February 12 Veterans News

February 12 Veterans News

VetsHQ News UpdateNew study on Gulf War Illness assailed by veterans advocates (Bradenton Herald) Military veterans advocates are assailing a new report by the Institute of Medicine, which concludes Gulf War illness research should focus on mind-body interconnectiveness rather than genetic and environmental factors. The finding “turns science on its head,” said James Binns, former chairman of the federal Research Advisory Committee on Gulf War Illnesses. “It would totally reverse the progress made in the past five years in beginning to understand the illness and develop treatments for it.” The Institute of Medicine previously concluded the illness was not psychiatric, Binns said in a press release. Anthony Hardie of Bradenton, who chairs a treatment research program funded by Congress, said he was similarly alarmed by the new conclusion. “It’s the same old government theme from the 1990s to deny what happened and deny care and benefits — just when research to understand the illness and identify treatments is finally making real progress,” Hardie said in a press release. Between one-quarter and one-third of the nearly 700,000 members of the U.S. Armed Forces who drove Saddam Hussein’s Iraqi military out of Kuwait in 1990-91 may suffer from Gulf War illness. Hardie, who has testified before Congress about Gulf War illness, believes his symptoms were triggered after coming in contact with toxic agents when going through an Iraqi bunker. “It had all the classic signs of a chemical warfare agent,” Hardie told the Herald in 2014, recalling the odors he smelled in the bunker. Hardie is a passionate and effective advocate for more research on Gulf War illness, even though he suffers from chronic widespread pain, sleep disturbances, frequent infections and fatigue. Rick Weidman, executive director for Policy and Governmental Affairs for Vietnam Veterans of America, was withering in his reaction to the new conclusions. “It’s outrageous that the VA undersecretary from the 1990s, who began the policy of minimizing Gulf War illness, was on the committee, or that the committee chair was on record before she was appointed saying you can’t say what caused it. Half the committee was psychiatric advocates. It’s exactly how the effects of Agent Orange were denied for 30 years after Vietnam. We intend to seek legislation to prohibit these corrupt practices,” Weidman said in a press release. Dr. Beatrice Golcomb, professor of medicine at the University of California-San Diego, said the Institute of Medicine failed to look at all relevant studies. “This ‘don’t look, don’t find’ practice has been a consistent problem in IOM Gulf War reports,” she said in a press release. Roskamp Institute in Manatee County has been studying the effects of Gulf War illness. “We try to mimic the disease in people with mice,” Fiona Crawford, president of Roskamp Institute, told the Herald in 2014. Roskamp researchers expose mice to the same agents soldiers were exposed to in the Gulf War. Roskamp also sought to find veterans to participate in its research, not only with Gulf War illness, but traumatic brain injuries, post-traumatic stress disorder and Alzheimer’s disease. Veterans exposed to chemicals, including nerve gas and nerve agent pretreatment pills, are more likely to be ill and have more severe illnesses. Exposure to related chemicals in civilian settings has produced similar chronic health problems, Golomb said. Researchers say treating Gulf War illness is difficult because symptoms vary from one person to another. Roskamp researchers have said their work is being used to develop a panel of biomarkers for Gulf War illness.

Key senator wants next president to retain VA Secretary Bob McDonald (Military Times)
An influential member of the U.S. Senate wants Veterans Affairs Secretary Bob McDonald to stay on in that role next year, no matter who becomes president. “Everything I’ve seen with Bob McDonald over the last 16 months, I’ve been very pleased with,” said Sen. Johnny Isakson, R-Ga., in an interview for C-SPAN’s “Newsmakers” taped Thursday. Isakson chairs the Senate Veterans Affairs Comittee. “I would certainly hope he would stay for continuity purposes, or the next president would pick him to stay. “The main thing we need at VA is continuity and commitment. Bob McDonald is a veteran, he ran a large business, he’s committed to the I-CARE program at VA. I want to make sure that goes through, and I would recommend him.” Isakson’s comments stem from questions about the presidential candidates’ VA reform proposals. While on the campaign trail, several have labeled the department a failure and a disgrace, and called for a massive downsizing and outsourcing of VA programs. Isakson said his committee is looking at ways to expand outside care programs so veterans have quick access to treatment, but he rejected calls for privatization of key department functions and dismantling the system. “The preponderance of veterans I talk to love their VA care and want to keep it,” he said. “They don’t want it to be replaced or taken away from them. I don’t find a lack of enthusiasm for VA among veterans.” When asked about specific candidates, Isakson said committee activities under his predecessor, Sen. Bernie Sanders, I-Vermont., were “not as active as they should have been” in oversight on a host of department problems but credited him with helping push through the massive Choice Card legislation in 2014. He also called VA criticisms from Republican frontrunner Donald Trump off-base and misinformed. “I don’t know that he has served or used any VA services, so I think he is regurgitating what he’s hearing in the press,” he said. “A lot of the things being reported are things that happened before I came along or Secretary McDonald came along. … The VA is making substantial changes.” Isakson said he expects that work to continue with a new veterans omnibus package, rolling together a host of proposed health and benefits reform proposals. Whether that legislation will include VA plans to overhaul the benefits appeals process remains to be seen. Isakson said he supports working on changes to that system, but is not sure there will be enough time to reach compromise on a new plan this year. The full C-SPAN interview will air Sunday at 10 a.m. and 6 p.m. Eastern.

