VA expands hepatitis C treatment to all patients with the virus (Military Times) The Veterans Affairs Department will begin providing hepatitis C treatment to all veterans in its health system who have the virus, regardless of their disease stage, VA officials said Wednesday. Having received a boost in funding from Congress late last year for the costly medications needed to cure hepatitis C, the VA is now able to treat the 174,000 veterans in its health system who have the disease, according to a VA release. VA Under Secretary for Health Dr. David Shulkin said that while the cost previously was too prohibitive to treat all but the sickest patients, VA now can treat all veterans with the virus who are eligible for VA health care, either in a VA facility or through the Veterans Choice program. “We’re honored to be able to expand treatment for veterans who are afflicted with hepatitis C,” Shulkin said. “Additionally, if veterans are currently waiting on an appointment for community care through the Choice program, they can now turn to their local VA facility for this treatment or elect to continue to receive treatment through Choice.” An estimated 200,000 veterans have hepatitis C, including 174,000 veterans enrolled in the VA health system. Hepatitis C is spread by shared needles or by contact with the bodily fluids of an infected person, and those most at risk include people who received a blood transplant or organ transplant before 1992, when widespread screening became available in the U.S. Roughly 60 percent of veterans who have hepatitis C served during the Vietnam era. Since 2014, VA has treated 42,000 hepatitis C patients with the medication sofosbuvir. In fiscal 2015, the department designated $696 million, or 17 percent of its total pharmacy budget, for the drug. It expects to spend $1 billion for medications containing sofosbuvir in fiscal 2016. California-based Gilead Sciences, the maker of the sofosbuvir, including brand names Sovaldi and Harvoni, has come under fire from lawmakers, who have accused the company of price-gouging. The company had been charging the federal government up to $68,000 for a treatment regimen that costs about $1,400 to make. As a result, public health officials, including the VA, could afford to treat only the sickest patients. The person who led the scientific team that created sofosbuvir, Raymond Schinazi, was a senior research career scientist who worked for the VA from the late 1980s until Feb. 1 of this year, when he retired. He requested his retirement on Jan. 21, the day he received an invitation to testify before the House Veterans Affairs Committee on his role in developing the medication and growing the company that profited from its sales. The Food and Drug Administration in January approved a different medication, Zepatier, made by Merck, to treat the disease. In a release on Wednesday, Merck executives said they priced the medication “to broaden and accelerate access to treatment for patients covered in commercial or public plans, including our country’s veterans.” … A Merck spokeswoman said it was too early to tell whether Zepatier will become the favored treatment within VA to treat hepatitis C but that the company priced it appropriately to ensure that it could be accessed by all veterans.
VA clerks in Texas manipulated wait data, federal report says (My Statesman)
A long-awaited internal investigation has found that Department of Veterans Affairs scheduling clerks throughout Central Texas masked the true nature of wait times at hospitals and clinics in the region by inputting false appointment data. More than 20 VA employees, from San Antonio to Kerrville to Austin, told investigators they engaged in the practice, according to a report released this week. Several said supervisors instructed them to manipulate the data and that they feared being fired if they did not participate. According to the investigation, one former scheduling clerk at the Austin Outpatient Clinic said she “was taught to manipulate the desired date by one of the supervisors and another employee. After moving to another facility, she was again trained to make the patient wait times equal zero.” Another scheduler in Kerrville said “a former VA supervisor threatened to fire her if she did not make the wait times equal zero.” The practice involved logging patients’ desired appointment dates to sync with appointment openings. Despite the findings, the VA Office of Inspector General did not find executives ordered the data manipulation. Instead, the report noted that “numerous employees opined that there was no malicious intent by any employee to defraud or mislead anyone regarding wait times. Many individuals indicated problems with scheduling ranged (sic) from improper training, lack of supervision, to non-centralized scheduling.” In a letter sent to congressional offices and released to the media late Wednesday, local VA officials hailed the report as vindication, writing that “it is important to note that OIG has not substantiated any case in which a VA senior executive or other senior leader intentionally manipulated scheduling data.” The