Veterans seek greater emphasis on PTSD in bids to upgrade discharges (The New York Times) Kristofer Goldsmith was discharged from the Army at the height of the Iraq war because he was not on a plane to Baghdad for his second deployment. Instead, he was in a hospital after attempting suicide the night before. On the sergeant’s first deployment, his duties often required him to photograph mutilated corpses. After coming home, he was stalked by nightmares and despair. In 2007, he overdosed on pills, and his platoon found him passed out in a grove of trees at Fort Stewart, Ga., that had been planted to honor soldiers killed in combat. Instead of screening Mr. Goldsmith for post-traumatic stress disorder, or PTSD, records show that the Army wrote him up for missing his flight, then forced him out of the military with a less-than-honorable discharge. When he petitioned the Army to upgrade his discharge, arguing that he missed his flight because of undiagnosed PTSD, it rejected his appeal. In the years since, he has appealed twice more for an honorable discharge and has been denied both times. … Many who have tried to upgrade their discharges have received the same response. Records show that the Army Review Boards Agency — the office with legal authority “to correct an error or remove an injustice” in military records — has rejected a vast majority of cases that involve PTSD in recent years. Since 2001, more than 300,000 people, about 13 percent of all troops, have been forced out of the military with less-than-honorable discharges. Congress has recognized in recent years that some of these discharges were the fault of dysfunctional screening for PTSD and other combat injuries, and it has put safeguards in place to prevent more — including requirements for mental health professionals to review all discharges. In recent years, less than honorable discharges have dropped drastically; and today, troops with PTSD are more likely to be medically discharged with benefits. But that has done little to help those like Mr. Goldsmith who were discharged before the changes. Now, Mr. Goldsmith and a small group of veterans are pushing for a bill in Congress that would overhaul the system by mandating that the military give veterans the benefit of the doubt, requiring the boards to decide cases starting from the presumption that PTSD materially contributed to the discharges. “We put out an unprecedented number of troops for minor infractions, and I believe a lot of them were suffering from PTSD,” said Representative Mike Coffman, a Colorado Republican and Iraq veteran. Mr. Coffman said he planned to introduce legislation this month that would shift the burden of proof about PTSD from veterans to the military. Congress created military review boards after World War II to correct wartime missteps, but observers say this has rarely happened in recent years. In 2013, the Army Board for Correction of Military Records, the supreme authority in the Army’s review agency, ruled against veterans in about 96 percent of PTSD-related cases, according to an analysis done by Yale Law School’s Veterans Legal Services Clinic. … In an attempt at a solution in 2014, the secretary of defense at the time, Chuck Hagel, instructed the boards to give “liberal consideration” to all veterans seeking an upgrade of their discharge because of PTSD. Since then, rulings in favor of veterans at the Army Board for Correction of Military Records have surged to 45 percent from 4 percent, according to records. But veterans say a more lasting remedy is needed. They point out that Mr. Hagel’s order could easily be reversed by the next president, and it does little to address the boards’ underlying problems. … Many veterans say they feel the boards give little credence to the medical evidence presented to them. Two months after he left the Army, Mr. Goldsmith was told he had PTSD at a Department of Veterans Affairs hospital. But denial letters from the Army Review Boards Agency said it was unclear whether the PTSD stemmed from his service in the military. … Veterans with less-than-honorable discharges lose education benefits, preferential hiring and tax breaks, and they can be barred from the veterans’ heath care system. They can also face a lifelong stigma.
