April 15 Veterans News

April 15 Veterans News

VetsHQ News UpdateReport: Multiple VA facilities shredding veteran claims documents (VetsHQ)
The Department of Veterans Affairs (VA) continued poor handling of veteran disability compensation claims is once again in the spotlight as multiple VA offices have reportedly been shredding veteran claims-related documents. VA Office of Inspector General (OIG) investigations into claims-related document shredding began at the VA’s Los Angeles Regional Office after an initial complaint was filed in January, 2015. Expanded and unannounced investigations took place at 10 Regional VA Offices across the country on July 20, 2015. The OIG team obtained around 438,000 documents destined for the shredder and found 155 documents that were related to veteran disability compensation claims. The reports, released Thursday, April 14, 2016, identified 69 of the 155 claims-related documents were “improperly scheduled for destruction”, and six out of ten VA Regional Offices did not “properly associate” documents with veterans’ claims folders. The report concluded improper handling and destruction of claims related documents is a systemic issue throughout the VA. … While the number of documents found to be improperly handled appears low, the effect on Veterans should not be minimized. The VA has 56 Regional Offices with regular shredding schedules and many more Veterans could be affected by the mishandling of claims related documents. The findings are an important reminder to Veterans to always keep your own copies of personal files and documents when filing a claim with the VA. According to the reports the biggest offender was the Atlanta Regional Office. Out of 71 documents reviewed 55 were incorrectly placed in the shred bin; 1 affecting benefits, 2 potentially affecting benefits, and 52 that did not directly affect benefits. Other VA Regional Offices reviewed included Baltimore, Chicago, Houston, New Orleans, Oakland, Philadelphia, Reno, San Juan, and St. Petersburg.

Senators move to give veterans access to medical marijuana (MilitaryTimes)
The Senate Appropriations Committee on Thursday passed an amendment that would let Veterans Affairs doctors discuss and recommend marijuana as a potential medical treatment in states where it is legal. An addition to the fiscal 2017 Military Construction, Veterans Affairs and Related Agencies appropriations bill, the bipartisan amendment sponsored by Sen. Steve Daines, R-Montana, and Sen. Jeff Merkley, D-Oregon, would let VA doctors discuss marijuana as a potential medical treatment, similar to the allowances given civilian physicians in medical marijuana states. The move marks the second time senators have tried to improve access to medical marijuana for veterans who are treated at VA medical facilities and want to use marijuana for medical purposes. The provision was approved by the full Senate last November in the fiscal 2016 VA appropriations bill but was stripped from the final law. Under the amendment, VA would be prohibited from using funds to “interfere with the ability of veterans to participate in medicinal marijuana programs approved by states or deny services to such veterans.” In January, 21 lawmakers wrote VA Secretary Bob McDonald urging him to allow doctors to discuss and recommend marijuana. The group, including 19 Democrats and two Republicans, wanted VA to abandon a policy that prohibits physicians from discussing the drug, which is still illegal under federal law. Twenty-three states and the District of Columbia have legalized medical marijuana, and 17 states have laws allowing physicians to prescribe oils derived from marijuana plants. Daines emphasized that the amendment would not change any laws preventing the possession or dispensing of marijuana on VA property. It was adopted by the committee in a 20-10 vote. The VA recommends that its physicians use “evidence-based” practices — therapies proved by scientific research to be effective — to treat mental and physical health conditions such as post-traumatic stress disorder, depression and pain. There has been no research in the U.S. on the effectiveness of medical marijuana for relieving symptoms of post-traumatic stress disorder or other conditions, although some veterans groups and marijuana legalization advocates say it does help relieve symptoms of combat-related PTSD and anxiety.

