March 21 Veterans News

March 21 Veterans News

VetsHQ News UpdateCruz, Cornyn, Abbott call for accountability in VA scandal (
In an apparent rejection of the Department of Veterans Affairs’ insistence that its top executives weren’t responsible for a 2014 medical wait time scandal, both of Texas’ US senators and Gov. Greg Abbott on Thursday said an internal investigation revealing systemic data manipulation in the state shows “failures of leadership at senior levels.” In a joint letter to VA Secretary Robert McDonald, the Texas leaders urged the firing of any VA executive “whose poor performance or misconduct warrants such removal.” That seems unlikely — so far, at least — in Texas. The American-Statesman reported last week that not a single Texas employee of the VA has been disciplined in the wake of the VA’s Office of Inspector General probe of wait time allegations, according to the US House Committee on Veterans’ Affairs. That investigation found data manipulation to be systemic in Austin, San Antonio and Kerrville. Under the scheme uncovered by investigators, scheduling clerks regularly inputted false dates for patients’ appointment requests, matching them to first available appointment dates in a practice called “zeroing out.” Several clerks told investigators that they feared being fired or receiving poor performance reviews if they didn’t participate in the data manipulation. The manipulation helped obscure the problem of lengthy waits for appointments. Yet the report didn’t assign responsibility for the widespread problems, instead pinning them on “improper training” and “lack of supervision.” The VA’s inspectors have issued similar reports across the country. According to the VA, 29 employees nationwide have been disciplined in connection to data manipulation. The VA, however, has trumpeted the inspectors’ reports as a kind of vindication. “OIG did not substantiate any allegations of a VA senior executive or other senior leader employed by a (Central Texas VA) facility intentionally manipulating scheduling data — nor any individual Central Texas employee,” VA spokeswoman Deborah Meyer said in an email. It’s unclear though how so many schedulers in so many offices simultaneously misunderstood scheduling instructions in a way that reduced the appearance of wait times. “We cannot explain the actions of the schedulers,” Meyer said. In their letter, Abbott and Sens. John Cornyn and Ted Cruz said the inspectors’ report shows that “Texas veterans were misled by a mismanaged, bureaucratic system intent on providing the appearance of short appointment wait times in order to improve the image and performance statistics of individual VA health facilities.” VA facilities in South and Central Texas were among dozens nationwide where former and current employees alleged VA officials were hiding the true extent of wait times in a scandal that eventually cost VA Secretary Eric Shinseki his job. In Phoenix, whistleblowers alleged the numerous veterans died while languishing on secret wait lists. In response, Congress approved $16.3 billion to pay for new staff and facilities and to pay for private sector care for veterans facing long waits. In Central Texas, the money helped fund 118 new positions — a mix of medical providers and support staff. Last year, VA numbers showed that the rate of delayed appointments was falling in Austin, but remained higher than the national average. Local VA officials say they have also revamped training for scheduling clerks and their supervisors.

Read More: OIG report verifies allegations at some VA medical facilities 

Senators urge VA to extend ‘presumption of exposure’ to more Korean War vets (KTVZ)
Sens. Ron Wyden, D-Ore., and Richard Blumenthal, D-Conn., led a bipartisan group of five senators Friday in urging the U.S. Department of Veterans Affairs to extend the presumption of exposure to Agent Orange to provide more veterans who served in the Korean Demilitarized Zone access to critical health care benefits. Currently, only veterans who served in the Korean DMZ during specific dates are granted a presumption of exposure to Agent Orange, which allows easier access to health care and benefits for conditions caused by the toxins. In a letter to VA Secretary Robert McDonald, the senators called on VA to extend the timeframe of the presumption to include veterans affected during the initial herbicide spraying. The letter was also signed by Bernie Sanders, I-Vt., Jerry Moran, R-Kan., Jon Tester, D-Mont., and Sherrod Brown, D-Ohio. “We urge the Department of Veterans Affairs (VA) to extend the presumption of Agent Orange Exposure to all the veterans who were affected by herbicide spraying in the Korean DMZ, including those who are currently deemed ineligible because they were in or near the DMZ only during the test phase of defoliation,” the senators wrote. “This presumption will allow easier access to critical health care and other benefits for veterans who urgently need it.” Blumenthal recently called on VA to extend the timeframe of the presumption at a Senate Veterans Affairs Committee hearing. During his testimony, Blumenthal referenced the case of Army veteran Eugene Clarke from Redding, Connecticut who has health conditions that could have resulted from Agent Orange exposure while serving in the Korean DMZ.