Study: Military falls short in treating new cases of war-related stress (USA Today)
The U.S. military is struggling to provide adequate therapy sessions for thousands of active-duty troops suffering from post-traumatic stress disorder and depression, a massive study released Thursday concludes. The RAND Corp. study of 40,000 cases, the largest ever, found that only a third of troops with PTSD and less than a quarter who are clinically depressed receive the minimum number of therapy sessions after being diagnosed. A RAND review of U.S. military and Department of Veterans Affairs treatment guidelines concluded that troops diagnosed with PTSD should receive at least four therapy sessions within eight weeks or at least two sessions to manage newly prescribed medications. The good news in the study: vast improvement in how the Army and other service branches follow up with inpatient cases of PTSD after servicemembers are released from mental hospital care, a crucial period when many suicides occur. “We just don’t have enough mental health professionals to meet the demand,” said Brad Carson, acting principal deputy undersecretary of defense for personnel and readiness. He said the military will turn increasingly to civilian therapists available through Pentagon contracts. Carson also plans to examine the RAND findings “to see ways that we can improve.” Since 2009, the military has increased mental health professionals on staff by 42% to 9,295. The study examined treatment for a year following diagnoses in 2012. There were 8,286 diagnosed with PTSD, 24,251 with depression and 6,290 suffering from both illnesses. RAND described the study as the largest independent examination of mental health treatment in the military. Army research found that one of the most vulnerable periods for suicide by soldiers is during the year after being released from hospital care. The suicide rate for soldiers in this group was 264 per 100,000, far outpacing the national suicide rate of 13 per 100,000 people. The RAND study shows the military has become more aggressive in treating servicemembers after they are released from in-patient psychiatric care. About 86% of those with PTSD or depression had a follow-up session with a mental health specialist within seven days after being discharged, and the rate jumped to more than 95% for seeing a therapist within 30 days, according to the study. … The RAND study cited a 2014 internal Army medical command memorandum emphasizing the need to see soldiers within 72 hours of being discharged from a hospital. It urges commanders to require a soldier to attend a session if one is missed. It also says no one will be discharged during a weekend or holiday to avoid losing track of follow-up care. About 2.6 million U.S. servicemembers served in Iraq or Afghanistan from 2001 through 2014. Rates of PTSD among these troops ranged from 4% to 20%, with depression rates ranging from 5% to 37%, depending on the study. RAND researchers found that the Pentagon could improve how rapidly doctors review the progress of a servicemember who was placed on medication after being diagnosed with PTSD or depression. Only 45% of those with PTSD and 42% of those with depression had their medication progress reviewed within 30 days after diagnosis, which is a proper standard, according to the RAND study. About 70% of those studied were in the Army, more than 90% of those who had PTSD had been deployed and the average deployment was 20 months. The average profile of a patient in the military with PTSD or depression was a soldier 34 years old or younger, white and married.
Jeb Bush lays out veterans reform plan (Breitbart News Daily)
Former Florida Gov. Jeb Bush told Breitbart News Daily on Friday morning that he believes the government needs to start “firing people” at the Department of Veterans Affairs who have screwed over veterans seeking healthcare. In the interview Bush laid out how his extraordinarily detailed plan for VA reform and his plans for helping veterans find jobs. “The first detailed policy plan we laid out was how to reform the Veterans Administration. We need to enhance the career civil service reforms that Congress has passed and that the president hasn’t implemented,” Bush said in the interview, conducted aboard his campaign bus after a town hall here on Thursday evening. “We should be firing people that have shown just sheer incompetence, no accountability. We need to lower, lessen some of the layers of the bureaucracy and hire more doctors and nurses and clinicians. The only thing that really matters is to have better care. We need to eliminate the performance bonus system that was manipulated and fire people that were part of lowering waiting lists without giving veterans care. We need to get veterans choice cards that allow them to see their own doctors should they so desire or their own private clinic in their own neighborhood or their own regional hospital. That will improve the quality of care for the Veterans Administration.” When it comes to building Department of Veterans Affairs hospitals, Bush said, it’s time for the Army Corps of Engineers to take over from government bureaucrats who have failed to deliver. “We need to get the Army Corps into the business of building whatever needs to be built,” Bush said. “The Veterans Administration has just shown sheer incompetence. There was a hospital in Aurora, Colorado, you may have heard of it that was started out at a $300 million budget—that’s pretty big—but it’s at a $1.8 billion right now. They can’t organize themselves out of a wet paper bag inside the Department.” Bush also detailed how he wants to have various other reforms at the VA, including how contracts are doled out and in how the VA treats various special areas like PTSD and women’s health matters. “We need procurement reform, information technology