After long delay, VA watchdog releases wait-time reports (Stars and Stripes) The top watchdog for the Department of Veterans Affairs has begun releasing nearly 80 investigations into wait-time problems at medical centers across the country after coming under fire for keeping the findings secret. On Monday, the VA Office of Inspector General released 11 reports on Florida VA facilities, some of which were found to have had patient scheduling problems or manipulated paperwork to make wait-times appear shorter than they were. The office will release 77 reports, 52 of which found some type of irregularity to varying degrees, according to a VA statement. “It has always been our intention to release information regarding the findings of these investigations at a time when doing so would not impede any planned prosecutive or administrative action,” according to a statement from the VA Office of Inspector General released Monday. Though many of the investigations were concluded more than a year ago, the VA Office of Inspector General has received more than 75 additional complaints this year about excessive wait times, delays in care, and problems with medical consults, according to VA OIG spokeswoman Catherine Gromek. “As a result, we do not think the problem was adequately corrected and we believe that VA has still not replaced its antiquated scheduling system,” she wrote in email. The investigations stem from revelations in the spring of 2014 that managers at the Phoenix VA Medical Center had manipulated wait times and veterans had languished for months and in some cases years awaiting treatment. Some of them died before receiving care. Two of the investigations released Monday – looking at medical centers in Miami and West Palm Beach – found schedulers had inputed the next available appointment date where the patient’s preferred date should have been, making it appear the clinics were more responsive to the patients’ desired schedule. Another found a VA medical center in Orlando and VA outpatient clinic in Daytona Beach to have manipulated scheduling records to show a reduced wait time for veterans. Three other Florida facilities were found to have more minor problems and none of the investigations released Monday found senior management to have manipulated the scheduling system. The VA released a lengthy statement ahead of Monday’s release, contending many of the findings were dated and described problems that have already been addressed. “Accountability actions have already been taken where appropriate, and additional training and efforts to increase access to care have been underway since 2014 when these issues were discovered,” the statement reads. The VA and Office of Inspector General have been at odds recently over the investigative findings and the speed at which they have been released. In addition to criticizing the office for dragging their feet, the VA statement Monday also called for the Senate to confirm lawyer Michael Missal, whose nomination to be the permanent VA inspector general has languished since October. The VA has been without a permanent inspector general for more than two years, spanning the length of an ongoing national scandal in veterans’ health care. “OIG’s investigations give us the opportunity to make necessary changes and better serve veterans,” the VA statement read. “However, the pattern of releasing results of investigations nearly two years after the fact is not only unhelpful, it creates the false belief among many that these problems still exist and discourages veterans from coming to VA for the care and support they need.”
Korea veteran waging long fight for Agent Orange benefits (New Haven Register)
A Connecticut veteran who has spent years trying to gain Agent Orange benefits for veterans who served in Korea in 1967 has persuaded the Veterans of Foreign Wars and two other veterans’ organizations to take his case before Congress. On Wednesday, VFW National Commander John A. Biedrzycki Jr. will ask Congress to pass a law requiring the U.S. Department of Veterans Affairs to grant VA health care and compensation to veterans who served in Korea in 1967 if they have illnesses linked to Agent Orange. Biedrzycki’s prepared testimony states that current VA rules exclude many veterans “who now suffer from diseases and illnesses that have been directly linked to the chemical defoliant.” Carlos Fuentes, VFW senior legislative associate, said documents provided by Army veteran Eugene Clarke of Redding swayed the national organization to seek the benefits change through Congress. The documents include proof of test spraying of defoliants in Korea in 1967 and of veterans’ exposure to Korean government spraying. Fuentes said VFW efforts to convince the VA to change its policy have been unsuccessful. The VFW claims 1.4 million members. … Five years ago, Clarke found information on the Internet that he and other veterans who served in Korea in the 1960s may have been exposed to Agent Orange. … Clarke learned that his Type 2 diabetes could have resulted from Agent Orange exposure, but that only veterans who served on the Korean Demilitarized Zone from April 1968 through August 1971 are eligible for benefits. Such eligibility means that if a veteran has one of a list of illnesses connected to Agent Orange, the VA presumes that it is the result of herbicide exposure. Without that presumption, a veteran from 1967 can try to obtain benefits, but has the burden of producing evidence of a