February 9 Veterans News

February 9 Veterans News

VetsHQ News UpdateVeterans Affairs again denies Agent Orange benefits to Navy vets (The Virginian Pilot) The U.S. Department of Veterans Affairs has once again turned down an effort by Navy veterans to get compensation for possible exposure to Agent Orange during the Vietnam War. In a document released Friday, the VA said it would continue to limit benefits related to Agent Orange exposure to only those veterans who set foot in Vietnam, where the herbicide was sprayed, and to those who were on boats in inland rivers. The VA compensates these veterans for a litany of associated illnesses, including diabetes, various cancers, Parkinson’s disease, peripheral neuropathy and a type of heart disease. Advocates for some 90,000 so-called Blue Water Navy veterans who served off the coast of Vietnam have been asking the VA for more than a decade to broaden the policy to include them. They say they were exposed to Agent Orange because their ships sucked in potentially contaminated water and distilled it for showering, drinking, laundry and cooking. Experts have said the distillation process could have actually concentrated the Agent Orange, which contained the toxic chemical dioxin and was used to kill vegetation and deny enemy cover. The U.S. Court of Appeals for Veterans Claims last April struck down VA rules that denied compensation for sailors whose ships docked at certain harbors in South Vietnam, including Da Nang. Those ports, the court determined, may have been in the Agent Orange spraying area. The court ordered the VA to review its policy. On Friday, the VA largely stood by its policy and again asserted that there’s no scientific justification or legal requirement for covering veterans who served off the coast. “Environmental health experts in VA’s Veterans Health Administration have reviewed the available scientific information and concluded that it is not sufficient to support a presumption that Blue Water Navy Veterans were exposed to Agent Orange,” the VA said in a fact sheet. U.S. Sen. Richard Blumenthal, D-Conn., the ranking member of the Senate Veterans’ Affairs Committee, criticized the VA’s decision. “Rather than siding with veterans, VA is doubling down on an irrational and inconsistent policy,” he said in a statement. “Veterans who served offshore and in the harbors of Vietnam were exposed and deserve the presumption of service connection for Agent Orange-related diseases.” Blumenthal and others are seeking adoption of the Blue Water Navy Vietnam Veterans Act, which would ensure that all vets exposed to Agent Orange are compensated. The VA opposes the legislation, as it has several previous iterations dating back to 2008. The VA’s new review relied on a 2011 report by the Institute of Medicine, as well as other published research, according to the agency’s fact sheet. The Institute of Medicine report said there was no way to prove Blue Water vets were exposed to the chemicals, but it identified plausible routes that Agent Orange could have traveled out to sea and into a ship’s distillation system. Although military policy at the time recommended against distilling water closer than 10 miles to shore – where the chemical concentration would have been highest – veterans said doing so was often unavoidable. The VA said it is working with veterans groups to “initiate a groundbreaking study of Blue Water Navy Veterans health outcomes. We hope to have data gathered and analyses published in 2017.” … John Wells, a Louisiana lawyer who has spent more than a decade advocating for Blue Water veterans, said his group would continue challenging the VA. “It wasn’t completely unexpected. We’re used to being betrayed by the VA,” Wells said. “We’re going to fight this thing until we’re done or dead.”

Learn more about the VA Blue Water Vet policy changes.

Learn more about Agent Orange and herbicide exposure.

Obama proposes 5 percent hike in VA budget (Stars and Stripes)
The discretionary budget for the embattled Department of Veterans Affairs would rise by about 5 percent under President Barack Obama’s proposed 2017 budget, which includes spending increases to improve the much-criticized claim appeals process and using some funds aimed at giving veterans access to outside care to pay for VA staffing and infrastructure. The proposed $182-billion budget includes $102.5 billion in advance appropriations for VA’s mandatory benefit programs. The rest of the proposal is about $75.2 billion, not including about $3.6 billion in medical care collections. VA is the second-largest department in the federal government, serving roughly 9 million veterans through benefits and a nationwide medical system. The budget must be approved by Congress, and the House Committee on Veterans Affairs will hold its first hearing on the proposal Wednesday. Lawmakers are likely to scrutinize additional spending at the scandal-plagued department. Included in the budget is an additional $46.2 million to improve the system for veterans to appeal denials of claims. As the VA has reduced its massive backlog of initial claims, the backlog in appeals has risen, leaving many veterans waiting years for a final decision. The proposed budget increase would include an additional 242 full-time employees to deal with appeals. One proposal that is likely to be controversial is using $969 million to improve VA staffing and infrastructure. The money was earmarked for the Veterans Choice Act — a program aimed at giving veterans a chance to seek outside medical help when the VA fails to provide timely care. The VA has been mired in scandal for nearly two years after the revelation of patients in Phoenix languishing on secret wait lists for years, some of whom died before receiving treatment. The scandal spread across the country, showing a toxic leadership culture at the VA, eventually costing then-VA Secretary Eric Shinseki his job. VA officials continue to face criticism from Congress and veterans, most recently for a series of appeals board decisions that overturned proposed punishments for department executives accused of wrongdoing. The decisions have led Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans Affairs, to call for an overhaul of the entire federal employee disciplinary system.