reform, there needs to be centers of excellence inside the Department of Veterans Affairs including post-traumatic stress,” Bush said. “There should be world class research and care provided for veterans coming home who have those challenges. There needs to be greater enhancement of women’s health issues because we have a larger number of women veterans coming home and they typically have not been in the same numbers as they were—now they’re in bigger numbers than they were in the Vietnam Era.” Bush told Breitbart News Daily, too, that he believes there needs to be better policies for helping veterans find jobs—including allowing their skills in the military to be easily transferred to the workplace, and long-term planning that begins while they are still on active duty. “I think we should begin to identify people in the military who are leaving six months prior to create a customized plan for them where we know where they’re going to go, where we allow for reciprocity for all of the licenses that they’ve earned in the military—if you’re a truck driver, you shouldn’t have to go to get a license for truck driving,” Bush said. “If you’ve done it in the military, it ought to be good for the people of South Carolina or Florida—eliminate all these protectionist tendencies that states have. If you’re a teacher, a mechanic, an electrician, a plumber, all the things that people in the military learn, there should be total reciprocity. If you did that, you should be able to make sure veterans didn’t fall through the cracks and that they would be given a first shot at getting jobs. The stability that would come from a job also would help them with their healthcare needs.” Bush also took a swipe at frontrunner Donald Trump, saying he’s thought through these issues and has a plan and strategy not even close to the level of which Trump has put together. Bush noted, too, that he put the plan together by listening to actual veterans talk about their concerns.
Bernie Sanders’ Senate work at the heart of VA’s latest woes (Military Times)
One major reason the Veterans Affairs Department can’t fire troublesome employees: Bernie Sanders. The Obama administration is moving to undo the Democratic presidential candidate’s past work as Senate Veterans’ Affairs Committee chairman in an effort to clean up the department, considering a change in employment rules for VA executives that Sanders fought for vigorously just two years ago. In recent weeks, the VA has seen a host of job actions against senior employees overturned by the Merit Systems Protection Board, an independent, “quasi-judicial” agency that serves as arbiter on a number of federal worker cases. They include the demotion of two VA executives accused of gaming the department’s hiring system for personal benefit, and the dismissal of a New York VA director over patient safety concerns. The appeals fight has grown into an escalating intra-administration showdown between VA leaders, who call the decisions off-base, and protection board officials, who blame bad legislative changes for the unsatisfactory rulings. Republican lawmakers had hoped to skip any appeals board when they reworked VA employment rules for senior executives two years ago, in the wake of the national patient wait-times scandal that forced the resignation of several top department leaders. But Sanders — the independent Vermont senator who at the time was chairman of the Senate Veterans’ Affairs Committee — insisted on preserving the protection board’s appeals role, and held up reform legislation in his chamber until it was included. For union officials, it was a small safety net in what they saw as an overly aggressive attack on their members. For VA critics, it was a poison pill that has prevented real accountability within the department for the last two years. “I felt it was important that we go in and give the [VA] secretary the ability to quickly discipline individuals,” said House Veterans’ Affairs Committee Chairman Jeff Miller, R-Fla. “Sen. Sanders felt like there needed to be an appeals process. … I have more faith in the secretary than I do the MSPB.” Sanders’ campaign did not respond to requests seeking comment on the disciplinary issues, but he has made the 2014 legislation one of the centerpieces of his platform. He lead the Senate’s veterans committee from 2013 to 2015, and touted his work repeatedly as proof he can negotiate with Republicans and reach critical compromises to help constituents. The 2014 reform legislation in particular, he said “increases accountability within the VA and ensures that all veterans have access to timely health care.” But VA officials have sparred with lawmakers over the access issues — a $15 billion Choice Card program, which Sanders reluctantly backed — and appear to be taking aim at the accountability reforms as well. In testimony before Congress earlier this month, VA Secretary Bob McDonald indicated he’s looking to do away with the appeals process for senior executives, moving to a firing process closer to what Miller and other Republicans had originally backed. … That’s a dramatic change for the department, which opposed similar disciplinary policies proposed for the entire VA workforce last spring. And it has sparked a furious response from officials with the Senior Executives Association, which represents the federal workers at the heart of the fight. … The senator took criticism from numerous veterans groups for being too positive about the department’s work at a time when he was leading a committee charged with oversight of VA’s failings. Earlier this month, at a New Hampshire town hall event, Sanders acknowledged that “we should have acted sooner” on reports of wait-time problems and expressed regret that he didn’t have a quicker solution for “those long waiting lines and the lies that some administrators were telling us.”