connection between the illness and Agent Orange. The VA considers those applications on a case-by-case basis, according to a spokesperson. About 55,000 servicemen were sent to Korea each year from 1966 through 1969, the duration of the “Second Korean War.” They usually served 13-month stints. What frustrates Clarke and his contemporaries is that federal law requires benefits for children born with spinal bifida whose parents served in Korea in 1967. Spinal bifida is associated with Agent Orange exposure. Children “get the benefits. The parents don’t get the benefits. That doesn’t even make sense,” said Glen Dunn, 71, of Fordyce, Ark., who served with Clarke. “It’s not even logical.” The National Veterans Legal Services Program asked the VA in 2009 to grant the 1967 veterans Agent Orange eligibility, but was not successful…. Presumptive illnesses designated by the VA as connected to Agent Orange exposure include several cancers, Type 2 diabetes, Parkinson’s disease, and certain ailments of the skin, nervous system, heart, tissues and organs…. The VA maintains that “there is no evidence for general use of Agent Orange on the Korean DMZ until April 1968,” according to a spokesperson. Clarke objects to the “general use” standard. He obtained a 1979 Defense Department letter to the VA that cites a pilot Agent Orange program conducted by the United States on the Korean DMZ in 1967 on nine locations covering 80 acres. … To Clarke, time is of the essence because of the veterans’ ages. Other similar battles have taken years, not all successful. After a 10-year fight, the VA approved disability benefits for Air Force Reserve pilots who flew planes from 1972 to 1982 that had been used to spray Agent Orange in Vietnam. In 2012, a law was passed to secure medical benefits for Marines exposed to water contamination at Camp Lejeune from the 1950s to 1980s. But in February, the VA denied presumptive Agent Orange benefits to Navy veterans who served off the Vietnam coast, after a federal court had ordered the VA to reconsider it previous denial. Legislation has been introduced in the House and Senate to give the Navy group the same eligibility as those who served on land in the Vietnam War. Now, they are given presumptive benefits only for non-Hodgkin’s lymphoma. All five Connecticut representatives co-sponsored the House bill. Clarke said he would continue to press U.S. Sens. Richard Blumenthal and Chris Murphy, and Rep. Jim Himes, his congressman, for their support. Blumenthal, a ranking member of the Senate Veterans’ Affairs Committee, has co-sponsored a bill that would require the Defense Department to keep a registry of Armed Forces exposure to toxic chemicals and declassify documents, thus providing evidence for benefit applications. Biedrzycki will be addressing the House and Senate Veterans’ Affairs committees. He will also ask for a benefits extension through 1975 to cover residual Agent Orange effects in Korea. The proposals are part of a legislative package of the VFW, Disabled American Veterans, and Paralyzed Veterans of America.
Read more about Agent Orange and herbicides
Attorneys generals ask VA to restore educational benefits to victims of predatory colleges (Seattle Pi)
Eight attorneys general are calling on U.S. Department of Veterans Affairs Secretary Robert McDonald to restore education benefits to veterans who were victims of predatory institutions, such as Corinthian Colleges. “Our veterans earned these benefits by serving our country,” Washington State Attorney General Bob Ferguson said Monday. “These institutions specifically preyed upon them, using false promises and dishonest statistics about their programs and job placement. These deceptive schools took veterans’ education benefits and left them without the right training and qualifications to reach their goals.” The attorneys general sent a letter to McDonald, asking him to use his authority to restore affected veterans’ benefits and eligibility, as well as to take steps to ensure veterans have full and accurate information about their educational options. Veterans are eligible for benefits including the G.I. Bill, which gives student-veterans benefits up to $21,084 per year, and vocational assistance, which helps veterans with service-related disabilities receive job training and education. In Washington state, Corinthian owned and operated six Everest College campuses, enrolling about 3,000 students, until February 2015, when their sale to Zenith Education Group was finalized. Zenith converted the for-profit schools to nonprofit status. Investigations are underway to hold Corinthian and similar institutions accountable for their deceptive practices, Ferguson said. In November 2015, his office obtained loan forgiveness for qualifying former students at The Art Institute of Seattle and Argosy University’s Seattle campus in an agreement that also contained requirements to reform the for-profit college company’s deceptive business practices. Ferguson joined eight other state attorneys general in April 2015, calling on the U.S. Department of Education to relieve the debt burden of thousands of students victimized by Corinthian and provide a process to help student borrowers get debt relief. An August 2015 letter with 11 other attorneys general called for the cancellation of federal loans where schools have broken state law. The other states to sign Monday’s letter are: California, Connecticut, Illinois, Kentucky, Massachusetts, New Mexico, and Oregon.