Read More: Agent Orange and Herbicide Exposure

Opinion: Why the Phoenix VA scandal drags on (Washington Times)
Newt Gingrich, former House speaker: 700 days. That’s roughly how long it has taken the Department of Veterans Affairs to seek the firing of three senior officials at the Phoenix VA who oversaw the systematic falsification of wait times for appointments. And that’s how long they could continue to receive full pay before the VA actually succeeds in firing them. It has been almost two years since President Obama promised swift action and accountability for those who tried to hide the abysmally long waits by keeping fraudulent records. Since those revelations, the trickle of horror stories out of the VA—of the thousands who may have died waiting for care, for instance—has become a sadly familiar fixture of newscasts. Yet that does not make it any less outrageous that it took the VA until last week—two years after the stories of corruption at the Phoenix VA came to public attention—for the agency to finally hold the senior officials responsible. “These executives will no longer serve in those positions,” the Arizona Republic reported, “but may fight their removals under a federal appeals process.” That could take an additional two years. Federal civil service law gives the officials the chance to appeal the attempt to remove them from their jobs—and during that time they may continue to be paid at taxpayer expense. At least one of the officials earns a salary of nearly $250,000 a year, according to the report. This means taxpayers are likely to pay half a million dollars to a person they’re trying to fire for cause. The crushing fact, of course, is that the real problem is much bigger than three employees at the Phoenix VA. The system that shaped them remains just as incompetent and corrupt as ever. Consider, for example, that between 2006 and 2013, the number of full-time employees jumped more than 40 percent, from 220,000 to 314,000. Yet with 94,000 additional government employees, the VA still has not developed a system to transfer a veteran’s medical records from the Defense Department to the VA faster than 175 days. The two giant bureaucracies recently spent $1.3 billion to build a joint medical record system for their health care services—before the two secretaries announced that they were abandoning the effort because they couldn’t get it to work. (That $1.3 billion is on top of the more than $2 billion the Defense Department spent on a failed upgrade of its own system of electronic medical records.) But to single out the VA for its failures makes just a little more sense than pointing to the employees in Phoenix. Because in addition to a Veterans Health Service that is dangerous to veterans’ health, we have an Internal Revenue Service that attempts to police political speech, a defense bureaucracy that can’t keep track of its money or its equipment, an Environmental Protection Agency that spills millions of gallons of toxic water into the Colorado River, and an immigration bureaucracy that ignores immigration law as a matter of policy. No wonder, then, that the public is “angry” and of a mind to vote against anyone associated with Washington. It’s the only rational response to incompetence and corruption of this scale. And no wonder, then, that the slogan “Make America Great Again” resonates with voters. At least it signals an understanding that something fundamental has to change. And no wonder, then, that we are witnessing the left wing react with outrage and violence. They understand the stakes. Bureaucratic socialism itself is at risk. A government that worked would mean the end of their world.

Military Times releases 7th annual “Best for Vets” employer rankings (Military Times)
Should you base your civilian career on your military job? Many service members use their transitions out of the military as a chance to start over and ditch the career paths that their military occupations started them on. Doing so comes with advantages and disadvantages, all of which transitioning veterans should weigh carefully. If you have a decade’s worth of military experience in a field that translates well into the civilian world, changing course could force you to start at the bottom, with a salary to match, rather than at a higher level that recognizes the technical skills you learned in uniform. “When you work from weakness, it only makes it more challenging,” said Evan Guzman, head of military programs and veteran affairs at Verizon, which tops our Best for Vets: Employers rankings for the second consecutive year. On the other hand, if Uncle Sam stuck you with a job you hate, you’re likely not doing yourself any favors in the long-term by seeking a similar civilian position. “What I always tell veterans is: Don’t go for the job that you fit; go for the job that you want,” said Michael Donoghue, a partner at PwC, a professional services firm formerly known as PricewaterhouseCoopers, which landed the fourth spot in our rankings this year. “Happy people work harder — and make more money.” In addition to Verizon and PwC, Union Pacific Railroad, USAA and BAE Systems round out the top five companies on our Best for Vets: Employers 2016 rankings. A record number of companies took part in our survey this year, which included more than 90 questions that explored in detail company culture, recruiting, policies and reservist accommodations. Competition was stiff for companies, but what they told us was largely good news for vets. All but one company that responded to our survey told us that they were actively looking for new employees to hire now. And the other one indicated that it planned to do so within the next year. Veterans accounted for more than 13 percent of the employee populations for responding companies and more than 17 percent of new hires, likely a result of a conscious focus on vet recruiting. On average, the companies dedicated one-fifth of their recruiting budgets to military-connected employees. They attended an average of nearly 39 military/veteran job fairs in the last year. More than three quarters of companies specially track applications for veterans, and about four in 10 give vets either a significant or slight preference in the hiring process. An average of four employees at each company spend most of their time working either to recruit or support military-connected employees. And more than 85 percent offer training on military culture, career paths and related matters. Better than three-quarters have a military affinity group at the company. These efforts appear to start at the top. A remarkable 95 percent of responding companies reported having at least one service member, veteran or military spouse in the ranks of their senior leadership. And more than one-third have received the Secretary of Defense Employer Support Freedom Award, the highest award given by the federal Employer Support of the Guard and Reserve organization. … Veterans, as well as company leaders behind programs to recruit and support veterans, all recommended that service members leaving the military approach the transition seriously, even as a job in itself, assessing their internal desires and their realistic options in the outside world. “They need to do research,” said Ruben Lopez, a former Army captain who now works as a general superintendent for Union Pacific. He added that an infantry soldier who thinks he has no applicable civilian skills shouldn’t just assume that’s the case. … Experts inside and outside of the military recommend that vets start planning their transitions 18 months before separating from the military.