Dr. Ben Carson makes pitch to veterans (Fox57)
Dr. Ben Carson made his way through the Capital city, Wednesday. The Republican candidate stopped at the Ramada Inn in Columbia to speak at a roundtable discussion about veteran issues. Carson said the country needs to put more effort into supporting veterans, especially when it comes to mental illness, like Post Dramatic Stress Disorder. “They should all have health empowerment accounts and it should allow them to go to any health care facility where we should be delighted to take care of them,” Carson said. He told the crowd that the government is misusing money and needs to invest more into important issues like taking care of veterans. “If we didn’t have veterans we would not be free,” Dr. Carson said, “We live in a very dangerous and violent world, we’re not going to be here very long if we don’t get the military right.” Carson noted every enlistee should be provided a support group to help them from the time they join the military and after. Wounded veterans like James Sutherland showed up at the roundtable and said he supports Carson’s mission to help improve veteran’s health. Sutherland emphasized his military benefits aren’t enough to support his family. “I’ve actually had to put my house up for sale, it should be closing with the buyer in about two weeks because I just couldn’t keep up with the payments anymore,” he said. Sutherland urges other veterans to look into what candidates plan to do to assist veterans.
Gov. Malloy says Connecticut is second state to end veteran homelessness (WNPR)
On Thursday, Governor Dannel Malloy said Connecticut has ended veteran homelessness in the state. Speaking on WNPR’s Where We Live, Malloy said the federal Housing and Urban Development Secretary notified him February 17 that the state had met this goal. He credited community partners and the Connecticut Housing department which Malloy said didn’t exist before he took office. “We signed on in 2014 that we would end homelessness among veterans by the end of last year and we did it,” Malloy said. In 2014, advocates estimated there were 500 homeless veterans living in the state. The governor said statewide coordination and additional resources have helped Connecticut solve the problem of homelessness among this population. “We’ve committed $1 billion to get housing built, including many, many affordable units. Eleven thousand committed to last year alone; over 16,000 committed to in the last few years; these units are coming online,” Malloy said. Lisa Tepper Bates, Executive Director of the Connecticut Coalition to End Homelessness, said this announcement doesn’t mean the state will never see another homeless veteran. “But we will have built a system whereby we can meet their needs, we can get them out of homelessness and back to housing very quickly,” she said. Connecticut is the second state to meet the federal definition of what it means to end veteran homelessness. Virginia was the first. The designation comes after an extensive review by the Interagency Council on Homelessness, the U.S. Department of Housing and Urban Development, and the U.S. Department of Veteran’s Affairs. Last August, Connecticut was the first state in the nation certified by federal officials as having eliminated chronic homelessness among disabled veterans who have been homeless for a period of at least one year or have had three or more episodes of homelessness that total one year.