VA employees disciplined in health enrollment scandal (MilitaryTimes)
Seven Veterans Affairs employees, including two senior executives, face disciplinary action for their involvement in a scandal surrounding the department’s health care enrollment system, which last year was found to contain the names of 300,000 deceased veterans. VA Deputy Secretary Sloan Gibson said Friday the employees, from the VA’s Health Eligibility Center in Atlanta, Georgia, and VA Member Services, and two Veterans Health Administration senior executives with “responsibility for enrollment and eligibility programs,” have received disciplinary notices. They have 30 days to respond and remain at work while the process unfolds, Gibson added. “This is a process that has not served veterans well. It’s been broken for a long time,” Gibson said. “I have not seen the evidence, but my presumption is the charges are associated with management negligence and failure to take appropriate action.” The VA Office of Inspector General last year found that the VA’s health enrollment system contained 847,882 pending applications, some dating back 20 years, and more than 300,000 from veterans who had since died. The investigation also found that roughly 10,000 applications may have been deleted from the system and veterans not notified of the error. VA has been under fire for the past year over its handling of holding employees accountable for mistakes and misconduct. Congress in 2014 passed legislation that allowed VA to accelerate the disciplinary process but said VA officials have been slow to react or to terminate employees when appropriate. In December, Gibson said VA was making its own changes to the process, no longer waiting for outside investigations to be completed before moving ahead with punishment and stopping placing employees on paid leave during disciplinary investigations. Regarding the actions proposed against employees overseeing the health enrollment system, Gibson said he would not “get into specifics,” but would announce any “conclusive actions,” when they are done. Since December, VA has been chipping away at the health applications backlog, starting with 34,000 combat veterans who should have automatically qualified for health care but wound up in the application system accidentally. According to Gibson, VA has since enrolled 6,500 of those veterans and continues to work to contact the remaining. VA also has started to reach out to the remaining 500,000 veterans in the system, having enrolled 11,000 veterans in the past two weeks and reaching a decision on care for another 10,000 former service members. VA in March announced that post 9/11 combat veterans who have applied for health care but have not heard from the department could enroll by phone. On Friday, Gibson said starting on Memorial Day, veterans will be able to apply for health care online, through a new portal, www.vets.gov. VA will abolish a requirement that all veterans provide a signed application for health care on July 5, he added.

Obama pledges support for vets at annual Wounded Warrior bicycle ride (USA Today)
With the sound of President Obama blasting a starting horn and a military band playing “Stars and Stripes Forever,” 65 wounded service members and veterans pedaled around the South Lawn of the White House and off on a three-day, 60-mile cycling tour. In hosting the annual Wounded Warrior Ride for the final time in his presidency, Obama said the indomitable spirit of the U.S. armed forces is about is “about dedicating your life to a cause that is bigger than yourself.” “It’s about support and love for each other and for our country that flows through everybody who serves under our proud flag. And it’s about the country that pledges to be with you every step of the way, not just when we need you, but also when you need us.” Many of the riders — from every branch of the armed forces and almost every rank — used adaptive bicycles, but Obama noted that others were “still working through wounds that are harder to see, like post-traumatic stress.” The annual ride began in 2004 with a single rider and is sponsored by the Wounded Warrior Project, a veterans charity that ousted two executives last month after a CBS News investigation into lavish spending and high overhead costs.