Proposal cuts dependent children’s GI Bill housing stipend in half (Military Times)
Military dependent children using transferred Post-9/11 GI Bill benefits would see their housing stipends cut in half under legislation being considered Tuesday by the House of Representatives. That stipend is one of the most valuable parts of the Post-9/11 GI Bill, calculated in most cases based on the Basic Allowance for Housing, or BAH, that active-duty service members would receive if stationed where the school is located. Depending on where and how GI Bill users attend class, it can put as much money in their pockets for housing costs as it puts in university coffers for tuition costs. Iraq and Afghanistan Veterans of America has expressed strong opposition to the proposal, which is included in a bill that also has other provisions on veterans education, health care, jobs and transition out of the military. In letters to the leaders of veterans committees in both the House and Senate, dated Feb. 5, IAVA Chief Policy Officer Matt Miller asked the lawmakers to “stand with our members in opposing any cuts to, or reduction of benefits in, the Post-9/11 GI Bill now or in the future.” A spokesman for the House Veterans’ Affairs Committee said the cuts were necessary to offset, or pay for, other aspects of the bill. He also noted that the cuts were “scaled back” from a recommendation from the Military Compensation and Retirement Modernization Commission to entirely cut the housing stipend for both dependent spouses and children. “A very small handful of Democrats on the committee objected to the bill’s offset, and the committee tried to address their concerns. But since the members in question offered no suggestions for replacing the offset, we are moving forward with the bill in its current form,” the spokesman said in a statement. The measure would not affect the stipends of veterans using Post-9/11 GI Bill benefits they earned themselves. Children who have already been transferred benefits — or who receive transferred benefits within 180 days of the bill going into law — would be exempt from the cuts, the spokesman said. Also included in the bill is a provision restricting the use of the Post-9/11 GI Bill for flight training, which has generated additional opposition. Chris Neiweem, a lobbyist who worked previously for IAVA and now represents an aviation school, said the restriction would not be necessary with proper cost control measures from the Veterans Affairs Department. “This would be a fairly significant rollback of the GI Bill benefit,” said Neiweem, vice president of the firm SRB Strategic. The House Veterans’ Affairs Committee spokesman said that characterizing the restriction as a rollback “is completely ludicrous,” adding that the GI Bill’s coverage of flight training costs without the cap on tuition costs that apply to other education programs has been a costly loophole. He quoted a previous statement by Rep. Jeff Miller, the Florida Republican who chairs the committee: “The GI Bill flight school loophole is so big you could fly a 747 through it. For years, some schools have exploited this loophole, gouging taxpayers with exorbitant tuition expenses of up to more than $500,000 for a single student.” The bill, HR 3016, is already through the House Veterans’ Affairs Committee and is expected to come up for a vote Tuesday in the full House.

Aviation groups oppose bill limiting flight training for veterans (AOPA)
AOPA and six other general aviation groups sent a joint letter to House leaders opposing legislation that would make it harder for veterans to pursue aviation careers. The Veterans Employment, Education, and Healthcare Improvement Act (H.R. 3016) would cap flight training tuition and fee benefits at $20,235, a move the Feb. 9 letter warns will “cause immediate and alarming changes to collegiate flight-training degree benefits for our nation’s military veterans.” “There are great jobs in aviation and our nation’s veterans have earned a right to pursue those opportunities,” said Jim Coon, AOPA senior vice president of government affairs. “By capping flight training benefits, this legislation would effectively put flying careers out of reach for many vets.” Without a sizeable, out-of-pocket investment, “a veteran would be unable to attain an aeronautical college degree with a commercial pilot license,” the groups wrote. The letter also acknowledged “abuses” at a small number of flight schools affiliated with collegiate degree programs but urged lawmakers not to let those issues limit access to flight training for veterans. “We wholeheartedly agree with the goal to strike a balance and control excessive costs,” the letter said. “However, capping education and training for pilots will harm veterans and limit their employment opportunities in the aviation industry.” The bill was placed on the “suspension calendar,” which is normally reserved for noncontroversial legislation—a move that some industry observers claim was designed to push the measure through the House without sufficient discussion. Debate on bills on the suspension calendar is limited to 40 minutes. In addition to AOPA, the letter opposing H.R. 3016 was signed by the Experimental Aircraft Association, General Aviation Manufacturers Association, Helicopter Association International, National Air Transportation Association, National Association of State Aviation Officials, and National Business Aviation Association. Last year, AOPA and other aviation groups spoke out numerous times to protect flight training benefits for veterans.