Navy funds autism-screening app, hoping for help with PTSD (Navy Times)
The Navy is paying for research into an app to screen for autism in the hopes that it could eventually be tweaked to look for signs of post-traumatic stress disorder. While developmental and trauma disorders might at first appear strange bedfellows, the researchers and a PTSD expert for the VA say it could be an exciting new direction. Facial expressions can indicate the presence of autism, PTSD and other disorders. The Autism & Beyond app uses a smartphone camera and an algorithm to read children’s facial expressions and assess their emotional responses. The app, which uses a general algorithm, could be expanded to PTSD to monitor people over time if speech and other signals are taken into account, according to Pedja Neskovic, who oversees the project in the Office of Naval Research. “It can find patterns, not just in facial expressions but in different kinds of data sets, such as brain signals and speech, and it can be used on a continuous basis,” he said. “It’s a completely new world.” William Unger, a PTSD expert and clinical psychologist at the Providence VA Medical Center, sees potential for an app to be used to help screen for PTSD if it can prove reliable for a large population over time. It’s always good to have additional tools, he said. “This is a technology in its infancy. You don’t know where it will go,” he said. “So does this science and this study really then lead to additional questions, additional technological developments which help us to move forward? It very well may. So I’m very excited, even though I’m saying it’s very far off from having utility.” M. David Rudd, an expert in suicide prevention and PTSD in military personnel, is skeptical. Rudd said he can’t see the extrapolation to PTSD, calling it “a pretty big gap to leap.” He worries about an app rendering erroneous results, a concern Unger also expressed. … The Navy has been working with the researcher who developed the algorithm for the app, Guillermo Sapiro, for about 20 years, supporting his research on image processing and data analysis. The Navy has invested hundreds of thousands of dollars in the app, Neskovic said. PTSD often goes undiagnosed. Patients may not recognize the link between their symptoms and a traumatic event they experienced or may not be willing to talk about that event, while sometimes symptoms are obscured by other issues, according to research published by the American Academy of Family Physicians. Some veterans don’t want to feel like there’s something wrong with them and try to cope on their own, Unger said. The app, as it’s designed for autism, shows funny videos designed to make children smile, laugh or express emotions. The way their head, lips, eyes and nose move is recorded, encoded and analyzed with the camera and app. If a child isn’t responding, that’s also classified. Duke University is studying whether it’s feasible for caregivers to screen kids for autism using a mobile phone at home. The app can be downloaded for free. Unlike a tool like WebMD, where the user needs to identify their symptoms and know the right questions to ask, the app does the behavior analysis automatically. The user just has to watch the videos, said Sapiro, an electrical engineering professor at Duke. He stressed that the app isn’t meant to replace specialists; it’s a pre-screening tool. The institutional review board at Duke approved the research. The initial results show that people are willing to use the app and they’re sending high-quality, usable videos, Sapiro added. Neskovic and Sapiro envision developing a PTSD app within five years. They’re investigating whether it could also possibly reveal signs of mild traumatic brain injury and depression.