Veterans Choice program hurting some vets’ credit scores (Military Times)
Some veterans are seeing their credit ruined by using the Veterans Choice health program because the Veterans Affairs Department is not reimbursing participating physicians promptly, forcing them to bill their veteran patients who often can’t pay. Veterans advocates and House lawmakers said Thursday that veterans using the community care program face long delays in treatment and bad credit because physicians are waiting up to six months for reimbursements from VA and are demanding payment from patients, often forwarding the bills to collection agencies. Rep. Raul Ruiz, D-Calif., said one of his constituents sought care for pain and orthopedic problems through the Veterans Choice program, but VA did not reimburse the specialists in a timely manner, forcing the veteran to reschedule needed surgeries and deal with aggressive collection agents. … In another case, a veteran in Saginaw, Michigan, needed follow-up care for an eye appointment through Veterans Choice. But while the initial appointment was approved, the needed sight-saving treatment was not. Since approval and payment were delayed, the providing clinic stopped treatment and demanded money from the patient before they would continue, Veterans of Foreign Wars senior legislative associate Carlos Fuentes said. To solve the issue, VFW contacted the Veterans Choice contractor Health Net Federal Services but was told that treatment could not be approved retroactively. The group then appealed to VA for help, Fuentes said. … The Veterans Choice program was launched in November 2014 to give veterans who face lengthy wait times for care or live 40 miles or more from a VA facility the option to see a private physician. It has come under fire for failing to improve veterans’ access to medical treatment since patients continue to face challenges making appointments or receiving approval for care. Providers have complained about the program as well, citing long delays in payments and disparate reimbursement rates. According to VA officials, the department paid less than 70 percent of its claims to providers within 30 days. In contrast, 99 percent of Tricare and Medicare claims from community providers are processed within 30 days. In fiscal 2012, VA spent $4.5 billion on care for veterans outside VA hospitals and clinics. That figure rose to $10 billion in fiscal 2015, and the Obama administration has requested $12 billion for community care programs in fiscal 2017. But despite vast sums of money appropriated for the programs, systemwide problems persist. Earlier this month, the VA Office of Inspector General found that for 64 percent of 450 appointments reviewed at a VA clinic in Colorado Springs, Colorado, veterans waited more than 30 days for care and none were offered a faster appointment through Veterans Choice. The VA inspector general also found that in Tampa, Florida, eligible veterans were not offered care through Veterans Choice and VA medical center staff “inappropriately removed” veterans from the Choice eligibility list. … VA officials say they are working to solve the problems, starting with the late payments, by changing requirements of providers to furnish medical documentation along with the bills. VA also is hiring more claims processing staff and establishing new productivity standards, said Dr. Baligh Yehia, Veterans Health Administration assistant deputy undersecretary for health for community care. … VA also is seeking to consolidate its private care programs into a single initiative, the New Veterans Choice program, and has asked Congress for legislative authority to implement the changes needed to jump-start the new program. As for the veterans facing bad credit, VA officials have written letters to credit bureaus to help restore former service members’ credit ratings. The department also introduced a toll-free number, 877-881-7618, for veterans to call if they have problems with adverse credit reports related to the Veterans Choice program. Rep. Dan Benishek, a surgeon who chairs the House Veterans’ Affairs personnel subcommittee, said the VA must fix the problem or risk losing willing program participants.