Amidst investigation, Cincinnati VA leaders gather to look ahead to facility’s future (WCPO)
Top officials at the Cincinnati Veterans Affairs Medical Center said Monday that despite controversy this month the facility provides quality care for veterans. Robert McDivitt, now-acting network director for this region, and Dr. Ralph Panos, now-acting chief of staff at the medical center, along with Cincinnati VA Director John Gennaro, said efforts are under way to hire more doctors for programs that are understaffed such as neurosurgery and orthopedics. VA officials appointed McDivitt and Dr. Panos last week after then-regional director Jack Hetrick and former Acting Chief of Staff Dr. Barbara Temeck — both at the center of an investigation by WCPO and Scripps News Washington Bureau that revealed possible conflicts of interest and unethical behavior — vacated their respective positions. The WCPO/Scripps investigation looked into cost-cutting practices and other allegations brought forward by more than 30 current and former VA medical staffers. The WCPO/Scripps findings sparked two federal probes. Hetrick submitted his retirement after receiving notice of his pending removal, and Temeck was reassigned to non-patient-care duties. VA Undersecretary for Health, Dr. David Shulkin, also suspended Dr. Temeck’s medical privileges. Documents WCPO/Scripps uncovered showed she prescribed medication to Hetrick’s wife when she did not have a license to prescribe controlled substances privately. One of the specific issues uncovered by WCPO/Scripps’ investigation was that cost-cutting tactics might have left the facility short-staffed, particularly when it comes to complex joint surgery specialists and neurosurgeons. VA officials have acknowledged previously that they no longer have any specialists on staff to perform total joint surgeries such as hip, shoulder or knee replacements. “We’re still working to recruit and identify with our affiliate a joint surgeon,” Gennaro said, adding that the Cincinnati VA has hired two general joint surgeons over the last several months. Currently, patients needing specialized joint surgery are referred to doctors outside the VA in the community. Panos called the recruitment process for doctors a “difficult endeavor, but it’s an ongoing and active recruitment, not only in orthopedics but other departments, as well.” McDivitt, formerly the VA’s medical center director in Ann Arbor, Michigan, also pointed during Monday’s roundtable to the facility’s close relationship with the University of Cincinnati College of Medicine. … Dr. Panos added that, thanks to a program run out of the VA’s Cincinnati facility, methicillin-resistant Staphylococcus aureus, or MRSA, infections have seen a five- to six-fold reduction across the country. But the Scripps/WCPO investigation showed that under Dr. Temeck’s tenure at the Cincinnati VA the rate of MRSA infections increased substantially. The highly contagious, drug-resistant infection is commonly associated with surgeries. According to the most recent publicly available data, Cincinnati has one of the highest rates of MRSA infections for VA hospitals nationally. The VA’s internal investigation team initially did not find any impropriety with respect to referrals through the Veterans Choice program or quality of care for veterans at the Cincinnati location, VA officials announced last week. However, the team did substantiate misconduct by both Hetrick and Temeck related to Temeck’s provision of prescriptions and other medical care to members of Hetrick’s family. VA OIG has accepted VA’s referral of the substantiated allegations for potential criminal investigation. The team’s final report is still forthcoming.
