January 22 Veterans News

January 22 Veterans News

VetsHQ News UpdateSecretary McDonald lays out ‘breakthrough priorities’ for VA in 2016 (Military.com) Veterans Affairs Secretary Bob McDonald told lawmakers on Thursday that by the end of 2016 veterans who walk into or call a VA medical center will have their clinical needs addressed “that day,” while 90 percent of veterans appealing a compensation decision will — with Congress’ help — get an answer within one year. The ambitious commitments were two of a dozen “breakthrough priorities” that McDonald detailed for the Senate Veterans Affairs Committee. Eight of the priorities are specific to serving veterans and four are to meet department needs, but McDonald said Senators should “make no mistake — all 12 are designed to improve the delivery of timely care and benefits to veterans …. We understand this will be a challenge, but we are committed to producing results for veterans.” The priorities also include:

  • Having all VA medical centers fully staffed up front with knowledgeable service-oriented employees.
  • Making sure vets needing to see a community provider do so within 30 days at least 85 percent of the time.
  • A disability claims backlog no more than 10 percent of inventory.
  • A more intuitive and efficient website for accessing information.
  • A well-staffed and courteous crisis hotline reachable by all veterans 24/7.
  • A more efficient and understandable compensation and pension exam process.
  • Continued progress in ending chronic veteran homelessness.
  • Ensuring all VA employees are trained to high customer-service standards.
  • Having 95 percent of all medical center directorships filled.
  • Closing 100 percent of current cybersecurity weaknesses.
  • Ensuring that half of all information technology projects are on time and on budget, with IT executives’ performance goals tied to strategy goals.
  • A more efficient medical-supply chain that will result in $150 million in cost avoidances redirected to veteran programs.

One of the hurdles McDonald will face is in taming the growing backlog of appeals claims, which in some cases have dragged on for eight years as veterans continue to add evidence to their case. The process has been complicated as well in recent years as a result of VA working to reduce its first-time disability claims backlog. McDonald reported that the claims backlog — those not acted on within 125 days of filing — has been reduced from its 2013 peak of 611,000 to 82,000. The progress was made over several years in part because the VA put additional personnel on the problem and then by moving from the traditional paper-based system to one an entirely electronic one. “We decided 1.4 million disability compensation and pension claims for Veterans and survivors — the highest in VA history for a single year” because of the new system, McDonald said. But Sen. Richard Blumenthal, D-Connecticut, said the emphasis on first-time claims only increased the number of appeals and “simply shifted the problem.” “And so the 440,000 appeals that currently are pending is, in my view, unacceptable,” Blumenthal said. McDonald did not dispute the issue, but pointed out that taming the appeals backlog is “one of our breakthrough objectives.” “Assuming we can work together on the legislation, we are planning to get 90 percent of appeals resolved within one year. And I think we can all sign up for that objective,” McDonald said. Under current law veterans may continue to add evidence to their file, which helps to draw out the decision time. McDonald said the law was developed some 100 years ago and needs to be changed. He did not spell out how he would change it but said he wants to work with Congress to come up with a solution.

VA chief to Congress: You can’t fire your way to excellence (PBS Newshour)
Veterans Affairs Secretary Robert McDonald on Thursday disputed claims by members of Congress that his scandal-plagued agency hasn’t dismissed enough employees, saying, “You can’t fire your way to excellence.” McDonald told the Senate Veterans Affairs Committee that he and other top leaders are turning the VA around, “providing more and better care than ever before” and holding employees accountable, including firing about 2,600 workers since he took office 18 months ago. The VA has struggled to respond in the nearly two years since a scandal emerged in Phoenix over chronic delays for veterans seeking medical care, and falsified records covering up the long waits. Similar problems were soon discovered at VA medical centers nationwide, affecting thousands of veterans and prompting an outcry in Congress. Despite the scandal, his “vision for VA (is) to become the No. 1 customer-service agency in the government,” McDonald said. The agency has “a lot of work to do to reach that goal, but we are making progress,” he said, noting that VA increased the number of health care appointments by more 1.2 million last year, completing 96 percent of those within 30 days of clinically indicated dates or those preferred by veterans. McDonald’s comments came as he outlined a 12-point plan he said would achieve “breakthrough outcomes” by the end of President Barack Obama’s term. The plan includes improving veterans’ access to health care, making it easier for veterans to navigate the complicated VA website, reducing chronic backlogs in disability claims and continuing to reduce veteran homelessness. McDonald praised passage of a 2014 law intended to make it easier for veterans to receive private care, noting that VA authorized 12 million private appointments last year alone. The move to private care was intended to alleviate chronic delays many veterans face in getting treatment at the VA’s nearly 1,000 hospitals and outpatient clinics, or to make it easier for veterans who live far away from a VA health site. Bolstered by the new law, the VA hired more than 41,000 people last year, bringing the total number of employees to more than 340,000, McDonald said. The new hires included 14,000 health care workers, 1,300 of them doctors and 3,600 of them nurses. Still, McDonald said the agency is plagued by “critical shortages” in health care, including 34 vacant positions directing VA medical centers nationwide. “Negative news articles” published since the wait-time scandal broke out in Phoenix have hampered recruitment efforts and made it difficult for the VA to hire and retain qualified workers, McDonald said. Employment applications are down by about 75 percent compared to two years ago, he said.

