VA scandals create battle over MSPB rulings (Federal Times)
The Department of Veterans Affairs announced two new investigations over the weekend, looking into possible wrongdoing at one of its hospitals. The VA said it will examine whether officials at Cincinnati VA facilities are guilty of misconduct, but the new case could again set the stage for an ongoing battle over the agency’s ability to punish executives of wrongdoing. Continued entanglements with the Merit Systems Protection Board have stymied VA attempts to penalize or even fire executives it has accused of wrongdoing in a number of scandals that have plagued the agency. As a quasi-judicial backstop meant to adjudicate civil service disputes, the MSPB often hears employee appeals when agencies seek to remove or punish agency workers for alleged wrongdoing. A series of scandals at the VA, coupled with appeal restrictions designed solely for the agency as a result of the Veterans Access, Choice and Accountability Act of 2014, have made the MSPB the central battleground pitting accountability versus federal employee rights. For its part, the MSPB has recently overturned or lessened several VA judgments, including the demotion of two Veterans Benefits Administration executives accused of using their positions for personal gain. That sustained struggle bubbled over last week, when VA secretary Bob McDonald suggested in a Feb. 10 hearing of the House Committee on Veterans Affairs that the agency shift senior executives from Title 5 to Title 38 status, a move that would limit grievance and appeals avenues for executives. Senior Executives Association interim president Jason Briefel blasted the idea, saying in a statement that the plan was “farcical.” But there are members of Congress that view MSPB’s recent rulings as no more than a stonewall preventing the VA from removing underperforming employees. Rep. Jeff Miller, R-Fla., as chairman of the House Committee on Veterans Affairs, has been a frequent critic of the MSPB’s rulings and said, in a statement on Feb. 8, that the board’s powers prevent the VA from being able to reform and recover from the scandals that have rocked it at late. “MSPB coddles and protects misbehaving employees rather than facilitating fair and efficient discipline,” he said. “And as long as we have a system in place that requires a similar standard to discipline federal workers as it does to send criminals to prison, accountability problems at VA and across the government will only continue.” Miller’s comments came in response to an MSPB ruling to overturn the firing of Linda Weiss, the former chief of the Albany, N.Y. Stratton VA Medical Center, for the continued fallout over delayed patient care at VA hospitals. The MSPB released a statement on its website on Feb. 11 calling allegations that it protects poor performers “baseless and unfair.” In noting that while the Veterans Access, Choice and Accountability Act limited VA employees to a week to file an appeal and the MSPB 21 days to file a decision, the board said rules for the burden of proof were unchanged and therefore, its decisions remained valid. “Therefore, unless the law is changed, these statutory burdens of proof continue to apply, as they do in all other appeals filed at MSPB,” the statement said.
Vietnam vets blame ‘jet guns’ for their hepatitis C (OC Register)
Near the end of the Vietnam War, Lynn Seiser lined up with other fresh-faced Army recruits to await a dreaded, often bloody ritual. Along with millions of other members of the military, Seiser, then 21, received his service vaccines not by way of disposable syringes but with needleless “jet guns” that blasted drugs into each arm using puffs of high pressure. The U.S. military at the time touted the medical device for its ability to immunize veterans en masse, cheaply and safely. However, the guns often weren’t sterilized between uses and “if you flinched, it ripped you open,” said Seiser, a former longtime Orange County resident and clinical psychology professor. “If anyone in the line had something, everyone would be exposed.” Decades later, a growing chorus of Vietnam War veterans like Seiser and medical experts – including some doctors within the U.S. Department of Veterans Affairs – argue that the inoculators, since removed from use, were a likely vehicle for the hepatitis C virus. The VA and the device’s manufacturer dispute that. But the Vietnam Veterans of America, a Maryland-based