investigation was sparked by allegations of data manipulation in Central and South Texas made by a San Antonio scheduling clerk in the spring of 2014, part of a wave of allegations that convulsed the VA over accusations of lack of transparency and resulted in the resignation of former VA secretary Eric Shinseki. Earlier this month, the OIG began releasing the results of investigations into scheduling practices across the nation. The federal Office of Special Counsel has complained that at least two investigations were “incomplete” and “failed to respond” to issues raised by whistleblowers. Local VA leaders said that despite the lack of “intentional wrongdoing,” the OIG report shows “the need for standardized training on scheduling.” All employees involved in scheduling have been retrained, they said. Several Central Texas supervisors told investigators the data manipulation was the result of “bad habits” of schedulers. One San Antonio administrators said “the concept of scheduling errors seemed to confuse schedulers.” The administrator “stated that there was pressure to get patients seen in a timely manner but there was no pressure to manipulate the data,” the report said. Investigators also determined that no VA employee received a bonus or award related “specifically” to wait time measures. Yet the report found data manipulation was widespread in San Antonio, Kerrville and the Austin clinic, where “almost all schedulers and clinics had zero wait times.” Several schedulers said they feared ending up on what one scheduler called a “hit list” if they scheduled appointments with wait times longer than 14 days. “In order to make sure her name was not on the list, she stated she would make the wait time equal zero,” the report said of a San Antonio scheduler.
Veterans suicide: ‘We must and will do more,’ VA says (Military Times)
Veterans Affairs Department officials said Tuesday they will make several changes to the department’s suicide prevention programs as part of ongoing efforts to reverse the tide of suicides among military veterans. Following recommendations made by veterans advocates and suicide prevention groups at a veterans suicide summit in Washington in February, VA officials said they will improve mental health services to include providing same-day evaluations and access to care for veterans who need immediate help. According to a press release on the changes, the VA also will establish three regional telehealth hubs focused on mental health treatment and provide additional resources to the VA suicide prevention program office. VA also will launch several suicide studies, including research on the impact of deployment and combat exposure on Afghanistan and Iraq veterans and a study using suicide and suicide attempt data to prevent deaths and develop early interventions. VA Undersecretary for Health Dr. David Shulkin called suicide prevention a “shared responsibility” between VA and communities. “We all have an obligation to help veterans suffering from the invisible wounds of military service that lead them to think suicide is their only option,” Shulkin said. “We must and will do more.” Under the new initiatives, the Veterans Health Administration also will work to ensure that opioid overdose antidotes like naloxone and flumazenil are available throughout VA hospitals and clinics. Wisconsin Democrat Sen. Tammy Baldwin has been pressing for this change since a constituent, former Marine Jason Simcakoski, died of an accidental overdose at the Tomah VA Medical Center in 2014. … The VA in 2012 estimated that 22 veterans die each day by suicide, but the number is an extrapolation derived from 1999-2011 data from 21 states, and the VA and advocacy groups say it should be interpreted with caution. VA is in the process of working with states and the CDC to obtain concrete data by midyear on the extent of the issue. During the Washington summit, advocates made a number of recommendations to address veterans suicide, to include designating a single organization to lead prevention efforts, changing privacy laws to allow doctors to discuss patient’s mental state with family members and ensuring veterans easily transition from Defense Department to VA medical care. Jackie Maffucci, the director of research for Iraq and Afghanistan Veterans of America who spoke at the summit, called the VA’s new prevention steps “bold” and said the VA deserves praise for taking action. … The latest announcement follows a series of changes at VA to address veterans suicide. In addition to hosting the February summit, VA also shifted oversight of its suicide hotline to a manager with a proven track record for improving call centers and has been upgrading the Veterans Crisis Line’s technology and staffing to better serve veterans. The Veterans Crisis Line had been under fire since a VA Office of Inspector General investigation found that some veterans’ calls went to voice mail in 2014 while other veterans were placed on hold. Veterans needing mental health support can call the hotline 24/7 at 800-273-8255, press 1. Chatting is available online at www.veteranscrisisline.net or by texting 838255.