Michigan veterans home didn’t check patients, probe complaints (Military Times)
Workers at a Michigan veterans home falsely claimed they were checking on patients after being alerted of possible falls, failed to properly investigate allegations of abuse and neglect, and took too long to fill prescriptions, the state auditor said Thursday. The 415-bed Grand Rapids Home for Veterans, one of two state-run nursing homes for veterans, provided insufficient care and continued with inadequate staffing levels even as the state filed four complaints over a 1 ½-year period against the contractor hired to supply nursing aides, according to the audit. The report flagged a host of problems and issued five “material” findings — the most serious that can be levied. Auditors looked at third-shift surveillance video to show that only about a half of required room checks and one-third of fall-alarm checks were done, even though the home produced documentation that the checks occurred. The audit found that of 38 abuse or neglect complaints made over a 23-month period, nine were not forwarded to the nursing director and stayed with managers of departments against which the complaints were lodged — a violation of policy. About one-third of prescriptions were filled late, and problems also were flagged with tracking medication inventories and insurance billing. The audit was made public by the Michigan Veterans Affairs Agency on Thursday, a day before its scheduled release by Auditor General Doug Ringler, after outraged lawmakers began issuing statements and promising oversight hearings. Sen. David Knezek, a Dearborn Heights Democrat and a Marine Corps veteran, said he was “devastated” by the auditor’s conclusions. “We owe our veterans and their families a debt of gratitude — not a legacy of heartbreak and mismanaged care,” he said. The agency agreed with the findings and said it is making changes to comply with recommendations and bring the home in line with industry best practices. “There is room for improvement. We have placed our focus on improving the quality of care,” Veterans Affairs Director Jeff Barnes told The Associated Press in a phone interview. In the fall, he appointed Leslie Shanlian, a nursing home administrator, as chief executive officer of the new Michigan Veteran Health System to coordinate operations in Grand Rapids and at the D.J. Jacobetti Home for Veterans in Marquette. An electronic medical records system should be ready within months, he said, and an automated dispensing system will help better control and oversee medications. The home will discontinue the use of fall-alarm sensors in beds and wheelchairs after reviewing research indicating that the pressure-sensitive devices can increase rates of falling and limit mobility. Shanlian said inspectors are spot-checking surveillance video now to see if the proper checks have been done, and workers have been warned that they could be fired for falsifying records. In his budget presentation last week, Gov. Rick Snyder proposed $8 million to pursue certification from the federal Centers for Medicare and Medicaid Services — which would qualify the state for more health care funding and bring additional inspections. It includes $6.1 million to remodel a floor at the Grand Rapids home. … Rep. Holly Hughes, a Montague Republican, promised to “get to the bottom of this and demand accountability from the people responsible, whether that be further inquiry, reprimands or job termination.” The audit said the company that supplies about 150 nursing aides, J2S Group-HealthForce in Grand Rapids, filed a complaint against the state after the state complained for a fourth time in October about the firm not meeting required staffing. Barnes said Thursday the Michigan attorney general’s office and company lawyers are close to finishing a contract change, including a potential pay-for-performance bonus incentive each time staff levels are at 100 percent for 30 consecutive days.
Program helps returning veterans in facing adjustment problems (Independent Mail)
A mental health group is pioneering, in the Upstate, a program for the families of veterans who are readjusting to civilian life. Michelle Ready of the National Alliance on Mental Illness is one of only four trained Homefront teachers in the nation. Ready, a Seneca resident, said the NAMI Homefront class is a free, six-session class for the family, friends and significant others of military service members experiencing problems. The class focuses on post-traumatic stress disorder, anxiety and depression and is taught by teachers with a military background. The class is not for the veterans, but for their family members, Ready said. “Being in an environment where your life is endangered one minute and then being thrust back into civilian life is traumatic for many ex-military,” Ready said. She saw the need to assist the military community and helped develop the Homefront course, which is now being taught across the country. Sometimes those in the military community are afraid to come forward when they experience mental health conditions for fear of losing their rank, job or security clearance, Ready said. Sometimes veterans feel they are weak or have a character flaw when they have problems. As a result, mental health professionals say, thousands of service member families suffer in silence. Some veterans not receiving help commit suicide. “We are losing 18 to 20 active duty service members and veterans to suicide each day,” Ready said. The mother of one veteran, who did not wish to be identified said, “You cannot help someone with mental health problems until you take care of yourself first.” “I realized I saw signs and symptoms of PTSD but did not know how to handle it. After taking the course I know better how to handle situations,” said the spouse of another veteran. The Homefront online classes are scheduled for Feb. 25 through March 31 from 6 p.m. until 8 p.m. and Feb. 29 through April 4 at the same times. Participants must register for the class at http://bit.ly/1mtOcGX and have access to a computer. Class space is limited. For more information, contact Ready at firstname.lastname@example.org or 864-882-5131.
