March 29 Veterans News

March 29 Veterans News

VetsHQ News UpdateSen. Burr, Tillis lead effort to get disability benefits for Camp Lejeune vets with bladder cancer (The Ripon Advance) U.S. Sens. Richard Burr (R-NC) and Thom Tillis (R-NC) recently spearheaded successful efforts to get bladder cancer added to the Department of Veterans Affairs (VA) list of presumptive diseases. The VA announced on Thursday that a presumption of service connection had been established for service members suffering from bladder cancer from contaminated drinking water at Marine Corps Base Camp Lejeune in North Carolina. Last year, the VA did not include bladder cancer on a list of eight presumptive diseases for veterans who served at Camp Lejeune. Veterans who suffer from presumptive diseases qualify for disability compensation. “I’m glad the VA is stepping up to help the veterans who were negligently poisoned by the water at Camp Lejeune,” Burr said. “The scientific link between bladder cancer and service at Camp Lejeune is clear. I had a lot of questions for the VA when bladder cancer was not included on the initial list of presumptive diseases. This is an important step in the right direction.” Burr and Tillis led efforts to get bladder cancer added to the list, recently urging Office of Management and Budget Director Shaun Donovan to not allow cost to be a deterrent to establishing disability presumption for bladder cancer. “While there was no excuse for the VA to initially deny disability compensation for veterans who developed bladder cancer as a result of past toxic water contamination at Camp Lejeune, I’m grateful that the VA made the right decision in the end,” Tillis said. “We have a debt of obligation to the veterans, family members and other civilians who were poisoned at Camp Lejeune, and today’s announcement helps us provide hundreds of more veterans with the compensation they need and deserve.”

Read MoreVA places hold on Camp Lejeune Veterans bladder cancer claims

Veterans face greater risks amid opioid crisis (PBS)
As the United States struggles to deal with what’s been called the worst drug crisis in American history, its veterans have also been caught up in the opioid epidemic. About 60 percent of those returning from deployments in the Middle East, and 50 percent of older veterans suffer from chronic pain, according to Veterans Affairs officials. That’s compared to about 30 percent of Americans nationwide. Veterans face a double-edged threat: Untreated chronic pain can increase the risk of suicide, but poorly managed opioid regimens can also be fatal. Veterans are twice as likely to die from accidental opioid overdoses than non-veterans, according to a 2011 study of the VA system. Until a few years ago, the VA was treating veterans’ chronic pain almost exclusively with prescriptions for opioid painkillers. Prescriptions for opiates spiked by 270 percent over 12 years, according to a 2013 analysis by the Center for Investigative Reporting, leading to addictions and a fatal overdose rate twice the national average. The VA has taken some steps to address the problem. Since 2012, the height of the VA’s opioid prescribing, the department has reduced the number of veterans receiving opioids by 20 percent, and cut the overall opioid dosages for about 17,000 patients, the VA said. It has also begun screening more patients for depression and potential substance abuse problems, and coming up with more comprehensive approaches to chronic pain. But the number of veterans with opioid-use disorders continues to grow, spiking by 55 percent over the past five years, from 2010 to 2015. The most recent figure, 68,000 veterans, represents about 13 percent of the total population of veterans currently taking opioids, according to VA data. Dr. Carolyn Clancy, the VA’s deputy under secretary for health and organizational excellence, attributed the rising tally to an increase in diagnoses. “I’m very pleased to say that we have made substantial progress across the system,” she said, citing the reduction in opioid prescriptions and initiatives to better track veterans’ care. She added: “We’re not done, but it is literally a priority that is part of the fabric across our system, and we monitor this on a regular basis.” But the VA has also acknowledged continued shortcomings in its handling of veterans with chronic pain, noting in a February letter to Sen. Joe Donnelly, D-Ind., that doctors don’t have enough time to follow up on veterans’ cases and that there is uneven access to care. … Perhaps the biggest challenge for the VA is finding a way to manage veterans’ chronic pain without depending solely on opioid painkillers. Addressing chronic pain is complex, Clancy said. … It’s also time consuming. By the VA’s own admission, doctors often don’t have enough time to spend with patients to craft more tailored treatments. … Some VA centers have started to introduce programs on managing chronic pain with acupuncture, yoga, mindfulness and physical therapy that can either reduce the need for painkillers or eliminate it entirely. But such programming is still lacking in many centers, veterans and advocacy groups say. Change is “happening, but it’s not happening everywhere,” said Jackie Maffucci, research director for Iraq and Afghanistan Veterans of America, an advocacy group, of the VA’s progress. “And it’s not happening 100 percent of the time.” … As the number of veterans diagnosed with opioid addictions increases, the VA has tried to curb opioid overprescribing and abuse. In 2013, the VA launched what it calls the Opioid Safety Initiative to track opioid use among veterans in its health care system. Veterans who take opioids are also required to sign a consent form and submit to urine tests. The VA has started connecting with state prescription drug monitoring programs, which log controlled substances to prevent patients from obtaining multiple prescriptions from different doctors. As of February 2016, the VA said that it’s currently connected to state programs in 37 states. By 2011, the year before the VA’s opioid prescriptions peaked, the number of veterans who overdosed on opioids had risen 33 percent, according to the VA. That’s only a fraction of the total that was taking opioids at the time, and the VA didn’t have more recent data. But the risk of overdose, either accidentally or otherwise, remains high enough that in 2014 the VA began distributing naloxone, the drug that can reverse an overdose, to veterans who might be at risk. VA officials said the drug has been used to save 63 veterans since then.