nonprofit, in recent months adopted the jet gun issue as one of its causes, due to mounting evidence and member concerns. “There’s a growing body of doctors out there who believe that hepatitis C was caused by air gun injectors,” said Dr. Thomas J. Berger, executive director of the group’s Veterans Health Council. The delayed reaction is explained by the nature of the disease, which can sit symptomless for decades or initially present minor symptoms such as fatigue and muscle aches. If left untreated, hepatitis C can lead to liver failure and death. The illness has been deemed an epidemic in the veteran population since the early 2000s, if not earlier. It’s widely reported that up to 1 in 10 Vietnam veterans have hepatitis C – roughly five times higher than the rate of the overall population. The agency has identified about 175,000 hepatitis C patients within its health care system and roughly 45,000 additional vets who don’t even know they have it, VA numbers show. Of course, the total number of vets infected may be far higher, as the majority of veterans do not use the VA system. Vietnam War service members are considered a high-risk group. VA officials in Washington, D.C., did not address the Register’s questions about total jet gun claims filed and how many were granted or denied. However, the Board of Veterans Appeals – an informal court that’s part of the VA – does publish the results of claim appeals. More than 100 appeals mentioning jet guns have been granted since 1992 and half mention the devices as the sole probable cause, said Shaun Brown, the son of a deceased Vietnam vet who analyzes the anonymized documents for his blog, jetinfectors.wordpress.com. More than 500 cases were remanded to the appropriate VA regional office for another medical opinion, he added. Top VA leaders have said the transmission of the hepatitis C virus via immunization jet guns is “biologically plausible,” but the agency does not consider the device one of the “known modes of transmission” of the disease, a 2004 public record shows. That means veterans who suspect the injectors were to blame for their infections – and are seeking disability benefits and treatment from the VA – face an uphill battle. A granted VA claim brings with it monthly compensation and the latest hepatitis C treatments at no cost to the veteran. VA officials require claimants to rule out any other risk factors – including injection drug use, tattoos given by reused needles and unscreened blood transfusions before 1992 – before they will consider the idea that jet guns could have been the root of infection. … The U.S. military used jet injectors to immunize millions of new recruits and troops heading overseas from the 1950s through the late 1990s. The now defunct Vernitron Corp. and the Walter Reed Army Hospital developed and patented the inoculator, which was branded as the Ped-O-Jet, government documents show. During the Vietnam conflict alone, at least 4.7 million service members were administered vaccinations in this manner, based on one government report that said 235,000 recruits were injected by jet gun each year over a span of three decades. An FDA hearing cites much higher figures: It said the Department of Defense jet gun vaccinated 20 million to 40 million military personnel from 1965 to 1980. Jet gun manufacturers alleged that one injector could deliver up to 1,000 injections an hour because syringes didn’t have to get changed out and vials were reused, which saved money. Such devices also were used on the general public. They’ve been credited for delivering hundreds of millions of vaccine doses in programs to fight diseases such as measles, smallpox and polio worldwide. By 1997, the DOD stopped using the device because of liability risk and the Ped-O-Jet maker’s decision to discontinue production, on the heels of research that revealed concerns of contamination. … Military officials at the time maintained they had not come across any reported cases of cross-contamination but imposed the jet gun ban out of an abundance of caution, records show. Dan Hughes, a Northern California native who now lives in Indiana, administered jet gun vaccinations to troops as an Army medic during the Vietnam War. If recruits tensed up, he said, the high-pressure blast would create a cut and produce bloody blowback. “We never wiped the tip of the gun off,” said Hughes, who has the infection but likely from a tainted blood transfusion.