Michelle Obama urges mayors to remove ‘stain’ of veteran homelessness (Los Angeles Times)
First Lady Michelle Obama urged the nation’s mayors Thursday to redouble efforts to ease homelessness among military veterans in a speech that both highlighted progress and underscored the magnitude of the problem. Obama, speaking at the winter meeting of the U.S. Conference of Mayors in Washington, said it was “an absolute outrage” that veterans were sleeping on the nation’s streets. “It is a horrifying stain on our nation, particularly when you think about all that these men and women have done for our country,” she said. The first lady lauded the city of Los Angeles for finding homes for more than 5,500 of the 7,000 veterans estimated to be on the streets as of January 2015, and for developing mental health and job placement services to keep them housed. Mayor Eric Garcetti’s office has said it would be early spring before the remaining L.A. homeless veterans could be placed in homes. In 2014, Garcetti joined the leaders of dozens of cities in California and across the country in accepting the Obama administration’s challenge to end veteran homelessness by the end of 2015. Houston, Las Vegas, Philadelphia and the state of Virginia are among cities and states that reached “functional zero,” the point at which veterans who become homeless are quickly identified and helped. Los Angeles is still trying to get to that point. Garcetti and Obama encouraged the assembled mayors to continue working. “We can win this war. We can fulfill this mission. I have seen it in Los Angeles,” Garcetti said. To get veterans off the streets, Garcetti said Los Angeles had sought more than $100 million in federal veterans’ housing grants, Housing and Urban Development housing grants and local money. To keep them off the streets, city officials are working with businesses and nonprofit groups to help veterans find jobs, get medical and mental health treatment and other resources they might need. … More than 44,000 homeless people were counted in Los Angeles County last year, a 12% increase from 2013, according to the Los Angeles Homeless Services Authority. Of the total, nearly 26,000 were in the city of L.A. Veterans make up about 15% to 20% of the city’s homeless, Garcetti said, and Los Angeles is working to scale up the veteran model to help other homeless Angelenos. … Obama urged other mayors to join her push. “Your peers have provided you all with a road map for how to get this done,” she told the mayors. “Whether you’re a big city, a small county or an entire state — someone just like you has done it.” Since joining the first lady’s challenge, Santa Barbara County has found housing for 90 of about 270 homeless veterans, Santa Barbara Mayor Helene Schneider said. Part of that progress resulted from focusing on the needs of 10 chronically homeless people along a single street. All 10 have moved into homes and one is now employed by a business he once panhandled in front of, she said. She pointed to the 1% rental vacancy rate in the city, and said Santa Barbara is starting a program to encourage landlords to give veterans priority for available rentals. Schneider, co-chair of the Conference of Mayors’ Hunger and Homelessness Task Force, said the challenge had forced cities to develop more sophisticated approaches to homelessness.