‘Disgrace’ as Philadelphia Vietnam veterans memorial vandalized (metro)
Brass star medallions that line the walls around the Philadelphia Vietnam Veterans Memorial were stolen recently. At least two star medallions were taken, apparently ripped off the granite. Steve Uchniat, president of Liberty Bell Chapter #266 of the Vietnam Veterans of America, who was looking forward to the installation of a statue at the memorial in honor of Philly’s only Medal of Honor recipient next month, was shocked when he heard the news. The medallions and other bars on the walls were installed a few years ago as a deterrent to skateboarders who were grinding on the memorial’s walls, he said. “They were put there for skateboarders. Now I guess the people are taking them so they can junk them, which I think is a disgrace,” Uchniat said. “That’s what they were for, they were to keep the skateboarders out from damaging the memorial, and now they’re breaking them off and trying to junk them.” Memorial caretaker Jim Moran told Philly.com that he disocvered two medallions and three “skateboard stoppers” on the walls were taken on Tuesday. Terry Williamson, president of the Philadelphia Vietnam Veterans Memorial Fund, said the stars were installed during a redesign that cost about $1 million and wrapped up last October. The redesign was intended to make the memorial publicly visible from all sides so that it didn’t attract any illegal activity. “Unfortunately, there are still idiots out there and this stuff happens,” Williamson said. “It’s extremely sad and discouraging when somebody desecrates the memorial that honors the 646 Philadelphians that gave their lives in the war, but frankly it does happen on occasion. It’s not nearly as bad as it used to be.” He estimated replacing the stolen metal would cost $500 to $1,000. “We will make repairs to it. Fortunately the damage was minor,” he said. Police did not have information available about whether surveillance footage had been pulled from the site of the memorial or if any suspects had been identified. The memorial’s central wall lists the names of soldiers who died in the Vietnam War. Two more names are currently taped up in paper that will soon be added to the granite wall, bringing the total to 648.
Op-ed: Treating the whole veteran (The Baltimore Sun)
Garry J. Augustine, DAV executive director: A proposal for reforming veterans health care under discussion would limit the mission of VA health care facilities and clinics to focus only on service-related injuries and illnesses, rather than the overall health of veterans. While this may sound reasonable, unfortunately, for many veterans — especially disabled veterans — such a plan could lead to lower quality of care and worse health outcomes. Should this proposal become law, VA doctors could only treat one very specific aspect of a veteran’s medical needs. For any other health condition not directly caused by military service, the best the doctor could do is refer the veteran to the private sector to seek treatment on their own. That is not quality care. Best practice in medical care is coordinated care that treats the whole patient within an integrated health care system; it is holistic and preventive, not piecemeal and cafeteria-style. That’s why over two decades ago the VA health care system evolved from primarily providing specialized in-patient care to becoming a full-spectrum provider. Under the cost-cutting proposal to keep VA care limited to conditions caused by military service, veterans could make an appointment at VA for treatment of conditions caused by military service, but would be forced to find private providers for every other medical issue they experience. For example, a veteran seen at VA for PTSD or amputations could not be treated for related conditions such as depression or diabetes. That is the very definition of fractured health care. And the result will be little or no coordination of care, more over-treatment or under-treatment for medical conditions, and, ultimately, poorer health care outcomes for veterans. Furthermore, if the number of veteran patients seen by VA doctors drops there is a corresponding drop in the development and maintenance of professional skills that doctors and clinicians need to provide quality care. This would inevitably lead to hospitals and clinics having to cut back on the number of services they offer due to either quality or cost concerns, and some VA hospitals and clinics would likely have to close because they no longer had the critical mass of veteran patients needed to maintain a safe, high-quality facility. For disabled veterans who rely on the VA, the result would be longer travel or waiting times to find VA care that they have earned and deserve. That’s simply not acceptable. The answer to ensuring veterans have timely access to VA care is not to reduce the number of patients in the VA health care system. Instead, VA needs to realistically assess the services and needs of veterans in each community to ensure that its resources are properly aligned when and where needed. This will require better strategic planning and budgeting processes and new accountability systems, such as an independent audits to ensure money is wisely spent to deliver quality care to veterans. The men and women who served this country deserve the highest standard of care, and that means treating the whole veteran, not just a legally defined set of service-connected conditions. That’s why Disabled American Veterans (DAV), representing nearly 1.3 million veterans of all generations, is setting the record straight on this and other simplistic ideas that would be bad for veterans.