VA won’t reinstate fired employee, despite judge’s ruling (Stars and Stripes)
An employee appeals board has ordered the Department of Veterans Affairs to reinstate a fired medical center director found to have ignored patient abuse, though the board upheld the charges against her. The decision by Judge Arthur S. Joseph of the Merit Systems Protection Board to reinstate Linda Weiss, former director of the Albany-Stratton VA Medical Center in New York, mirrors two other recent reversals in cases involving regional directors and pits the VA and the board in an increasingly bitter battle for control of employee discipline. VA Deputy Secretary Sloan Gibson vowed to ignore the order to restore Weiss to her director’s job and to award her back pay. “We believe today’s untimely decision is unenforceable under the law, and does not entitle Ms. Weiss to return to VA employment,” he said in a statement. Weiss, who retired while the case was pending, could not be reached for comment Wednesday. Joseph’s order comes more than a week after the board issued a statement that the VA’s discipline had been reversed. The statement did not provide an explanation or instructions. Gibson criticized the lag time between the judge’s order and the board’s statement, contending it violated the Veterans Access, Choice and Accountability Act, which requires VA executive appeals to be expedited within 21 days. Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans Affairs, blasted the board’s decision and called for sweeping reform of the federal employee disciplinary system. … The multiple disciplinary setbacks led VA Secretary Bob McDonald to endorse Gibson’s idea to make the department’s executives at-will employees, meaning they would lose the ability to appeal punishments to the MSPB, though it could mean higher salaries. In their case against Weiss, the VA said she was aware of a nursing assistant abusing patients but failed to remove the employee from patient care in a timely manner. Joseph sustained the VA’s charge of failure to take timely action but found removal to be an unreasonable penalty. Joseph also criticized Gibson for not considering any mitigating factors, such as Weiss’ 42 years of service to the VA prior to her offense or evidence that the threat to patient safety might have been less severe than originally reported. In his ruling, he also noted no one else was disciplined in the matter, despite the apparent involvement of other, lower-ranking employees. “The record fails to establish that the deciding official considered any of the previously discussed mitigating matters, including the fact that the offense was not as serious as the agency has argued,” the judge wrote in his ruling. In January, MSPB judges also overturned demotions for the directors of the Philadelphia and St. Paul, Minn., VA regional offices, despite largely upholding the VA’s findings of wrongdoing. In those cases, as with Weiss, judges noted the Veterans Access, Choice and Accountability Act only allows them to rule on whether a punishment is appropriate, as opposed to allowing them to offer a lesser penalty. “If (the act) did not prohibit it, I would mitigate the penalty,” Joseph wrote in his Weiss ruling. “However, because that is not allowed, the only option is to reverse the action outright.”
ALS link to veterans of Persian Gulf War suggested again in report (ALS News Today)
U.S. veterans who fought in the Persian Gulf War of 1990-91 appear to be at an increased risk for amyotrophic lateral sclerosis (ALS), according to report from the Institute of Medicine (IOM) of the National Academies of Sciences, Engineering, and Medicine. The U.S. Department of Veterans Affairs had requested the review, evaluating and summarizing all available scientific and medical literature regarding health effects in military veterans of the first Gulf War. The department requested that special attention be given to neurological disorders, cancer, and Gulf War illness. The new report confirmed findings in the IOM report of 2010 that ALS is more frequent in Gulf War veterans than in the general U.S. population. Although researchers are still in the dark about potential causes of this link, a recent study suggested that both ALS and Gulf War illness might be linked to toxic exposures during deployment. Veterans also appear to have an increased risk for Gulf War illness, chronic fatigue syndrome, functional gastrointestinal conditions, and mental health disorders such as post-traumatic stress disorder, generalized anxiety disorder, depression, and substance abuse, the recent IOM report said. These findings likewise supported the conclusions of the 2010 report. Reports of increased rates of ALS in Gulf War veterans started emerging in the 2000s, and other research into veterans also reported that the association may be valid for those who fought in other wars as well. In the new report, ALS was the only neurologic disease found to be associated with deployment to the Gulf War. The committee, however, stated that Gulf War veterans are still a young population and that other service-related neurodegenerative diseases might not become obvious until they are older. The committee recommended that the Department of Veterans Affairs continue to assess Gulf War veterans for neurodegenerative diseases. A particular focus should be placed on age-related neurodegenerative diseases that might take years before becoming clinically evident. They specifically mentioned ALS, Alzheimer’s disease, and Parkinson’s disease as targets for follow-up evaluations. “Taking into account the findings from this and previous IOM Gulf War and Health reports, the committee concluded that the health conditions associated with Gulf War deployment are primarily mental health disorders and functional medical disorders, and that these associations emphasize the interconnectedness of the brain and body,” The National Academy of Sciences wrote in a press release.