Brain bank opens to help study PTSD in war veterans (News On 6)
Post-Traumatic Stress Disorder affects half a million veterans in the United States. In Oklahoma, 11,590 veterans were treated for PTSD last year in outpatient clinics with the Oklahoma City VA Health Care System and 817 veterans were hospitalized for the illness. More than 50 brain banks exist in the United States — allowing researchers to study brain tissue samples from donor’s suffering from alcoholism, Alzheimer’s disease and even depression. Yet there has never been a brain bank to study PTSD – until now. … Dr. Benedek is an expert on PTSD. We visited him on the campus of the Uniformed Services University just outside of Washington D.C. “When people are exposed to severe trauma there are changes that occur in their brain,” he said. But with the opening of the national PTSD Brain Bank this year, researchers will investigate the impact of stress, trauma and PTSD on brain tissue in order to advance the scientific knowledge of PTSD, particularly the identification of PTSD biomarkers. “That trauma may cause changes in the dimensions of certain pieces of the brain that are linked to the control of emotions and also the control of thinking,” Dr. Benedek said. “It’s a complicated illness, PTSD, and we can learn a lot, we have learned a lot, we still have a lot to learn.” Veterans enrolled in the program, agree to be followed while they are alive and then donate their brain tissue after they die. “It would be very nice if we were able to A. find medication to prevent PTSD, B. look into the crystal ball and say this person shouldn’t go because they are going to get it, we’re not there yet,” he said. The national brain bank is seeking veterans with PTSD to participate in research about PTSD that affects veterans. Veterans without PTSD are also eligible to participate in the brain bank because it is important to study veterans without PTSD to compare the impact of stress, trauma and PTSD on brain tissue. Veterans interested in learning more about enrolling in the brain bank are encouraged to call its toll-free number 1-800-762-6609 or visit its website. Participating sites are located at VA medical centers in Boston, Massachusetts, San Antonio, Texas, West Haven, Connecticut, and White River Junction, Vermont, along with the Uniformed Services University of Health Sciences at Bethesda, Maryland (USUHS).

Veterans testify on Kansas medical marijuana bill (The Tampa Tribune)
Navy veteran Raymond Schwab started treating symptoms from Post-Traumatic Stress Disorder with a slew of prescription medications that he said nearly ruined his life. But he found relief in cannabis therapy that helped him to get a degree and be a more effective parent, Schwab told a panel of Kansas senators on a second day of hearings. The Kansas Senate’s Corrections and Juvenile Justice Committee heard Schwab — who was deployed during the Bosnian War in the 1990s — and other opponents testify about a bill that would soften criminal penalties for marijuana possession, allow for hemp oil to treat seizures and promote industrial hemp research. State senators heard from proponents of the measure on Wednesday. The testimony came on the eve of an anticipated Kansas Supreme Court ruling on the legality of a voter-approved Wichita ordinance relaxing penalties for possessing small amounts of marijuana. The court is expected to decide Friday whether to strike down the ordinance because it conflicts with state law. The case has been closely watched by activists in other Kansas communities. In tearful testimony on Thursday, Schwab said that he moved to Colorado to gain access to medical marijuana that remains illegal in Kansas. He added that the section of the bill allowing for medical hemp preparations to treat seizures was “not enough,” so he testified against it. Several other opponents echoed Schwab’s concerns that the bill did not encompass their ailments, which ranged from chronic pain to depression. The dissenters said that a broader version of the measure could reverse rampant abuse of prescription drugs. Law enforcement representatives differed with the veterans, saying that the bill would be a gateway to medical marijuana usage. Ed Klumpp, a lobbyist for the Kansas Association of Chiefs of Police, said that the loose restrictions on the measure posed as a public safety threat. “These bills tend to be a precursor to the broader legalization of marijuana,” Klumpp said. He added that the bill would increase costs for crime labs and create a need for more personnel to differentiate the usage of medical marijuana from recreational. Committee Chairman Greg Smith, an Overland Park Republican, said that the senators would continue discussing the bill next week.