Expanding medical marijuana laws could help vets (Long Island Report)
A medical marijuana program went into effect last month in New York State, but the New York State Department of Health is already considering expanding the list of conditions eligible for treatment. Currently the law only allows medical marijuana to be used as treatment of life-threatening conditions such as cancer or HIV, and those suffering may only vaporize cannabis oils or ingest the active chemicals in capsule form. Yet patients suffering from post-traumatic stress disorder may have a new way to treat their symptoms if the Department of Health does in fact expand the program. PTSD doesn’t only affect veterans but they are more likely to suffer from it. It’s a diagnosis received by over 10 percent of the veterans treated at Northport Veterans Affairs Medical Center. Much of the treatment focuses on reducing the signature symptom of PTSD, hyperawareness. As Dr. Keith Shebairo from the Northport Veterans Affairs Medical Center explains, “During the war they would have to notice everything around them and that sense of uneasiness can often follow them home.” When these men and women are so beaten down by these feelings of anxiety and depression that many are choosing to take their own lives. As Dr. Shebairo explains, “22-23 [veterans] kill themselves every day.” The medical director at Long Island Veteran’s Home, Dr. Frank Cervo, detailed the type of treatments offered, “We have a specialists here who work with them … those that require treatment generally receive psychiatric or psychological services.” Apart from therapy, the Northport VA employs activities such as yoga and meditation. The question that remains is will they also be able to use marijuana. Dr. Tommy O’Brien II is a physician certified in medical marijuana evaluations. He often makes appearances on local New York City television stations where he prefers to go by Dr. Tommy. He believes a more lax medical marijuana program will come about in “a matter of time … New York is more conservative than other states like California, which is why it’s easier to get medical marijuana out there than it is here. However it’s also clear marijuana laws are becoming more liberal across the country I wouldn’t be surprised if state laws are become more lax in the next few years.” When asked if New York State should expand the program to include those suffering from PTSD Dr. Tommy stated, “I do, not only as a doctor but also as a veteran. I know there are a lot of my brothers out there suffering and they should be allowed to enter the program if their doctor recommends it.” Others aren’t as eager as Dr. Tommy. Dr. Cervo is a bit more cautious in regard to prescribing the drug. When asked if he approved of adding PTSD to the list of conditions approved for medical marijuana he said, “Unfortunately that decision is so far out of my hands and away from my realm of experience I couldn’t give an answer. You have to be certified to prescribe it, if those professionals who are certified believe it should be used it’s not my place to disagree.”
Theft of 24,000 painkillers from Salt Lake VA hospital under investigation (KUTV)
A former veterans’ hospital employee is accused of stealing painkillers from the facility. According to our news partner, The Salt Lake Tribune, a former pharmacy supervisor worked around security at the VA and created fake patients to cover up taking 24,000 painkillers and 25 vials of testosterone. Investigators have been looking into the case for close to a year, but at this point, no one has been charged. The Veterans’ Affairs office in Salt Lake City released a statement Wednesday saying they have taken action. “As soon as we became aware of irregularities in prescription distribution, we immediately notified the inspector general abd the Drug Enforcement Agency, who are now working with the U.S. Attorney’s Office. The VA in Salt Lake City has since cooperated fully with the investigation. Clearly, we regret that this diversion occurred.”
Iowa bill to help claim the remains of veterans (KIMT)
A bill that would help locate and identify unclaimed remains of Veterans is in the works. The Iowa Senate Committee met on Tuesday to discuss a bill that would make it easier for deceased Veterans to reach their final resting place and receive a military burial. The Iowa bill would allow funeral directors with unclaimed cremated remains to contact the Iowa Department of Veterans Affairs six months after they have filed the death certificate. A local director says they make sure they do all they can to connect deceased veterans with their loved ones. “We try to follow any lead that we get from where the person has passed away and from there we exhaust all of those opportunities and then from there it goes to a national veterans committee,” stated Scott Graham, Major Erickson Funeral Home director. One major factor in the bill could be the funding for the burial stated Mike Flatness, a local Veteran. Under the current law, Iowa funeral directors are not allowed to release cremated remains to anyone but family members.