Senate keeps VA watchdog nominee in limbo despite crises at the agency (USA Today)
The confirmation battle over Supreme Court nominee Merrick Garland isn’t the only one mired on Capitol Hill. Senators also are blocking the nominee to be the top watchdog at the Department of Veterans Affairs. President Obama nominated Washington lawyer Michael Missal in October to be the inspector general at the VA, but one-by-one, senators — both Democrat and Republican — have placed holds on any confirmation vote for Missal, citing problems at the VA they want addressed first. The paradox is that under federal law, the inspector general is an independent watchdog responsible for rooting out those problems and making recommendations for improvement. And the post has been vacant at the VA since December 2013, occupied by interim inspectors general even as crisis after crisis plagued the agency. “It’s just crucial that these agencies — every agency, but in particular the VA with all the problems they’ve had — that they have a completely independent, completely transparent and permanent IG,” said Sen. Ron Johnson, R-Wis., chairman of the Senate Homeland Security and Governmental Affairs Committee, who has tried to persuade colleagues to allow a vote on Missal. Johnson was one of 10 senators from both parties who urged Obama last summer to nominate someone to fill the post. Their pleas followed increased criticism of the interim inspector general at the time, who failed to publicly release the findings of 140 investigations of veteran health care. … “We write to urge you to nominate an Inspector General (IG) for the U.S. Department of Veterans Affairs (VA) as soon as possible to help rebuild the trust that was lost through systemic failures in accountability and transparency at the Department,” the senators wrote in a June 2015 letter to Obama. Along with Johnson, fellow Republican Sens. Kelly Ayotte of New Hampshire, Mike Enzi of Wyoming, and Joni Ernst of Iowa also signed the letter. So senators welcomed the news when Obama nominated Missal three months later. They held committee hearings to vet the nominee, and his nomination was approved by both the Veterans’ Affairs Committee and Johnson’s committee. As of Jan. 20 this year, all that was left was a vote by the full Senate to confirm him. Then the holds began. Under Senate rules, a single senator who has reservations about a measure can request that a vote on it be delayed until his or her concerns are addressed. Sen. James Inhofe, R-Okla., held up the vote for three weeks until he received assurances the inspector general would cooperate with an independent, outside entity in investigating problems at VA medical centers in his state. USA TODAY had reported in December that the Oklahoma City VA has repeatedly failed to provide adequate care to veterans. Sen. Tammy Baldwin, D-Wis., who had signed the letter to Obama, then held up the vote for a week until she was confident the interim inspector general would release the findings of more than 70 investigations of wait-time manipulation after USA TODAY reported the IG had failed to release them for months. The reports showed schedulers at 40 VA medical facilities in 19 states and Puerto Rico regularly “zeroed out” veteran wait times, and supervisors at seven of those facilities instructed them to do so.  Sen. David Vitter, R-La., placed a hold on Missal’s nomination after the VA appointed Skye McDougall as south-central regional director overseeing medical centers in Louisiana, Arkansas, and Mississippi. She was accused of misleading Congress last spring about wait times at a VA facility she oversaw in the Los Angeles area. She had briefly been named as a new regional director overseeing the Phoenix VA last fall but landed in the south-central post after blowback from Sen. John McCain, R-Ariz. Vitter lifted his hold on Missal’s nomination last month after receiving assurances the new inspector general would investigate wait times in Los Angeles at the root of the accusations against McDougall and also reports that the VA transfers poor managers around rather than disciplining them. But not all senators in the region appear to be satisfied. Sen. Roger Wicker, R-Miss., another Gulf Coast lawmaker who opposed McDougall’s appointment, would not confirm nor deny whether he currently has a hold on Missal’s nomination. Such holds are secret and anonymous unless senators make them public. … Johnson, meanwhile, has continued to try and nudge colleagues to allow a vote on Missal, although he says they have “legitimate beefs” against the VA. “This has nothing to do with the quality of Mike Missal. I think everybody recognizes he’d be highly qualified and probably a very effective inspector general,” he said. “This is just a senator or more putting a hold because they’re upset with the VA in terms of different personnel issues in their particular state.” 

Fight over GI Bill cuts builds (MilitaryTimes)
A coalition of Democratic lawmakers and veterans organizations is vowing to block any legislation that includes proposed cuts to the Post-9/11 GI Bill, even if that means shelving a host of other proposals they authored. At issue is a measure passed without objection in the House earlier this year which would cut in half the housing stipend for dependents of veterans attending school on GI Bill benefits. The move would save the government about $773 million over the next 10 years and help pay for a host of other veterans initiatives. “This goes back on a promise that all of us here are unwilling to break,” said Rep. Tim Walz, D-Minn. “In the entire federal budget, there is nowhere else to fund [veterans] programs? That cannot stand.” For students in high-cost cities such as San Diego or New York, that cut would total $1,000 to $1,800 a month. It would not affect students already using the transferred benefit but could affect families planning on the extra money in the future. But officials from Iraq and Afghanistan Veterans of America said the move goes back on a promise made to those families that the full benefit would be available when they need it, and for the first time pulls money out of the GI Bill to fund outside programs. They painted the legislative proposal as a betrayal of veterans’ service and accused lawmakers of viewing earned benefits as a “piggy bank” for other wants. “This is a whole new level of stupid, to cut the GI Bill in a time of war,” said Paul Rieckhoff, CEO of IAVA. “This is about keeping a promise, investing in the future, about retention and recruiting and morale. “Find the money somewhere else. Either you’re with us or against us.” Officials from Student Veterans of America pushed back on that ultimatum, saying the issue is more complex than the opposition coalition will admit. “We need to remember who the Post-9/11 GI Bill was intended for: veterans,” said Derek Fronabarger, SVA’s director of policy. He challenged the idea that the legislative proposal amounts to “cuts” in veterans benefits, saying “in reality the changes are a transfer of benefits from dependents, via a 50 percent drop in [housing stipends], to Fry Scholarship recipients and reservists.” Supporters of the cut have also argued that the benefit is overly generous to children of troops, sometimes awarding them housing stipends well beyond their dorm and living costs. Savings from the change also would go to pay for a host of other programs, leaving other veterans groups with a difficult choice of whether to support the proposal. “The Veterans of Foreign Wars would never actively support any standalone provision that reduces benefits for veterans or service members, but we felt that [this bill], taken in its entirety, contained enough good provisions to support its passage,” said VFW national spokesman Joe Davis. He noted that among those are improvements to postnatal care for female veterans, expanded service animal therapy for veterans with post-traumatic stress disorder, reauthorization of the veterans work-study programs, and critical changes to VA home loan guarantees. But Walz and others argued that’s a false choice. Michael Little, director of legislative affairs for the Association of the United States Navy, said any cut to the GI Bill benefit risks adding to the stress load of military and veteran families. “If we want to talk about funding veterans’ benefits, the last place we need to look for money is in the GI Bill,” he said. “The discussion about the GI Bill shouldn’t be about where we’ll cut, it should be on sustaining and strengthening it beyond our current military budget situation.” So far, Senate lawmakers haven’t indicated whether they’ll move ahead with the House proposal or revise it for inclusion in an anticipated veterans omnibus package due out before the end of the month. Opponents hope the latest objections convince them to look elsewhere for money. “When we look troops in the eye and make them promises … they expect us to keep those promises,” said Rep. Tammy Duckworth, R-Ill. “It’s not fair to rob one group of veterans to pay for services for another. “We can do better.”

