly similar to those in humans, researchers said. Researchers created “shock tubes” to test simulated blast effects in the rodents. In mice, the explosions ruptured parts of the blood-brain barrier and led to the loss of certain neurons in the cerebellum. They also revealed the buildup of proteins associated with dementia and Alzheimer’s disease. Further neuroimaging in both mice and humans showed additional structural changes in the cerebellum, including damage to the fibers that connect regions across the brain. … The study’s findings suggest that scientists should pay more attention to how mTBI affects the cerebellum to understand the emotional difficulties many veterans face, Peskind said. Dr. Brent Masel, national medical director for the Brain Injury Association of America, said he wasn’t “terribly surprised” at the findings that the cerebellum appeared to be vulnerable to repeated blasts. But Masel, who was not involved with the study, said the research offers potentially important insight into the chronic harm from blast-induced mild trauma. “It’s a piece of the puzzle and, eventually, we’ll be able to put it together,” he said.
Sen. McCain addresses feds regarding Phoenix VA officials returning to work (KTAR)
Arizona Sen. John McCain penned a letter on Wednesday to a federal official in regard to the employment of several officials involved in alleged manipulation within the Phoenix Veterans Affairs hospital, according to a recent press release. McCain wrote and publicly released his letter to Department of Veterans Affairs Secretary Robert McDonald regarding the imminent return of two senior Phoenix VA officials who were suspended for a year and a half after allegedly manipulating wait times for veterans. In the letter, McCain stated he was “disturbed” that the VA has allowed the cases involving excessive wait times for veterans to continue for so long without resolution. “I do not understand why these two cases have been allowed to be delayed for this long under your leadership,” the letter read. He also asked for McDonald to provide him with a “detailed explanation” of the delays and updates on the status of all current and former Phoenix VA officials who are currently suspended or on paid leave and are awaiting administrative action. McCain also mentioned the recent Senate Veterans Affairs Committee hearing regarding issues at the Phoenix VA hospital and claimed senior officials “repeatedly” gave inaccurate testimony regarding the inaction against the two officials. “The return of these two officials to work elsewhere in the VA pending their investigation implies that there are no actions expected against these individuals in the near future,” the letter read. Although the two officials are scheduled to work at the regional headquarters office, not the Phoenix hospital, McCain said the repeated inaction by Phoenix VA officials proves their continued misconduct and contributes to the growing mistrust by veterans. “I continue to be extremely disappointed by the VA’s refusal to hold senior executives accountable for manipulating veterans’ wait-times in order to get bigger bonuses,” McCain said in a statement. “By allowing these individuals to return to work, the VA has clearly demonstrated that these cases will drag on even longer.” McCain said he believes McDonald should bear the full responsibility for the inaction taken by officials at the Phoenix VA hospital. “Secretary McDonald is singularly responsible for the VA’s refusal to take action and its failure to expeditiously hold personnel responsible for the gross mismanagement and neglect of our veterans at the Phoenix VA and VA hospitals around the country,” he said in a statement. In December, a whistleblower found the Phoenix VA is reportedly still short of doctors, despite the facility making changes in the wake of the national scandal.
Researchers think DNA from veterans could revolutionize medicine (WUNC)
What could be the biggest genetic research project in history is underway in a surprising place: the roughly 1,700 medical facilities run by the U.S. Department of Veterans Affairs. The Million Veterans Program, which recently logged its 400,000th participant, aims to collect blood samples from a million veterans in the next couple of years. Scientists say genotyping the samples–essentially ‘bar-coding’ bits of DNA to isolate differences in people’s genetic makeup–could predict a person’s likelihood for getting a particular disease and lead to personalized pharmaceuticals. “I think this is revolutionary for medical science,” said Dr. Timothy Morgan, lead researcher of the program at the V.A. Hospital in Long Beach. Earlier genetic studies in the United States have had sample sizes of around anywhere from 5,000 to 200,000 patients, but none has ever attempted anything like a million patients before. The Million Veterans Program started when geneticists working for the VA realized they were sitting on a treasure trove of potential data. While most Americans switch medial providers from time to time, the roughly seven million veterans who use the V.A. generally enter its healthcare system at a young age and stay in it until they die. “What the V.A. has that nobody else in the world has is a very powerful medical records system,” Morgan said. With the Million Veterans Program, researchers using the system could decide they want to look at genetic markers for a disease like prostate cancer or diabetes. They’d query the electronic records and find perhaps tens of thousands of cases. They’d then be able to run the corresponding genotypes through software to look for similarities at certain positions along the DNA strands. Those strands that are contained in the database–the mere 0.02 percent of our genes that vary from person to person–are also the ones that could reveal why one person gets sick while another does not, Morgan said. Finding the exact genes related to that various could lead to targeted studies on how to prevent and treat many diseases. Dr. Pragna Patel, a human geneticist and professor at the Keck School of Medicine at the University of Southern California, said the pie-in-the-sky goal is to get to personalized drugs. … And veterans specifically represent an optimal group to study–despite the fact that they skew heavily male, Patel said. “They represent a cross-section of the U.S. population in terms of ethnic ancestry. So, that’s important,” she said. “And they’re afflicted with the same common ailments such as heart disease, depression, emphysema as the general populace is. And so the information gained from studying them can be applied to everybody.”