Vietnam Veterans Day honors troops (Military Times)
Hundreds of events were held across the U.S. on Tuesday to commemorate Vietnam Veterans Day, an unofficial observance that marks the final withdrawal of combat units and support personnel from South Vietnam in 1973. Part of an ongoing effort to honor U.S. troops who served during the Vietnam War era, the events — from a wreath laying by Defense Secretary Ash Carter and Veterans Affairs Secretary Bob McDonald at the Vietnam Veterans Memorial in Washington, D.C., to photo exhibits and memorials at VA centers and cemeteries — are meant to recognize those “who have ‘borne the battle,’” McDonald said. “When Vietnam veterans came home 50 years ago they didn¹t get the kind of welcome that veterans get today,” McDonald said. “What Ash and I tried to do today was to welcome home all those veterans and make sure that they felt the thanks and appreciation that veterans today feel.” The Defense Department is overseeing a 13-year commemoration to recognize those who served on active duty from Nov. 1, 1955, to May 15, 1975, many of whom returned home from the unpopular war without fanfare or appreciation. Since 2011, Sen. Richard Burr, R-N.C., has tried to designate March 29 officially as Vietnam Veterans Day, but his proposed legislation has failed to gain steam in Congress. In 2012, President Obama issued a proclamation formally observing the day in response to a request from Burr and Sen. Barbara Boxer, D-Calif. “Our veterans answered our country’s call and served with honor. … Yet, in one of the war’s most profound tragedies, many of these men and women came home to be shunned or neglected — to face treatment unbefitting their courage and a welcome unworthy of their example. We must never let this happen again,” Obama wrote in 2012. The Vietnam War Commemoration will run through Veterans Day 2025, and more than 5,300 activities have been planned to date. A full listing of events, as well as an interactive historical timeline of the Vietnam War, fact sheets, map and more, can be found at the DoD Vietnam War Commemmoration website. According to the VA, more than 329 medical centers, regional benefit offices and national cemeteries planned to participate in events Tuesday. “Our nation is currently commemorating the 50th anniversary of the Vietnam War, a long overdue opportunity to honor the 7.2 million living Vietnam veterans and the 9 million families of those of us who served. … Thank a Vietnam veteran and welcome them home,” McDonald said.

Sen. John McCain calls for universal, permanent VA Choice Card (azcentral)
Arizona Sen. John McCain unveiled a new action plan for the U.S. Department of Veterans Affairs at a Monday town hall in Phoenix, declaring that after nearly two years of reform efforts “our veterans still have not gotten the care they need and deserve.” The Republican senator’s new initiative calls for the VA Choice Card — which allows some patients to obtain private care at the department’s expense — to be made universal and permanent. In the aftermath of a 2014 scandal over delayed care for veterans, the Choice Cards were authorized by Congress for use by veterans stuck on months-long wait lists for VA doctor appointments, and by those who lived more than 40 miles from a veterans hospital or clinic. McCain said those limitations should be dissolved so all veterans can get care from non-VA providers. He also ripped the federal agency for failing to educate employees and veterans so they can take advantage of the existing Choice Card. “The question remains: Is the VA getting better?'” McCain said. “Veterans who try to access the Choice Card complain they have to wait hours on hold with the VA call center just to reach someone knowledgeable about the program.” … McCain stressed at the town hall that his reform plan includes new legislation that would enable the VA to more easily demote or fire senior executives who violate the law or department policies. It also calls for improved training and performance evaluations. Other provisions in the Care Veterans Deserve plan would:

  • Allow all veterans eligible for VA care to use walk-in clinics without pre-authorization or co-payments.
  • Keep VA medical facilities open nights and weekends, and invite private health-care workers to volunteer during those hours.
  • Subject Arizona VA hospitals to peer reviews from the Mayo Clinic or other private health-care experts.
  • Change the VA’s pay structure to retain top physicians.