VA says it’s met congressional mandate to make its health records interoperable with DoD (Federal News Radio)
More than two years ago, lawmakers, impatient with the Defense and Veterans Affairs departments’ faltering efforts to combine their electronic health records, ordered them to at least translate their existing systems into a data format that both departments could understand. The Defense Department certified that it had done so last October, and VA has now done the same. VA signed off on the documentation attesting it has met the interoperability standards on Apr. 8, officials told the House Veterans Affairs Committee Thursday. For the time being, both departments’ clinicians are using an application called the Joint Legacy Viewer to access patient data in one another’s data systems. As of this week, about 55,000 VA users have been trained to use JLV. That represents roughly a quarter of VA’s clinicians, and the department expects the number to grow to 120,000 by the end of this year. Still, after two years of work, JLV remains a temporary workaround. The fact that VA clinicians can now see an electronic view of a patient’s entire health history during the time he or she was in the military is a giant step forward, but the viewer is separate from the AHTLA and VistA electronic health record systems in which DoD and VA medical staff, respectively, do most of their work on a patient’s record. So VA’s next planned step is to take the behind-the-scenes integration work both departments have done to make JLV a reality and turn it into web-based interface that integrates seamlessly with the VistA EHR. That product, the Enterprise Health Management Platform (eHMP) is due for wide deployment across VA medical centers in 2017.

Vets get light therapy for pain and insomnia (King5)
It’s a sad statistic, but nearly half of returning veterans tell us they suffer from chronic pain and are four times more likely to develop sleep disorders. But instead of treating them with medications with heavy side effects, researchers are shedding some light on the matter with a different approach. Sleepless nights have been a way of life for Lisa Smith for nearly three decades.  “I could sleep for a good 15 minutes, go into a good, deep 15-minute sleep and all the sudden, I’d be wide awake.” She’s convinced her tossing and turning started when her tour of duty ended, but her body’s military time clock didn’t. “So, I’m still getting up early in the morning, 4:30, 5 o’clock in the morning, getting ready as if I’m going to stand in 6 o’clock formation,” she explained. She also began developing back pain. Now, a new study is shedding light on why. “We live on a planet that has a 24-hour day. So, because of that, plants, animals, fish, lizards, everybody has some sort of circadian rhythm tied to that 24-hour clock,” said John Burns, PhD, Professor at Rush University Medical Center in Chicago. Your body clock, officially known as your circadian rhythm, helps control the release of melatonin, essential for a good night’s rest. Researcher John Burns says when your body is out of sync, “what accompanies that is sleep disorder, sleep problems and mood problems. And we also think increases in pain sensitivity.” Now, researchers at Rush University are testing a drug-free alternative to treatment: light therapy. After they wake up, participants like Lisa sit in front of a UV-free light box for an hour to help reset their body’s clock. Smith said, “It just feels like a bright day.” And it works. She explained, “It reminds me kind of like when I was a kid. In the summertime, I would play outside under the sun for so long and then at nighttime I was just worn out, just time to go to bed.” For the first time in years, she’s sleeping soundly and waking up without pain. Participants sit in front of the light box for two weeks. Researchers are studying how long the effects last. The vet bright light study at Rush University is still recruiting. It’s one of 13 federally funded studies exploring non-drug approaches to managing chronic pain and other health conditions in veterans.