Committee approves language on VA participation in drug monitoring programs (The Ripon Advance)
The House Veterans Affairs Committee approved a provision authored by U.S. Rep. Jackie Walorski (R-IN) on Thursday that would require Department of Veterans Affairs (VA) facilities to participate in drug monitoring programs. Language authored by Walorski was added to an amended version of the committee-approved Promoting Responsible Opioid Management and Incorporating Scientific Expertise (PROMISE) Act, H.R. 4063. “Indiana is in the midst of a prescription drug epidemic,” Walorski, a member of the House Veteran Affairs Committee and the Armed Services Committee, said. “It’s alarming that Veterans Affairs medical facilities are not required by law to report the amount of powerful drugs and opiates they prescribe.” VA facilities can currently choose whether or not they participate in statewide drug monitoring programs requiring that other doctors, physician assistants and nurse practitioners review patient records before painkillers are prescribed. Pharmacists are responsible for recording prescriptions they fill in a database. “Without the VA’s participation, there’s a glaring void in reporting that leaves veterans, already at an increased risk of abuse, even more vulnerable,” Walorski said. “My language ensures the VA follows the same rules and regulations as all other doctors and pharmacists to ensure veterans don’t abuse prescription drugs. I’m committed to increasing oversight and transparency over VA doctors to allow us to more closely monitor if veterans are being improperly treated.”
VA announces appointment of principal deputy under secretary for health (Lake County News)
The Department of Veterans Affairs (VA) announced the appointment of Dr. Richard A. Stone to the position of principal deputy under secretary for health. Dr. Stone will serve as the second-in-command to Dr. David Shulkin, VA’s under secretary for health. Dr. Stone began work Monday. “We are excited to bring Dr. Stone on board as the principal deputy under secretary for health,” said Dr. Shulkin. “Dr. Stone’s keen ability to provide oversight of complex health care systems, programs and services has been truly remarkable and his experience in leadership roles within health care validate his skills as an innovative and dynamic leader who will benefit VA as a whole as we continue transformational initiatives.” A practicing physician in a career that has spanned three decades, Dr. Stone has served in both the uniformed military service and civilian clinical practice. In the military, he served as commander of military medical units at all levels of command – from detachment to medical command – including multiple recalls to active duty. Prior to that, he was the director of the health care operations for the Defense Health Agency (DHA) transition team, overseeing the complex and historic transition to DHA from the Military Health System. In this role, he served as the chief medical officer and led a joint services team that provided business case analysis and business process re-engineering to 10 major shared services encompassing more than $30 billion in annual expenses. He also previously served as deputy surgeon general and deputy commanding general of support to the Army Surgeon General. In the private sector, Dr. Stone has owned and led an ambulatory medical and surgical practice, and served as senior medical officer for a community health care system in his home state of Michigan. A graduate of Western Michigan University, Dr. Stone earned his medical degree from Wayne State University. He also earned a master’s degree from the Army War College. Dr. Stone has a number of academic awards and honors to his credit including distinguished alumnus of Western Michigan University College of Arts and Sciences; and Legion of Merit, Bronze Star and Combat Action Badge. He also has been a member of the Department of Defense Recovering Warrior Task Force since 2011 and is a fellow in the American Academy of Dermatology.
Free legal clinics offered for Virginia veterans this week (The Virginian-Pilot)
Virginia veterans are getting the chance to attend free legal clinics this week. Clinics will be held Tuesday Chesapeake, Wednesday in Richmond, Thursday in Roanoke and Friday in Annandale. Volunteers will help veterans and their spouses with estate planning, wills, powers of attorney and advance medical directives. The program was developed through a partnership between Attorney General Mark Herring’s office, the Virginia Department of Veterans Services and the Virginia State Bar. Herring’s office says more than 100 veterans and their spouses have signed up. Herring is expected to visit all four of the free clinics this week.