VA pays millions to keep doctors on paid leave for years (Sun Herald)
Taxpayers are paying millions for VA hospitals to keep health care providers with questionable records on paid leave for years, a Clarion-Ledger investigation has found. In 2014 alone, 2,560 employees at the Department of Veterans Affairs spent at least one month on paid leave (some the entire year), costing taxpayers $23 million — more than any other federal agency. “Because of the federal government’s dysfunctional civil service laws that put the job security of bureaucrats ahead of the safety of veterans, the VA doesn’t have the ability to adequately discipline most misbehaving employees,” said U.S. Rep. Jeff Miller, chairman of the House Committee on Veterans’ Affairs. “As a result, the department’s problems don’t get fixed. They fester, as problem employees are either paid to do nothing, shuffled around or not dealt with at all.” VA Secretary Robert McDonald acknowledged employees remain on paid leave too long. “Originally, administrative leave was designed to take people out of system while they were being investigated so they didn’t create adversity or harm,” he said. He said his agency is streamlining the process so employees can be disciplined more quickly. At the G.V. “Sonny” Montgomery VA Medical Center in Jackson, two surgeons, whose annual salaries total more a half million, have been on paid leave more than two years. They count against the Jackson VA’s budget, but veterans receive no care from them. Retired Maj. Gen. Erik Hearon, former assistant adjutant general and commander of the Mississippi Air National Guard, said veterans are hurt by this because they can’t see these surgeons and taxpayers are hurt by this because they have to pay for veterans to receive care elsewhere. … Sen. Charles Grassley, R-Iowa, questioned the VA’s record on paid leave, pointing out the agency kept 46 employees on paid leave for more than a year. He and other senators have introduced legislation in hopes of curbing that abuse by the VA and other federal agencies. … He said such paid leave “shouldn’t be a crutch for management to avoid making tough personnel decisions or a club for wrongdoers to use against whistleblowers.” Some on paid leave have taken the VA to court. On July 25, 2013, the Jackson VA suspended neurosurgeon Dr. Mohamed Eleraky from performing any more surgeries at the Jackson VA. Nine months later, the hospital suspended him from seeing any more patients. He is now suing the Jackson VA, saying the hospital has failed to give him a fair hearing. But the lawsuit gives no reason why he was suspended. Taxpayers continue to pay his more than $329,000 in annual base pay. His lawyer, Whitman Johnson III of Flowood, would not comment. The VA secretary said, in the past, the VA relied on the inspector general’s office to do investigations and “were told to stay out of the way.” Now, he said, “we are starting our own investigations, not putting people on administrative leave but putting them on another job.”
Rep. Lamborn speaks out against Colorado Springs VA scandal (The Gazette)
A scheduling scandal at the Department of Veteran Affairs clinic in Colorado Springs is “shameful” and the department’s leadership has failed to “embrace” fixes approved by Congress, U.S. Rep. Doug Lamborn, R-Colorado, told Colorado Springs business and community leaders Tuesday. The department’s inspector general reported earlier this month that the Floyd K. Lindstrom Clinic off Fillmore Street wasn’t delivering timely care and had falsified appointment days. The report revealed that 68 percent of veterans sampled waited more than a month for care and that employees falsified appointment dates. To make it seem like veterans were more quickly seen, 28 veterans were shown to have same-day appointments when they actually waited an average of 76 days. “This report makes me furious. I am sick and tired of not getting the outcome that we as taxpayers are paying for and veterans deserve,” Lamborn said in a 30-minute “State of the Fifth District” speech to 125 attending a Colorado Springs Regional Business Alliance luncheon at the Antlers hotel. “Each and every person who honorably serves this nation deserves to be cared for in a timely and honest manner.” The department should immediately fire all employees responsible for falsified waiting lists, Lamborn said. Congress has given the department more authority to fire “failing” employees, boosted funding to increase staffing and created a system for veterans to get care from private-sector providers when the department’s network couldn’t provide care on a timely basis, he said. Congress will schedule hearings to determine how and why the scandal unfolded, how to fix the problems with the local clinic and “ensure that we hold the VA accountable” for the scandal. Lamborn called on President Barack Obama to rein in the “out-of-control VA Department. They are failing our veterans.” He said Obama is not “engaged” on the scheduling scandal, which began nearly two years ago when CNN reported that at least 40 veterans died waiting for care at VA facilities in Phoenix, and called on him to “speak out.”