Summit highlights difficulties of veterans’ caregivers (Stars and Stripes)
Torrey Shannon has to drive more than 30 minutes just to get milk and all medical appointments need to be house calls to her remote home more than 9,000 feet up in the Colorado Rockies. She’s rarely able to stray far from her house. Shannon provides round-the-clock care for her husband, retired Staff Sgt. Dan Shannon, who survived a gunshot wound to the head in Iraq. He needs to live in a remote area because severe post-traumatic stress disorder and brain injury has left him overwhelmed by cities. Despite this, she said she has struggled to get the support she needs as a veteran’s caregiver — most recently when the Department of Veterans Affairs insisted her husband travel to a city to be reassessed to determine whether he still qualified for caregiving benefits. It took 10 months for her to convince the VA to conduct the reassessment at the Shannons’ home to avoid a potentially harmful trip. “The man had his head opened up, his records support it, why do I have to keep proving it?” she said Wednesday at a summit in Washington, D.C. on veterans’ caregivers. The summit was aimed at increasing partnerships between government agencies, such as the VA, and private groups to provide support to caregivers, whose needs are often overlooked, said Kristina Kaufmann, executive director of Code of Support Foundation, a nonprofit group that provides support services to veterans and their families and hosted the summit. “Forty years ago, we completely failed an entire generation of (Vietnam) veterans and their families and they are still paying for it and so are we,” she said. There has been a lot of focus on treatment for veterans coming home from Iraq and Afghanistan with serious physical and psychological wounds. Behind the injuries is often a spouse who assumes the role of caregiver. It can be a full-time job, often on top of child care, and sometimes spouses are forced to quit their jobs and greatly alter their lives. A 2010 law created a VA program to assist caregivers of Post-9/11 veterans, but that still left gaps in support for people taking care of veterans from earlier eras and many Post-9/11 caregivers say government efforts still fall short for them. After officials with VA, the Department of Defense and the Department of Health and Human Services listed a litany of programs aimed at helping caregivers, the caregivers who spoke at the summit said lack of easily available information about those options is still a problem. “From where we’re sitting every day right in the thick of the military community, we’re not seeing what you’re talking about,” said Kat Honaker, who took care of her husband, wounded Iraq War veteran Jeremiah Honaker until he committed suicide in 2014. Meg Kabat, national director of the VA Caregiver Support Program, said more needs to be done to better serve caregivers and that VA is working with other departments to expand services. “When you support caregivers, you’re taking care of veterans,” she said. “It’s something we need to continue talking about.”

Veterans open to using health IT for mental healthcare (FierceHealthIT)
Veterans being treated for mental health issues show interest in using technology to receive care, with a few caveats, according to research published at Telemedicine and e-Health. Seventy-four patients at a Boston VA outpatient clinic completed a pencil-and-paper survey on their interest in using computers, cellphones and tablets for their mental healthcare. These patients were being treated for conditions such as depression, post-traumatic stress disorder or anxiety disorders. Overall, 86 percent of the patients had access to an Internet-capable device and 97 percent reported having a cellphone, though fewer than half reported owning a smartphone. In addition, only nine patients had a tablet and noted they had little interest in health-related communications using the device. Younger patients were more open to technology-based communications, and most preferred using a desktop or laptop, especially when privacy was a concern or when a small screen might pose a limitation. Using computers, patients were interested in receiving laboratory results (68 percent), reporting symptoms to providers (63 percent) and having providers inquire about how they were doing (61 percent). Nearly half were interested in a live video session with their provider or a video that summarized a therapy session. For cellphones, a little over half were most interested in receiving appointment reminders and medication refill reminders, but they showed little interest in video-related uses. There was little interest overall in reminders to take medication, though previous research has shown that such reminders can improve medication adherence. Researchers from the VA Connecticut Health Care System in West Haven, Connecticut, recently found interest in using computerized psychotherapies among veterans participating in outpatient substance use treatment.

New Mexico veterans retire American flags (KRQE)
The New Mexico Veterans’ Memorial in Albuquerque is collecting American flags that need to be disposed. “They are dirty, they are torn,” said a volunteer. Some of the flags are faded. Others are old. “Don’t throw it in the trash or the dumpster,” the volunteer said. Instead, volunteers at the Veterans’ Memorial want people to bring their old American flags to them. “Treating the flag properly from the beginning to the end of its life, I think is important,” said New Mexico Veterans’ Memorial President Donald Loftis. Donald Loftis is a Vietnam veteran. To him, the American flag is more than a piece of fabric that flaps in the wind. “It’s a symbol of honor, not only for our nation, but for those who have served,” Loftis said. That’s why retiring the flag in the right way is so important to him. On Saturday, volunteers from the Veterans’ Memorial and Sagebrush Community Church held a flag retirement ceremony. They cut the flags into four pieces making sure to never cross into the field of blue. “The honor is to keep the stars together because it has only been separated one time during the Civil War, so we don’t cut the flag on the stars. We just cut the stripes,” Loftis said. Once the flag had been cut. Volunteers put saw dust in a fire pit. Then, they put the flags in the pit with the stars facing upward. The fire was lit. Then, the group said the Pledge of Allegiance. “It’s such an honor to be able to see a ceremony like this,” said Sagebrush Community Church volunteer David Tomasi. The ceremony was intended to honor those who have given the ultimate sacrifice and those who continue to serve. Volunteers at the memorial have a flag retirement ceremony about twice a month.