Advocates: Disabled vets need faster access to housing grants (Military Times)
The Veterans Affairs Department needs more staff to handle its program that helps disabled veterans to purchase or modify homes to improve their independent living, according to advocates. In many areas of the country, inadequate staffing contributes to delays in processing Specially Adapted Housing program grants and results in poor customer service to veterans, said Heather Ansley, associate general counsel for corporate and government relations for Paralyzed Veterans of America, testifying before the House Veterans’ Affairs Committee’s panel on economic opportunity. Investments in staffing are needed, she said, because staff members are not able to handle the large work load, including the influx of veterans with amyotrophic lateral sclerosis. “Veterans with ALS are critical users of the SAH grant program and the housing adaptation assistance it provides,” she said. The system is not responsive enough to those with more rapidly changing disorders like ALS, she said. PVA recommends expediting the process for veterans who are terminally ill, including those with ALS, she said. According to service officers with PVA, veterans are having trouble reaching their SAH agents. This is not only unfair to the veterans, but to the agents who are trying to serve them despite too many tasks and too few resources, Ansley said. While it’s understood that application reviews need to be complete, said Rep. Ryan Costello, R-Pa., “we must strive to improve the timeliness of service for all veterans.” VA is working to free up other staff to assist with the grants, said Mike Frueh, director of loan guaranty service for the VA’s Veterans Benefits Administration. Frueh said the VA looks at efficiency and effectiveness across the board, and that these staff members need to be located around the country, but staffing can be adjusted if there’s a spike in need in one area. VA requires in-home interviews be conducted with veterans within 30 business days of eligibility determination, and the typical SAH process requires numerous communications and in-person meetings with the veteran. VA implemented streamlined policies and procedures for the SAH grant process in February 2014, Frueh said. He noted that there has been an overall increase in the number of veterans eligible for the program, citing expansions in the program, the military drawdown and VA’s reductions in the disability compensation claims processing time. In fiscal 2015, VA approved more than 1,800 grants totaling $96 million, he said, an increase of about 44 percent over 2014, and an increase of 65 percent over 2013.

Tighter limits on appeal rights of VA execs being considered (The Washington Post)
Senior executives at the Veterans Affairs Department would be even further restricted in their rights to challenge disciplinary actions against them under a plan being discussed between the department and congressional committees overseeing the VA. While the roughly 350 Senior Executive Service members at the department already have fewer rights than their counterparts at other agencies, the change being considered would essentially end their right to outside review of discipline ranging up to firing, according to the Senior Executives Association. At a hearing on the 2017 budget before the House Veterans Affairs Committee on Wednesday, VA Secretary Robert A. McDonald raised the prospect of putting senior executives there under a set of personnel laws called Title 38 that apply to medical personnel at the department. While those laws provide for more flexibility in paying employees than standard federal employment laws, called Title 5, they also allow for discipline to be challenged only through internal department channels. Under a 2014 law, SES members at the VA already have a shortened time to file an appeal at the Merit Systems Protection Board; the board’s hearing officers, called administrative judges, must issue a decision within 21 days or else the agency wins by default; and there is no right of further appeal beyond that level. That law was enacted in the wake of disclosures that appointment scheduling data had been manipulated to make it appear that waiting times were shorter. McDonald said the department is considering further restrictions in the wake of recent decisions by MSPB administrative judges who overturned the department’s proposed discipline of three senior executives — one who was proposed to be fired, the other two demoted — even under those procedures. … He and other top VA officials had first raised the prospect of moving senior executives to Title 38 in a meeting with the bipartisan leaders of both the House and Senate veterans committees the day before. No formal proposal has been made, however. … No members of the committee commented directly on the idea at the hearing, although Chairman Jeff Miller (R-Fla.) had called for further tightening of appeal rights in light of the MSPB rulings. Specific language based on the idea “will be immediately incorporated into current and ongoing negotiations between the House and Senate Committees on Veterans’ Affairs on a package of veterans legislation, with the goal of getting it signed into law this year,” a congressional aide said in an email.

VA wants vets charged in serious sex crimes barred from VA burials (Military.com)
The Department of Veterans Affairs is asking Congress to pass legislation prohibiting veterans charged with the most serious category of sex crimes from interment in veterans’ cemeteries. The proposed ban would go further than current law prohibiting convicted and registered Tier III sex offenders from being buried in VA cemeteries by barring those who die before being convicted or who flee to avoid prosecution. Tier III sex offenders are those convicted of aggravated sexual abuse, or sexual abuse or abusive sexual contact against a minor under age 13, according to federal statute. In 2011, Rep. Vicky Hartzler, R-Missouri, sponsored the Hallowed Grounds Act, which was signed by President Obama in January 2013. The law put Tier III sex offenders in the same category as veterans convicted of capital crimes, who have been barred from veteran cemetery burials since 1997. That year, President Clinton signed legislation to ensure Army veteran Timothy McVeigh, convicted of blowing up the Alfred P. Murrah Federal Building in Oklahoma, would not be eligible for such interment. Veterans groups backed the intent of Hartzler’s bill. According to VA spokesman James Hutton, a veteran already may be forbidden a VA cemetery or Arlington National Cemetery burial in the event he dies before being convicted if he is being prosecuted for a Tier III sex offense under federal statute. … The VA’s legislative proposal would amend the definition of a state capital crime to include Tier III sex offenses, Hutton said, thereby filling a statutory gap and eliminating inconsistent — federal or state — application of the law for the same offense. The VA is not the first to ask for the change. The U.S. Army appealed to Congress for the same kind of bill during a 2012 hearing to consider Hartzler’s bill. … The ban on burying accused Tier III sex offenders in VA cemeteries is one of more than a dozen legislative proposals being sought by the VA as part of its budget request for next year. These include proposals to allow the VA to furnish government headstones and markers for the privately marked graves of all Medal of Honor recipients; tie the authorized burial allowance to the Consumer Price Index; expand eligibility for grave medallions; and expand certain benefits to veterans buried on tribal lands.