Veterans say R.I. needs to do better on outreach (Boston Globe)
The state is on the verge of hiring a director to oversee its veterans’ affairs division, though some veterans say what they really need is someone to work directly with them and help them get the benefits they’re entitled to. Rhode Island’s veterans division does not have a person focused solely on outreach and helping veterans with claims. Many other states and towns employ veterans’ services officers. Massachusetts has one in each municipality, according to its department. Connecticut assigns them by congressional district. Leaders of Rhode Island veterans’ organizations say that the state tries to help its veterans but that the efforts are often disjointed. They worry veterans don’t know about their benefits or don’t pursue them, in part because the state doesn’t have someone dedicated to working with their groups and federal officials to help. ‘‘They just don’t know what’s available to them,’’ said David Smith, commander of the Disabled American Veterans of Rhode Island. ‘‘And I don’t know if all the veterans’ groups know all the information.’’ Two caseworker positions, at a salary of about $56,000 each, were added to Rhode Island’s budget in 2014 for this purpose. The job specifications weren’t approved until July, and the posts haven’t been filled. There’s also an opening at the division for a director, a position authorized in 2011 and funded by Democratic Governor Gina Raimondo last year. The state plans to announce the appointment in coming weeks. The position was advertised with many of the same job responsibilities that the division’s current associate director has, at a salary of $108,000 to $122,000 annually, months after Raimondo signed an executive order promoting a lean government. ‘The last thing we need is another layer of bureaucracy, especially if the positions are so closely similar and almost duplicate,’’ said Ana Sarver, who is retiring from the Navy. … The state needs people to tell younger veterans, especially, about their benefits, because they’re not necessarily going to veterans’ organizations to find out, added Sarver, who was stationed in Rhode Island and plans to return. Other veterans say they want someone with a director’s title and the influence that comes with it to advocate for them, but agree that the state should focus more on outreach. ‘‘There is no communication coming from the state, saying this is available or we’re going to try to do this for you,’’ said Frank Collins, commander of an American Legion post in Providence. … At the Veterans of Foreign Wars, Jim Boardman spends two days a week helping veterans claim benefits. The state needs a caseworker to help handle the overflow of cases from veterans’ organizations because the current system ‘‘really doesn’t work,’’ he said. According to the Executive Office of Health & Human Services, the director will be charged with fully staffing the office. Sophie O’Connell, a spokeswoman, said they expect to move quickly on hiring the caseworkers, which are fully funded, once the new director is in place. The veterans’ division co-hosted a summit recently to talk with veterans about how the state can better meet their needs. One of its staffers does outreach as one of several duties.
Veterans groups caution VA on community care development (Military.com)
Three of the country’s leading veterans’ service organizations said they’re generally pleased with the Veterans Affairs Department’s budget request for next year but are concerned the department is moving too quickly to provide health care outside of VA facilities. Al Kovach Jr., president of the Paralyzed Veterans of America, which teams with Veterans of Foreign Wars and Disabled American Veterans to draft an independent VA budget each year, said the groups understand the desire to leverage community medical services to make sure veterans’ needs are met. But the groups believe the VA is moving too quickly to develop private care options. “VA needs to ensure that it devotes critical resources to expand internal capacity, and increase staffing in the existing health care system, particularly for specialized services such as spinal cord injury or disease,” Kovach said. Overall, the VA is requesting $182.3 billion for fiscal 2017. The figure includes more than $78 billion in discretionary funding, mostly for health care, and nearly $104 billion for mandatory programs such as disability compensation and pensions. The department is also proposing to establish a new Medical Community Care budget item with $7.2 billion from the existing medical services account and nearly $5 billion from funds appropriated for the 2014 Choice Act. Carl Blake, the Paralyzed Veterans of America’s executive director for legislative affairs, told Military.com on Friday that all the veteran service organizations recognize the importance of providing care to veterans within the community when it’s the right kind of service. “To make it work will mean making the VA health care system an integrated healthcare network, with the VA as the core and the community [providers] as part of that network,” he said. That means partnering with providers and facilities able to meet veterans’ specific needs, rather than general medical providers, Blake said. This kind of care is not duplicated in the civilian sector, he said. “You can’t ignore the fact that specialized care such as mental health, blinded [care] and spinal cord injuries do not develop in a vacuum,” Blake said. Veterans groups and lawmakers have been aware for some time of the need to provide services to veterans within their communities or closer to their homes. Congress, for example, has passed legislation authorizing more veterans to get health care locally in cases where VA facilities are more than 40 miles from their homes.