Blumenthal, others back bill that aims to stem suicides of women veterans (New Haven Register)
A study showing that women veterans commit suicide at six times the rate of civilian women has prompted U.S. Sen. Richard Blumenthal and colleagues to propose legislation requiring the VA to develop gender-specific suicide prevention programs. The “Female Veterans Suicide Prevention Act” would expand the Department of Veterans Affairs’ annual evaluation of mental health and suicide-prevention programs to include data specific to female veterans. The act also would require the VA to determine which programs are the most effective for female veterans. “With suicide among women veterans happening at an alarming rate, (the proposed bill) will help save lives by ensuring VA is providing the care, counseling and outreach these veterans need,” said Blumenthal, D-Conn. Co-sponsors include Sens. Barbara Boxer, D-California; Joni Ernst, R-Iowa; and Sherrod Brown, D-Ohio. In the recent study, VA researchers tracked more than 173,000 veteran and non-veteran suicides in 23 states from 2000 to 2010, to compare suicide rates among different subgroups. They found the overall rate of veteran suicides increased by about 25 percent over that 10-year period, while the non-veteran rate increased by 12 percent. Of note, while the suicide rate for female non-veterans rose 13 percent, it climbed 40 percent for female veterans. In addition, the suicide rate for women veterans in 2010 was 34.6 per 100,000 – six times the rate (5.4) among women civilians. The difference in rates among men was smaller – 36 per 100,000 for veterans, compared to 21.4 for non-veterans. The VA researchers said there were a number of possible factors for the higher suicide rates among veterans than civilians, including a higher incidence of adverse childhood experiences, injuries such as traumatic brain injury, and military sexual trauma among women. The higher disparity in suicide rates between women veterans and non-veterans suggests “possible gender-based differences in the effectiveness of VA suicide prevention initiatives,” they said. “These results further support continued efforts to better understand health disparities, including suicide, among women veterans, (as well as) the most effective clinical and public health strategies to prevent suicide among this fastest-growing subgroup.” The study also found that VA health programs seemed to help men more than women. Overall, veterans who utilized such programs were less likely to commit suicide than those who didn’t. But while the suicide risk among VA-enrolled men decreased over 10 years, there was “no meaningful change” among women veterans over time. There are more than two million women veterans in the U.S., making them the fastest-growing population of veterans treated by the VA. While the VA has made strides to improve mental health and suicide prevention programs aimed at women, there is no gender-specific data available on the efficacy of these programs.

Trump campaign promised money to veterans group for appearance (CBS News)
Donald Trump’s presidential campaign offered to present a veterans charity with a six-figure check last week if they appeared on stage at a New Hampshire campaign rally, the vets group confirmed to CBS News. Liberty House executive director Keith Howard told CBS that Trump’s campaign called him Friday asking if he would appear at a Londonderry, New Hampshire rally on Monday — just one day before state residents are scheduled to vote in the nation’s first primary contest. The GOP front-runner, Howard was told, would hand over a six-figure check to the charity on the event stage. Despite the campaign’s attempts — first reported by The Daily Beast — to cajole Liberty House into appearing at Trump’s rally, Howard ultimately declined to appear. “I’ll be goddamned if I, in any way, support a political candidate or make a campaign appearance with any candidates,” Howard said in an interview with The Daily Beast. “We stand for doing the right thing.” Howard told CBS later that he feared Liberty House — a Manchester-based nonprofit that provides housing services to American veterans transitioning from homelessness — could be put in legal jeopardy over such a public endorsement of a presidential campaign. The head of the veterans charity said he consulted with the New Hampshire Attorney General office and was advised that making a campaign appearance could endanger the group’s nonprofit status. The Trump campaign did not immediately respond to a request for comment. Liberty House was one of the organizations Trump promised to fund last month after the candidate held a benefit in lieu of attending a Fox News-hosted GOP primary debate in Iowa. The Donald J. Trump Foundation, the nonprofit arm of Trump’s business empire, said it raised $6 million that night, with the candidate himself donating one million dollars. The organization later promised to disburse the funds to 22 different veterans charity groups. Of the Trump campaign and his foundation, Howard noted that the “line seems to be non-existent.” Still, Liberty House will be accepting the promised cash — in a decidedly less flashy, public way. Trump’s campaign eventually decided instead to present the check to New Hampshire State Rep. Al Baldasaro, a Trump supporter and a military vet, at Trump’s rally Monday afternoon. At a later time, Baldasaro will then pass on the funds to Howard and Liberty House on behalf of the Trump Foundation.