VA officials evaluating electronic health record recommendations (FierceEMR)
Department of Veterans Affairs (VA) CIO for the Office of Information Technology LaVerne Council said Thursday that the VA this summer will go into more detail on its future electronic health record plans. At a hearing held by the House Committee on Veterans’ Affairs Subcommittee on Health, Council said Veterans Health Administration Under Secretary for Health David Shulkin is in the process of evaluating her recommendation for a “state-of-the-art, world class” EHR system. While Council was light on details, she did say the system is “incredibly responsive,” agile and leverages Health Level Seven International’s Fast Healthcare Interoperability Resources (FHIR) standard. … Council previously has discussed the possibility of replacing the Veterans Health Information System and Technology Architecture (VistA), the agency’s homegrown EHR system, with a commercial, off-the-shelf product, similar to what the Department of Defense is doing via a contract awarded last summer to a team led by Leidos, Cerner and Accenture. Council and Shulkin also discussed ongoing efforts around the use of two scheduling systems–the Veteran Appointment Request (VAR) mobile application and the VistA Scheduling Enhancement (VSE) system. Shulkin reiterated a statement made by Council at a House Oversight & Government Reform committee hearing last month that, should VAR and VSE be deemed successful, the VA will use those solutions to improve scheduling efforts over the much broader Medical Appointment Scheduling System (MASS), for which Systems Made Simple and Epic won a $624 million contract last August. Shulkin said the entire VSE project would cost taxpayers a total of $6.4 million, whereas just to pilot MASS over roughly a year, it would cost $152 million. To date, $11.8 million has been spent on MASS, which is on hold while VAR and VSE are tested over the next couple of months, Shulkin said. … Rep. Ann McLane Kuster (D-N.H.) noted that while the savings sound intriguing, she wants assurances that VAR and VSE would be sufficient over the more robust MASS system before abandoning it.

No funding for veterans home in Kentucky state budget (BG Daily News)
A (Kentucky) state budget being voted on Friday does not include funding for a long-sought 90-bed veterans nursing home in Bowling Green. “I’m absolutely disappointed,” state Rep. Jim DeCesare, R- Bowling Green, said, adding that the proposed allocation would be in the form of a commitment to issue a $10.5 million bond and would not require any immediate expenditures. “But they showed no desire to do that,” he said of some legislators. Democratic leaders – other than House Speaker Pro Tem Jody Richards, D-Bowling Green – failed to get behind the proposal, DeCesare said. “Our people have been working on this for years,” he said. Richards said there was an effort to get it in. “That’s the biggest disappointment in the budget,” Richards said. Richards and DeCesare were part of the leadership group that worked on the budget proposal until 3 a.m. EDT Thursday. The full House and Senate are voting on the budget Friday before sending it to Gov. Matt Bevin. … In the end, the votes were not there to get the funding included. Ray Biggerstaff, a local veteran and veteran’s advocate who has been helping lead the effort to get the facility for several years, said “ignorance and stupidity” were to blame for the lack of funding. … The project has bounced in and out of proposed budgets this year. The Office of Kentucky Veterans Centers’ five-year capital projects budget request sent to Bevin’s office included the Bowling Green facility, but it was not included in the budget Bevin sent to legislators in January. A House budget amendment sponsored by House Republicans and approved by a 49-46 margin last month included the funding, but a subsequent Senate version of the budget did not, nor did the compromise version now being sent to Bevin. The project to serve the region’s approximately 40,000 veterans is on the U.S. Department of Veterans Affairs’ list of priority projects with funding of about $20 million allocated, but the project can’t move forward without the matching state funds. If the allocation were in the budget, the Bowling Green facility would have moved from about the 109th spot on the federal priority list to about 54th, Richards said previously. Richards said he was unsure of what the lack of funding will do to the project, other than ensure it does not move up the priority list. The Inter-Modal Transportation Authority Board – the governing body of the Kentucky Transpark in Bowling Green – formally approved last year a donation of about 20 acres valued at more than $1 million at the transpark for the proposed facility. The next chance to get state funding is in 2018 when the state’s next two-year budget is due. “We will work with the Department of Veterans Affairs; we will do everything we can,” to get it in the budget, Richards said. Biggerstaff said he will continue working with the Department of Veterans Affairs and pursue other options.

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