VA launches twin investigations, removes oversight authority from Cincinnati regional director (WCPO)
A federal probe of practices at the Veterans Affairs Medical Center in Cincinnati resulted in a sweeping change of control late Friday, prompted by an upcoming four-month Scripps Washington Bureau and WCPO Insider joint investigation. The VA regional network director’s authority over the Cincinnati hospital will be removed until further notice, pending the results of twin investigations launched by the VA and its inspector general, the agency said. The Cincinnati hospital, which normally reports in to the Vertically Integrated Service Network (VISN) 10 region in Cincinnati, will temporarily report in to VISN 4 executives in Pittsburgh. The move was to “ensure no conflict of interest” during the inquiry, the U.S. Department of Veterans Affairs said in a statement to Scripps. The agency opened the first of two investigations of the Cincinnati VA Medical Center after reporters from E.W. Scripps Co. briefed agency officials in Washington on an upcoming investigative story involving hospital leadership and alleged conflicts of interest with VISN 10 leadership. The Scripps News Washington Bureau and WCPO Insider have been investigating several issues raised by dozens of whistleblowers at the hospital, which cares for 43,000 local veterans and had a 2015 operating budget of $373 million. Scripps began its investigation in October and briefed agency officials on the upcoming story as part of the reporting process. The VA’s Office of Medical Inspector opened an investigation Tuesday, four days after the Scripps briefing. Sources at the hospital say VA investigators entered the hospital on Monday and stayed through most of the week interviewing employees. “We will investigate these allegations and, if substantiated, hold anyone accountable as appropriate based on facts and evidence,” said James Hutton, media relations director for the VA. “It is simply the right thing to do for our veterans and our hard-working, dedicated employees there.” As a team of Scripps reporters continued to work on the story, the VA headquarters office in Washington asked its Office of Inspector General to launch a second investigation on Friday. The VA did not reveal what specific allegations are being investigated. However, the Scripps team briefed agency officials on evidence of potentially inappropriate conduct involving a high-ranking official at the Cincinnati hospital, regional network director Jack Hetrick and one of Hetrick’s family members. After Hetrick was questioned about the matter in a recent interview, Hetrick’s family member threatened litigation in an attempt to stop some of the allegations in the upcoming Scripps report from coming out. Scripps is currently in the process of confirming additional details prior to publication of its entire investigation.
Struggling veterans receive aid with Reno-based program (KRNV)
There is a resource for area veterans and their families in Reno you may have never heard about. The VA Sierra Nevada Health Care System – Healthcare for Homeless Veterans is getting homeless vets the help they need to get off the street. Last year the center, located off Capitol Hill in Reno, identified and worked with more than 200 homeless veterans in Reno. The program is on track to help at least that many or even more this year. A safety inspection of a Reno motel a few weeks ago brought this resource into focus. Following the inspection, police said six people were relocated because of unsafe and unhealthy living conditions. This is where News 4’s Terri Hendry met Jerry Green. Green mentioned his military service and declining health. He said, “I have congestive heart failure, COPD, I have sugar diabetes, you name it.” His plight prompted us to make some phone calls on his behalf. That is where Reno’s VA Healthcare for Homeless Vets Center was discovered. Matt Kerr and his staff specialize in providing housing to veterans who are at risk of losing their housing or are homeless. He said, “Research shows anyone with a stable place to go makes it a lot easier for them to be more successful.” Elizabeth Pope and her staff do the initial assessments, connecting homeless vets to whatever service they need. She said, “We are part of the VA Medical Center, so if you are eligible for VA Medical Care, you would be eligible for the assistance we provide. Army veteran Mark Regas is a success story. He is no longer homeless. He is sober and now employed at the center. He said, “It took me nine rehabs. You know, I was sober five-and-a-half years one time. But it’s taken me nine rehabs this time to get over four years of sobriety. You should never stop trying.” In Green’s case, it turns out he is not eligible for the veteran’s services, but through the center’s connections in the community with partnered agencies, Green is now getting the help he needs. This is something the center sees and does every day. The facility also offers showers, laundry and a food pantry for homeless veterans.