Nearly 100 people attended the event. Most of those who spoke complained about struggles to obtain VA care or benefits. Most of them asked questions such as “How long do I have to be in pain?” and “What’s being done to fix things?” McCain stressed that there have been improvements. But he said changing the VA bureaucracy is difficult — “like kicking a sponge” or “turning one of those oil tankers around” in mid-ocean.

Imaging predicts long-term effects in veterans with brain injury (Bioscience Technology)
Diffusion tensor imaging (DTI), a type of MRI, may be able to predict functional post-deployment outcomes for veterans who sustained mild traumatic brain injury (MTBI), or concussion, during combat, according to a new study published in the journal Radiology. MTBI is a public health problem of increasingly-recognized importance, particularly among military veterans. Recently, there has been a dramatic rise in the incidence of combat-related MTBI. More than 300,000 U.S. service members were diagnosed with MTBI between 2000 and 2015, according to the Armed Forces Health Surveillance Center. Current assessment of MTBI remains challenging due to the difficulties in establishing the diagnosis, predicting outcomes and separating the effects of MTBI from other conditions like post-traumatic stress disorder (PTSD). DTI uses measurements of water movement in the brain to detect abnormalities, particularly in white matter. Previous studies have linked DTI metrics to neurocognitive function and short-term functional outcomes in groups of patients. The desire to uncover possible long-term effects spurred Jeffrey B. Ware, M.D., from the Philadelphia VA Medical Center in Philadelphia, Pa., to evaluate combat veterans using this technique. Dr. Ware and colleagues used brain MRI and DTI to study 57 military veterans who had a clinical diagnosis of MTBI upon return from deployment. The average length of time between injury and post-deployment evaluation was 3.8 years with an average follow-up duration of 1.4 years. … The results showed significant associations between initial post-deployment DTI measurements and neurobehavioral symptoms, timing of injury, and subsequent functional outcomes. The measurements also correlated with greater healthcare utilization among veterans with MTBI. Following initial post-deployment evaluation, 34 of the study participants returned to work. Veterans who did not return to work displayed significantly lower fractional anisotropy (FA) and higher diffusivity in a specific brain region, the left internal capsule. These measures imply less structural integrity in that area of the brain. As this region is known to contain important fibers providing motor stimulation to the typically dominant right side of the body, the results may provide a correlation between impairments in fine motor functioning and inability to return to work. “Our findings suggest that differences in white matter microstructure may partially account for the variance in functional outcomes among this population. In particular, loss of white matter integrity has a direct, measurable effect,” Dr. Ware said. “It was illuminating to see the association between measures of white matter integrity and important outcomes occurring months to years down the road in our study population.”

MouthMobile brings free dental care to veterans (Military Times)
Veterans who can’t afford to make regular trips to the dentist may now have an alternative — the dentists are coming to them. Aspen Dental, a nationwide network of locally owned and operated dental practices, and Got Your 6, a nonprofit dedicated to empowering veterans to strengthen communities, have teamed up for the Healthy Mouth Movement, which includes a “MouthMobile” that will stop at more than 30 cities across the country over the next several months. The dental clinic on wheels offers care ranging from a regular cleaning to a set of dentures. “When you think about empowering veterans and strengthening communities, oftentimes veterans don’t have the basic services, including dental care,” said Bill Rausch, an Army veteran and executive director of Got Your 6. Not all veterans qualify for dental care at the VA, Rausch said, so this provides an opportunity for them to receive the care they need. Aspen Dental created the Healthy Mouth Movement in 2014, which started as a broad outreach effort to anyone who needed dental care but typically who normally couldn’t get it. “The following year, we decided to hone it to our nation’s veterans,” said Dr. Jere Gillan, a dentist with Aspen Dental and an Air Force veteran. “We see a huge disparity in dental care in a lot of Americans but really in the veteran community.” The MouthMobile stops in cities where local dentists and hygienists will volunteer their time and services to treat veterans for a day. Since the Healthy Mouth Movement was initiated, Aspen Dental has helped almost 7,000 people across the country, resulting in nearly $4 million in free dental care and education. The MouthMobile has seen 164 patients since the 2016 tour began in February, with more than $76,000 in dental care and assistance donated. One veteran who visited the rolling dental clinic didn’t feel comfortable or confident enough to leave his house, Rausch said, but after receiving a set of dentures, he’s pursuing a career and volunteering. … For those who aren’t dentists but still want to contribute to the program, all they have to do is smile … then take a selfie and post it with the hashtags #Smile4Vets and #Sweepstakes. “For every selfie shared, Aspen Dental donates $1 to Got Your 6,” Rausch said. Anyone who shares a selfie will be entered to win a year of free dental care, plus a meeting with NASCAR driver and Healthy Mouth Movement ambassador Danica Patrick. … Appointments for the MouthMobile are filled in advance with support from local veterans organizations. To learn more about the MouthMobile tour, visit HealthyMouthMovement.com.