VA home loan limit would end under proposed law (Military Times)
Lawmakers have taken a step toward removing the cap on the amount the Veterans Affairs Department can guarantee under its VA home loan program, in legislation passed by the House this week. It’s unknown whether the Senate will take similar action. Witnesses told lawmakers that changes in the program — like higher loan guarantee limits — could help more veterans take advantage of the benefit. Higher loan guarantee limits are “absolutely necessary,” said Sherri Meadows, vice president of the National Association of Realtors, testifying Feb. 10 before the House Veterans’ Affairs Committee’s panel on economic opportunity. “Veterans should be able to purchase a home wherever they choose to live.” Generally, the VA can guarantee a loan of up to $417,000. About 90 percent of VA loans are made without a down payment from the borrower, said Mike Frueh, director of loan guaranty service for the Veterans Benefits Administration. In an analysis conducted by the VA last year, about 15,000 veterans wanted to buy homes in areas where homes were more expensive than the loan guarantee cap, Frueh told lawmakers. The VA cap is not a lending cap. It’s the amount that the VA guarantees. VA doesn’t set a cap on how much a veteran can borrow to finance the home, but there are limits on the amount of liability the VA will assume on that loan, which usually affects the amount of money an institution will lend a veteran. That limits the risk to the lender if the borrower defaults. “No down payment is important,” Frueh said. “Setting an artificial cap on the amount we can guarantee is going to eliminate people who want to buy a home above that cap, because that no down payment is an important part of the benefit.” Meadows also said veterans need flexibility to negotiate all fees, so they aren’t at a disadvantage when negotiating with a seller to buy a home. A variety of fees, from termite inspection, to document recording, to postage and delivery fees, are a part of the closing, but veterans aren’t allowed to pay these fees. While the association supports the VA’s efforts to shield veterans from excessive fees, Meadows said, the inability to negotiate these fees can put veterans on an uneven playing field with non-VA buyers, she said.

President Begaye to sign Navajo Veterans Act Saturday (KANU)
Navajo Nation officials plan to revamp the tribe’s Veterans Administration. President Russell Begaye will hold a signing ceremony Saturday of a bill designed to more closely involve the tribe’s veterans in policymaking that affects their benefits and services. … Many Navajo veterans have limited access to state and federal benefits, and say they experience poor healthcare. The Veterans Act will move the VA, which is staffed by less than 30 people, from the tribe’s human resources department to the Office of the President and Vice President. It’ll also create the Navajo Nation Veterans Administration and Advisory Council. Jamescita Peshlakai is the veterans’ liaison for the office of the president. “It provides for the opportunity for veterans to become more involved. The veterans themselves know what their challenges are. They’re the ones who have the experience and expertise and we’re just bringing them on board,” she says. Peshlakai says there could be anywhere between 10,000 and nearly 40,000 Navajo veterans, but no clear estimate exists. The new law will modernize recordkeeping technology and allow the tribe to get a more accurate count of its veterans. Though the bill doesn’t include any new funding for the VA, President Begaye says he’ll contribute carry-over funds to the agency.

VA official sentenced for accepting job-related gratuities (The Sacramento Bee)
A Veterans Affairs contracting official has been sentenced for accepting gifts in relation to his job duties, which included influencing the award of construction contracts for the Sacramento VA Medical Center. Anthony Castaneda, 45, of Oakdale in Stanislaus County, was sentenced Thursday by U.S. District Judge Morrison C. England Jr. to five months of house arrest and two years of probation for receipt of a gratuity by a public official, according to a U.S. Attorney’s Office news release. According to court documents, while working as a contracting official for the Department of Veterans Affairs, Castaneda was in a position to influence the award of construction contracts at VA facilities, including the VA hospital at the former Mather Field. In 2010, Castaneda received from a construction contractor a prepaid vacation package at a theme park worth approximately $2,250. Castaneda and his family traveled to the theme park for five days in October 2010. At the time he accepted the gift, authorities said, Castaneda was in a position to influence the award of contracts by making recommendations about which contractors should be given VA business. Court records also show that Castaneda received a second vacation package from the same contractor worth approximately $1,440 in 2008. Castaneda pleaded guilty in federal court in Sacramento in August. In addition to his period of house arrest, Castaneda was ordered to forfeit the value of the 2010 vacation and to pay a $2,000 fine. The contractor involved, Jacobo Tadeo Herrera, pleaded guilty to providing a gratuity to a public official. He was sentenced in December in federal court in San Jose to three years probation. The case resulted from an investigation by the Veterans Affairs Office of Inspector General and the FBI.