VA prepares for hackathons focused on PTSD, brain injuries (FierceGovernment IT)
This weekend the Veterans Affairs Department will host coordinated hackathons in both San Francisco and Austin. It hopes to draw on the tech communities in both cities for developer talent, as well as bring together clinicians, veterans, caregivers and the public to guide technology innovation. Both hackathons will focus on technology that will improve access, diagnostics, rehabilitation and community reintegration for veterans experiencing mild Traumatic Brain Injury and Post-Traumatic Stress Disorder, said the VA in an emailed announcement. A panel comprised of VA officials, mTBI and PTSD experts, veterans and caregivers will select up to three winners in each city who may be asked to present in April at the Brain Trust Innovation Showcase in Washington, D.C., said the department. During the kickoff Feb. 20, there will be speakers and participant pitches, then participants will be asked to form their teams and develop ideas. Feb. 21 will be a last day sprint to complete prototypes and present to judges. Winners will be selected that day.
Mortgages for vets using VA loan program surges to 21-year best (The Mortgage Reports)
The VA mortgage program is increasing in popularity. In the Department of Veterans Affairs 2015 fiscal year, ultra-low VA mortgage rates combined with the program’s common-sense underwriting to push VA mortgage lending to levels not seen since 1994. The VA guaranteed more than 631,000 home loans in the most recent fiscal year, a 19 percent surge from the year prior. Furthermore, use of the VA’s in-house refinance program — a speedy program known as the VA Streamline Refinance — more than doubled over the same period of time. Today’s military borrowers are taking advantage of the VA Home Loan Guaranty program for what it is — a cost-effective, sound way to purchase or refinance a home. … VA loans are loans guaranteed by the Department of Veterans Affairs, and made possible via the G.I. Bill of 1944. The program, for which the official name is the VA Home Loan Guaranty program, can be used by veterans of the Armed Services and National Guard and Reserves, and active-duty members of the U.S. military. Structurally, the VA loan is similar to other loan types such as the FHA loan, conventional loan, and USDA loan. You borrow money from the bank to purchase or refinance a home, and then you make monthly mortgage payments until the borrowed amount has been satisfied. However, because of how the Department of Veterans Affairs supports its flagship home loan program, borrowers using VA mortgages benefit in ways that other borrowers using other program don’t. As one example, VA loans are “no money down” mortgages, which means that you can buy a home using a VA loan without having to make a down payment. FHA loans and conventional mortgages require 3.5 percent and three percent down payments, respectively, at minimum. As another borrower benefit, VA loans never require mortgage insurance. No matter how large or how small your down payment, when you’re using a VA loan, mortgage insurance is waived. There is no other government-backed program which will allow the same. And, VA mortgage rates tend to be lower than rates for other common loan types. According to Ellie Mae, whose mortgage origination software handles more than 3.7 million mortgage applications annually, borrowers using VA home loans get access to mortgage rates which can be 40 basis points (0.40%) or more below the rates of a comparable 30-year fixed-rate conventional loan. Even if you’re putting 20 percent down on a home, then, using a VA mortgage can be smarter than going with a conventional one.
NY creates mobile app for veterans to access services (The Washington Times)
There’s a new mobile app designed to help New York’s veterans access state and federal services. Gov. Andrew Cuomo announced the creation of the application Thursday. It’s compatible with Apple and Android products and has help for veterans looking for information on health care, jobs and benefits. The program also locates the closest state veterans’ affairs office. Cuomo says the app is an example of how technology can be used to improve the delivery of state services and programs. The program was developed by the state’s Division of Veterans’ Affairs. Other apps created by the state include ones that help the public learn about state parks and fishing and hunting programs, check train times or even report suspected terrorism.