Indiana VA’s to start monitoring prescriptions (WFYI)
For the first time Indiana VA hospitals will begin to track and share prescription information between providers in an effort to curb drug abuse. The U.S. Department of Veteran Affairs will be working with Indiana’s Prescription Drug Monitoring Program called INSPECT to provide a more complete picture of what drugs Indiana vets are using and who’s prescribing them.The move requires that veterans prescription information through the VA be submitted to the online data base. Allen County Judge Wendy Davis sits on the Governor’s Drug Task Force advocated for this tool to be more widely implemented. She says the new requirement is a step in the right direction. “Unless we don’t start taking some sort of action like this, we’re never going to get anything resolved, so I think this is definitely heading in the right direction and now we need to follow up on it make sure that it’s working the way it’s supposed to with INSPECT,” Davis said. The Roudebush VA in Indianapolis will be the first to implement the program, followed by VA centers in Crown Point, Fort Wayne and Marion. The Evansville VA will not submit data to INSPECT because of an existing agreement with an Illinois program.
UVU students hoping to increase veteran graduation rates (Daily Herald)
A group of public relations students at Utah Valley University is helping connect veterans to a new mission — graduation. “I really didn’t know the extent to which our veterans needed help or needed assistance in education until we started this project and really started doing this research,” said Tasia Briggs, a member of Apogee PR. … The campaign, Operation Graduation, is one of two being run by students participating in the Public Relations Students Society of America Bateman Case Study Competition. Its goal is to help increase participation in the local Student Veterans of America chapter and help connect veterans with benefits. The campaigns run through Tuesday. The Operation Graduation campaign is aimed at institutional changes at UVU to help student veterans succeed, including getting veterans involved in service projects, creating veteran-preferred classes for math and English, adding a veteran-specific focus to orientation, getting special graduation cords for veterans and adding information on all course syllabi telling veterans about the Veteran Success Center and the Student Veterans of America. “Every single department that we have talked to, every single chair, have been on board,” said Chantelle Thompson, one of the students running the campaign. The group has also hosted monthly classes to connect students with resources to help them graduate. February’s class had to do with study tips. Many of the group’s recommendations have either been approved or are waiting on final approval. The veteran-preferred classes — classes set aside for veterans and then later filled with other students to fill capacity — should launch in August. Other changes, like veteran-specific tours for prospective students that would end at the Veteran Success Center, have already been approved by the UVU administration. According to the group, there are 795 identified veterans on campus, but there’s expected to be about 400 more who haven’t self-identified as one. Of the 795, only half access their benefits. Team member Holly Richardson said of the approximately 200 veterans who are seniors at UVU, only 10 percent are anticipated to graduate in April. That could be attributed to feeling lost in the university system, running out of benefits before finishing their classes or a fear of what’s to come after graduation. By connecting the veterans to each other, the team hopes to create a support network for the veterans to encourage and look out for each other, eventually increasing graduation rates. “When they come back and try to transition back in, they miss that sense of camaraderie they have with their team,” Richardson said. “There’s an automatic sense of belonging when you’re with other vets.” After some team members went to the national Student Veterans of America conference, the group decided it wanted to run a campaign that would continue to help veterans after it was over. At the conference, students sat down with dozens of veterans to learn about the realities and struggles of returning to civilian life. “They are working in a professional field as a soldier,” Thompson said. “They are the best at what they do, and they go back to school where they have been gone for years, and they go to an amateur place where they are expected to learn, and they’re told they’re not professionals and they have to recreate a professional life.” The team found that many of the veterans didn’t know about the Student Veterans of America, its programs or the on-campus Veteran Success Center. “I feel like our faculty, our staff, our administration and our students are so supportive and they want the veterans to succeed, they just don’t know how to help,” Thompson said. The group has already received approval for faculty and adviser training on how to be resources for veterans, and for priority registration for veterans enrolling in the veteran-preferred classes.