VA’s fate becoming heated debate in presidential primaries (Government Health IT)
What to do about the Veterans Administration has become one of the more visible issues for the presidential candidates continue their primary seasion. For the Democrats, Hillary Clinton and Bernie Sanders denounced the idea of privatizing the agency in their debate Thursday in New Hampshire, and The New York Times devoted a front page story to Sanders’ role in passage of a bipartisan bill to try to fix the veterans’ health care waiting list. The Republicans, for their part, want to dismantle parts or all of the VA and offer a variety of private sector alternatives. “I am absolutely against privatizing the V.A. and I’m going to do everything in my power to build on the reforms Sen. Sanders and others in Congress have passed to fix what is wrong with the V.A.,” Clinton said during the debate. “There are a lot of issues about wait time and services that need to be fixed because our veterans deserve nothing but the best.” Sanders said that in 2014, as chairman of the Senate Veterans Affairs Committee, his first version of the veterans bill was rejected with only two Republicans in favor. “The Republicans talk a good game about veterans but when the money was on the line to protect our veterans, frankly they were not there,” he said. “What I did next was I had to retreat a little. I had to compromise. I worked with John McCain and with Jeff Miller in the House and we put together probably the most comprehensive veterans’ health care bill in the modern history of the country.” The Times story, “Faith in Agency Clouded Bernie Sanders’s V.A. Response,” said Sanders at first was slow to push for a bill to overhaul the agency, but when he realized the agency’s issues, he moved forward. “Mr. Sanders eventually changed course, becoming critical of the agency and ultimately joining with Senator John McCain, the Arizona Republican, and other colleagues to draft a bipartisan bill to try to fix the veterans’ health care waiting list,” the story said. Republicans plan to offer a variety of private services for veterans. On Saturday, Jeb Bush, John Kasich and Marco Rubio each praised veterans, saying that returning soldiers should be able to go to any hospital or doctor to get medical treatment, the Associated Press reported. The three candidates believe that vets should have a range of healthcare choices. Bush called for overhauling the VA earlier. “The entire system needs to be simplified, reformed and refocused on its most important mission–to ‘care for those who shall have borne the battle,'” Bush wrote. Likewise, Sen. Ted Cruz earlier said veterans should have a choice of where to seek medical treatment.

Veteran stuck with giant bill that VA won’t pay (WOWT)
An elderly Fremont veteran claims Omaha’s VA Health System admitted to misdiagnosing him with a serious heart condition which led to unnecessary and expensive treatment. That veteran tells WOWT 6 News he’s now stuck with the bill. Larry Brown contacted Six On Your Side to help him make sense of a growing stack of medical bills; bills Omaha’s VA Health System refuses to pay even though Brown, who is 72 years old, is a Navy veteran who served in Vietnam and Japan. “I don’t think I let people down when I was serving. And I don’t expect the VA to let me down either, but I feel like they have,” said Brown. In 2014, Brown’s VA doctors diagnosed him with atrial fibrillation, an irregular heart beat which can lead to blood clots, strokes, and heart failure. He was put on blood thinners to reduce his risk. Then, late last year, Brown checked himself into his local emergency room. “I just didn’t feel right,” he told WOWT. Brown didn’t know it at the time, but he was bleeding internally. Brown’s local ER doctors called doctors at the Omaha VA to arrange a transfer, but the VA didn’t have enough beds. Brown was sent by ambulance to Nebraska Medicine and stayed several days of treatment. He said he racked up a $15,000 bill. Shortly after he was discharged, Brown got a phone call from the VA asking him to attend a meeting with his VA doctors. “They had made an error with my heart monitor results. They had confused them with another patient,” said Brown. This meant he was misdiagnosed in 2014 for atrial fibrillation and those blood thinners he was prescribed could be the cause of his internal bleeding. That bleeding which led to a giant medical bill that the VA won’t pay. Brown says the VA told him it can’t pay the bill because Medicare is supposed to do it. He told WOWT 6 News he thinks it’s their responsibility. He said, “I feel the VA hospital was at fault and it should be their responsibility to cover that.” Brown also said this incident has forever changed the way he thinks about the VA Health Care system. “Now my trust and confidence level is down to about zero. I don’t believe the doctors anymore. It’s just taken away the trust that I had,” said Brown. WOWT contacted the Omaha VA about Brown’s story, and in a statement, they said: “VA does not discuss patients’ health care situations publicly to respect their privacy in accordance with the Health Insurance Portability and Accountability Act of 1996. However, VA takes patient concerns very seriously, and has a process to look into complaints to ensure we are providing excellent health care that ensures the health and well-being of all enrolled Veterans.”