Sen. Schumer says FACT Act would hurt some veterans (WBGN)
U.S. Sen. Charles Schumer (D-NY) announced Thursday his push to block legislation he said would further victimize veterans and others suffering from mesothelioma cancer and asbestos poisoning. According to The Mesothelioma Center, veterans are at a higher risk of developing asbestos-related illnesses because of the military’s past use of asbestos. This material was used in building ships, tanks, automobiles and other aircraft due to its heat resistance and fire-proofing capabilities. According to a statement released by Sen. Schumer’s office Thursday, the House of Representatives passed the Furthering Asbestos Claim Transparency (FACT) Act. Schumer’s office said veterans suffering from mesothelioma can apply for compensation through asbestos trusts. The money comes from corporations that were required to contribute to these funds after knowingly exposing veterans and others to asbestos. According to Schumer’s office, the FACT Act threatens this system. This bill would require sick veterans to publicly disclose personal information in order to receive compensation from asbestos trusts. It also requires these trusts to publish this information on a publicly-accessible database online. “The most shocking part about this House bill is that it leaves defenseless those who defended us by serving our country,” Sen. Schumer said in the statement, “This legislation would not only delay the compensation process, it would intimidate those suffering from asbestos-related diseases, like mesothelioma, by requiring the publication of their personal, sensitive information on the internet. The whole purpose of our legal system is to level the playing field of justice, but this bill would put a thumb on the scale for the companies who may have knowingly exposed our veterans to asbestos. That is just plain wrong, and I plan to go to the mat for those who served our country to make sure this doesn’t pass the Senate.” According to The Mesothelioma Center, U.S. military veterans account for nearly one-third of all mesothelioma legal cases. They also account for 30 percent of known deaths from mesothelioma.

San Bernardino County exceeds goal of ending veteran homelessness (The Sun)
San Bernardino County met and exceeded its goal of housing all its homeless veterans identified in last January’s point-in-time homeless count, county officials announced Thursday. But there is still work to be done, as roughly 100 more homeless veterans have been identified since the county embarked on its mission in July. “We will stand by the commitment we’ve made to our veterans by finding them permanent housing,” Board of Supervisors Chairman James Ramos said in a written statement Thursday. “I’m proud to say we achieved and exceeded an important goal, but there is much more work to be done on homelessness in our county.” In June, the Board of Supervisors unanimously approved a recommendation by one of the nation’s leading experts on homelessness to implement a strategy to permanently house all 401 of its identified homeless veterans from last January’s point-in-time homeless count on or by Dec. 31, 2015. By Thanksgiving, all had been housed, along with roughly 100 other homeless veterans who were identified after the homeless count, according to a news release. The next step will be to house the approximately 100 homeless veterans identified since July. “The transitory nature of homelessness means the numbers of homeless people in the county changes day to day,” said Supervisor Josie Gonzales, who is the chairwoman of the county’s Interagency Council on Homelessness. “But the model used to tackle the homeless veterans issue worked and will be applied to assist other sections of the county’s homeless population.” County CEO Greg Devereaux recruited homeless czar Philip Mangano to serve as an advisor to the county. Mangano is the CEO of the American Roundtable to Abolish Homelessness and is the former executive director of the U.S. Interagency Council on Homelessness under former President George W. Bush. Mangano said Thursday the strategy the county put in place has caught the attention of U.S. Veteran Affairs Secretary Robert McDonald in Washington D.C. He said it was the confluence of political will in Washington and San Bernardino County to end veteran homelessness that is attributed to the county’s success. The county’s strategy, Mangano said, entailed forming the San Bernardino County Advisory Group on Ending Veterans Homelessness, composed of various county agencies, for the purpose of brainstorming ways of clearing obstacles and slashing through bureaucratic red tape that hinders the housing of homeless veterans. The group met with housing providers to get a clear picture of what those obstacles were, then set out to eliminate them, Mangano said. … Various county agencies and nonprofits that joined in the effort include the San Bernardino County Department of Veterans Affairs, the California Apartment Association, the Housing Authority of the County of San Bernardino, Lighthouse Social Services Centers in Colton, National CORE, Arrowhead United Way, Loma Linda University Health, Inland Valley Hope Partners and the Faith Advisory Council in San Bernardino.