Senator Warner responds to veteran brain injury investigation (13News Now)
A U.S. Senator is getting involved after a 13News Now investigation uncovered veterans might not be getting the medical care and benefits they have earned. Sen. Mark Warner said we need to know if Veterans Affairs hospitals are allowing vets to see the proper medical specialists to diagnose Traumatic Brain Injuries. We brought our story to Sen. Warner when we couldn’t seem to get uniform answers from the VAs in our area. We have been trying to find out whether or not the people vets are trusting to diagnose brain injuries are qualified to do so. Warner told us his office is now investigating. Vets around the country and right here in Hampton Roads are suffering from Traumatic Brain Injury or TBI, an injury we’ve seen time and time again in the War on Terror. In most cases, it affects everything a vet does and has become the price paid for a veteran’s service. “We’ve seen too many folks come back from the conflicts in Iraq and Afghanistan with these kind of injuries,” Sen. Warner said. The case of Minnesota vet Anton Welke illustrates the problem we’re trying to get to the bottom of: Anton suffered a head injury while serving on the USS John C. Stennis in 2002. … The Navy vet is one of several hundred who were seen by unqualified medical staffers at the VA. We’ve been telling you the VA’s own rules specify who is qualified to perform the exam, which can make that crucial initial TBI diagnosis. The list includes just four specialists, like psychiatrists and neurologists. … Reporters at our sister stations across the country have learned vets are often unknowingly forced to trust unqualified medical professionals to make the diagnosis. It is a diagnosis that affects the compensation and benefits vets receive. We’ve seen cases in Minnesota and Texas, places with large veteran populations, just like Hampton Roads. “I find that unacceptable,” Sen. Warner reacted. “I mean, the VA is a public entity. It is funded by the taxpayers. It’s got to follow its own rules and procedures.” When we tried to get information from the Hampton and Richmond McGuire VAs, our requests were originally denied. Then, months later, the medical centers sent us lists that don’t match. They interpreted the same requests differently, so we still aren’t sure exactly what’s going on here. We don’t know whether or not the right people are making the diagnoses. “It shouldn’t be left to some nurse practitioner or somebody that may not have the adequate skills to do it and so I want to see this data as well and if they’re not following their own rules they need to be held accountable,” Warner explained. Shortly after we interviewed Sen. Warner, the regional VA media affairs office contacted us to try to clarify the data. We’re still working with them in the hopes of finding out if veterans here are receiving the care their sacrifice has earned. “They have the right and it is our responsibility to make sure that they get that diagnosis by the appropriate medical personnel,” Warner added.

Florida Veterans’ Affairs Chief to step down (Palm Beach Post)
Florida Department of Veterans’ Affairs Executive Director Mike Prendergast told Gov. Rick Scott and the Florida Cabinet on Tuesday that he is resigning to run for Citrus County sheriff. Prendergast, who has had a home in the Gulf Coast county for more than two years, said he will recommend Al Carter, the Veterans’ Affairs deputy executive director, as his replacement. “Al has been in the agency with me for almost four and a half years now, and Al understands how the agency works,” Prendergast told reporters after formally advising Scott and the Cabinet of his plans during a meeting at the Capitol. Carter is a retired U.S. Army colonel who spent 28 years in the military, including tours in Qatar, Afghanistan and Iraq. Prendergast, a Republican, will run for a position that has been held by Democrat Jeff Dawsy for two decades. Dawsy has announced he will not seek re-election. Prendergast, who becomes the fifth candidate to enter the sheriff’s contest, said Citrus County may be ready for “a fresh face” and added that one out of every five voters in the county has served in the military. “There are a lot of counties across our state that have a huge veteran demographic, but this is by far one of the largest veteran demographics among the electorate,” Prendergast said. Prendergast served as Scott’s first chief of staff before taking over Veterans’ Affairs in June 2011. Scott and the Cabinet accepted the resignation. “We do expect you to win if you’re going to do this,” Scott told Prendergast. Prendergast, a graduate of Clearwater Central Catholic High School, spent 31 years with the armed forces. He served as a military police officer and on combat deployments in Iraq and Afghanistan, along with assignments in Africa, Europe and Asia, according to his Veterans’ Affairs biography.

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