VA owes Florida hospitals $134 million for unpaid bills (News Channel 8)
After performing a July cataract surgery on a veteran participating in the VA’s Veterans Choice program, Dr. Lawrence Goldberg of St. Petersburg is still waiting for the Department of Veterans Affairs to pay up. “A couple of months would be fine, but this is getting kind of ridiculous,” Dr. Goldberg said. Money isn’t the only problem. The Veterans Choice program was born to helps veterans get in to see private sector doctors and to reduce waiting times to schedule appointments. Heath Net, which runs the Veterans Choice program, requires voluminous documentation, Goldberg said. “The documentation is way over and above. They want all the office notes, which if we had to do this with every patient, I really couldn’t practice and see very many patients in a day,” he said. For one patient, Goldberg’s office has spent multiple hours on the phone with Health Net. “Each time you talk to them it takes about a half an hour to get in and talk to someone,” Goldberg added. 8 On Your Side found the problem with delayed payments isn’t confined to the Veterans Choice program. In October, the secretary of the VA received a letter from 12 Florida Congress members, informing him the VA was behind on its bills to Florida hospitals – about $134 dollars behind. According to a survey taken by the Florida Hospital Association, the VA is looking at 29,760 unpaid claims in Florida. More than 10,000 of those are more than a year old. In fact, 5,812 unpaid claims are more than two years old. Congressman David Jolly (R) Fl., signed the letter demanding an explanation from V.A. secretary Robert McDonald.
First Veterans Court in Kansas to help veterans avoid prison (Fox 4 News)
Veterans Treatment Court is now an option for those who qualify in Johnson County. The program is the first in Kansas courts to rehabilitate veterans before they get into the corrections system. There are several Veterans Treatment Courts in the state of Missouri, but Wednesday was the first time a veteran was offered treatment instead of jail under this new court system in Kansas. Featured speaker, Kansas Supreme Court Chief Justice Lawton Nuss, began by telling the crowd gathered in Division 14 about his uncle, who was an air rifleman in World War 2, and drank to cope and forget. He is someone who may have been in the position many vets are today; in court as a result of disorders related to their service. “You know ma`am, I served 28 years in the Air Force, saw a lot of different things in my time in the service,” said Andrew Jones. Jones is a mentor in the Veterans Treatment Court. Instead of going down the path to jail, each veteran enters into a diversion program, working with someone like Jones, entering into a treatment program and is accountable to the Johnson County Department of Probation. “When they say, ‘freedom isn`t free,’ sometimes it is just a catchphrase. But for people on the ground who have seen and done things that maybe they didn’t want to do, when they’re back here struggling, to me as a veteran, as a citizen of the United States, I owe it to them to try to help,” said Jones. When the court was first discussed in March of 2014, Judge Ryan said he called over to the jail to find out how many veterans were incarcerated that day, and there were over 60. That was something on his mind that showed this type of program was necessary.
VA opens Cape Canaveral National Cemetery for first burials (Space Coast Daily)
The Cape Canaveral National Cemetery opened for first interments of casketed or cremated remains of eligible Veterans, spouses or dependents on Wednesday. The cemetery hosted a private committal service for the family and friends of 12 deceased Veterans who received military honors on Tuesday. The 318-acre cemetery in Brevard County will serve the burial needs of more than 163,000 Veterans in the cemetery’s service area for the next 100 years. The land, located at 5525 U.S. Highway 1, between Huntington Avenue and Johns Road, was purchased in July 2012 for $2.1 million. The property is located approximately two miles south of Interstate 95, Exit 231, and approximately 12 miles north of Titusville. To make burial arrangements at a time of need, family members or funeral directors may call the National Cemetery Scheduling Office at 800-535-1117. Burial in a national cemetery is open to all members of the armed forces, and Veterans who have met minimum active duty service requirements, and were discharged under conditions other than dishonorable. Members of the reserve components of the armed forces who die while on active duty, while on training duty, or were eligible for retired pay, or were called to active duty and served the full term of service, may also be eligible for burial. Their spouse, widow, or widower, minor children, and, under certain conditions, unmarried adult children with disabilities, may also be eligible for burial. Eligible spouses and children may be buried even if they predecease the Veteran.