Director: Gulf Coast VA ‘remains very strong’ (Sun Herald)
After a turbulent 2014, the following brought both challenges and successes to the Gulf Coast Veterans Affairs Healthcare System, said Director Anthony Dawson during his annual State of the System address. In the 18 months since a scandal over hospital and clinic wait times broke out within the veterans health system, starting in Arizona, officials on the Gulf Coast — and nationwide — have worked both to fix the problem and to regain the public trust. Dawson said he was focused on looking forward as well, to improvements and innovations in how the system delivers care and interacts with its clients. … More veterans are coming to the VA for health care and each veteran is seeking more care. The Gulf Coast VA had about 1 million patient encounters in 2015, 57,000 more than in 2014. According to numbers from November, 97 percent of patients were seen within 30 days. That number is better than the 94 percent in June, but about even with the 96 percent from November 2014. That’s because even as staffers work harder to see patients more quickly and efficiently, there have been more patients. “We have indeed become victims of our own success,” Dawson said. To deal with the growing numbers, Dawson said he’s hired 437 new staffers, including 35 physicians and 102 nurses. He’s also sought ways to speed the hiring process. In the next year, he will hire one “floating team” for each hospital in the system so they can stay fully staffed, even as doctors and nurses take sick days or vacations. That will mean fewer canceled appointments, he said. Several hospitals are building additions or doing renovations so they can treat more patients. Biloxi undergoing a major renovation to add beds in the acute-care center. … Transparency and community involvement are a centerpiece of Dawson’s plan for 2016. In 2014, the system spent $69 million paying for care in the community. It 2015, that number was $80 million. The Veterans CHOICE Act was also implemented, allowing veterans who meet certain conditions to receive care outside the VA. At the same time, Dawson has been holding regular town hall meetings with stakeholders and making time for face-to-face conversations with patients and families. “Our mission is delivering excellent, patient-centered care,” he said. “Transparency was always my position but especially since Phoenix.” … Dawson doesn’t just have the Gulf Coast system playing defense from the scandal. The system is actively innovating to provide better care. It will even have a staff member in charge of innovation. Some things are simple. The Gulf Coast system is one of three selected to participate in a pilot phone program that allows delivery of care by telephone. It’s simple, and it leaves staff more time for patients who must come to the VA. It is one of eight programs in the country to participate in a pilot program for general innovation. “Embracing innovation is key,” Dawson said. “The changes we’re seeing across the world are breathtaking and in health care it’s even faster. We’re striving for innovation to become part of our DNA.” The status of the Gulf Coast Veterans Health Care System, Dawson said, “remains very strong.”

Schumer to feds: Ramp up New York VA upgrades (Finger Lakes Times)
U.S. Sen. Charles Schumer has visited the Canandaigua VA Medical Center several times since he helped save the facility from closure more than 10 years ago. During his most recent stop Tuesday, he urged federal officials to expedite a planned $122.4 million campus upgrade he called long overdue. Schumer explained that under a new federal policy passed last September, the Department of Veterans Affairs must turn over construction projects of more than $100 million to the U.S. Army Corps of Engineers to manage. However, he said, the process of transferring that responsibility should not hold up the project. … Schumer said in 2007, the Department of Veterans Affairs announced it would start a major reconstruction project to modernize the Canandaigua VA campus and provide state-of-the-art care to meet the needs of current and future veterans. That came after Schumer, local veterans and the community, during 2003 and ’04, convinced the VA’s Capital Asset Realignment for Enhancement Services (CARES) Commission to reverse its recommendation to close the historic facility. Instead, the VA agreed not only to keep the campus open but modernize it and safeguard it from any future efforts to close. Schumer said because of that, the local hospital became one of only four major VA construction projects across the country that Senate appropriators recommended to receive construction funds in 2014. To begin the redevelopment project, Schumer secured $36.58 million in fiscal year 2010 to complete a new campus master plan, begin the project’s preliminary design work and complete environmental assessments. In 2013, Schumer wrote to then VA Secretary Eric Shinseki to include funding for Canandaigua VA work in a budget request. The following year, Schumer announced the VA agreed to this request and would provide $122.4 million as a part of the fiscal year 2015 omnibus spending bill to begin the construction phase of the project. The funds are for Phase I of the work and represent a substantial portion of the Canandaigua VA’s estimated $300 million redevelopment plan, which includes a modern outpatient clinic, additional housing and services. Now that oversight of the project has been tasked to the Army Corps, Schumer is urging the agency to get the project on track. … Schumer said when the $122.4 million was approved in December 2014, it was anticipated construction contracts could be awarded within 12 months. However, soliciting contracts to build and renovate the facilities has not begun.