VA hospitals compare favorably on deaths, readmission rates (Fox News)
Veterans’ hospitals compare pretty favorably with others when it comes to treating older men with three common conditions – heart attacks, heart failure and pneumonia, according to a study on death rates and readmissions. Chances for dying or being readmitted within 30 days of treatment for those conditions varied only slightly for patients hospitalized within the VA system versus at outside hospitals, the 2010-2013 study found. The results contrast with longstanding concerns about challenges facing veterans and the VA health system, including quality questions and long waits for care. They suggest that VA hospitals “are still able to deliver high-quality care for some of the sickest most complicated patients,” Dr. Ashish Jha, a Harvard health policy expert, said in an editorial published Tuesday with the study in the Journal of the American Medical Association. The study analyzed claims for men aged 65 and older treated at 104 VA hospitals and for male Medicare patients treated at 1,513 non-VA hospitals nationwide. Each comparison involved at least 7,900 patients. At VA hospitals, death rates were marginally lower after a heart attack – 13.5 percent vs 13.7 percent; and for heart failure – 11.4 percent vs 11.9 percent. They were slightly higher for pneumonia – 12.6 percent vs. 12.2 percent at non-VA hospitals. Readmission rates ranged from about 17 percent to 25 percent for the three conditions and were highest at VA hospitals, but only by about 1 percentage point or less. “Both groups are now working on quality in ways they didn’t a decade ago and the levels of good performance are quite comparable” for the conditions studied, said lead author Dr. Harlan Krumholz, a Yale University cardiologist and researcher.

Opinion: Veterans Affairs in need of reform, not dismantling (The San Diego Union-Tribune)
San Diego Union-Tribune Editorial Board: The problems are well documented in the Department of Veterans Affairs: Delayed care. Backlogged disability claims. Chronic veteran homelessness. Executives accused of wrongdoing — and an appeals board that, as of Monday, voided disciplinary actions in three straight high-profile cases. Amid these issues, a special report by Union-Tribune reporter Jeanette Steele shed light on the worst failure of all. She reported that at least 27 San Diego County veterans under age 45 died by suicide between 2014 and the first half of 2015, most suffering from depression or post-traumatic stress disorder after serving in a combat zone since Sept. 11, 2001. Their stories are heartbreaking, their families’ lingering pain and questions even more so. Their loved ones say the U.S. Department of Veterans Affairs, and other health institutions, are failing veterans in despair. That’s clear. The question of what to do is complex, but we believe calls to tear down the VA, the nation’s second-largest federal bureaucracy, would lead to more lives lost or drifting. Let’s focus on what needs to be done, not which other agency or agencies or part of the private sector should do it. Let’s have the difficult discussions about whether antidepressants are being overprescribed to young military men and women and whether patient privacy measures prevent family members from helping. Let’s agree that these veterans should be “walking into one building,” as an Army veteran and policy analyst at the nonprofit advocacy group Swords to Plowshares in San Francisco put it so precisely. Last year Congress responded to problems with new legislation and funding for the VA. This year, let’s increase accountability. A new president will nominate a new VA secretary to his or her cabinet. Let’s have it be a turnaround expert, for the agency and for veterans. But let’s not wait to make changes. We put people in harm’s way overseas. We should lead those men and women out of it back home now.