April 8 Veterans News

April 8 Veterans News

VetsHQ News UpdateVA bosses in 7 states falsified vets’ wait times for care (USA Today)
Supervisors instructed employees to falsify patient wait times at Veterans Affairs’ medical facilities in at least seven states, according to a USA TODAY analysis of more than 70 investigation reports released in recent weeks. Overall, those reports — released after multiple inquiries and a Freedom of Information Act request — reveal for the first time specifics of widespread scheduling manipulation. Employees at 40 VA medical facilities in 19 states and Puerto Rico regularly “zeroed out” veteran wait times, the analysis shows. In some cases, investigators found manipulation had been going on for as long as a decade. In others, it had been just a few years. In many cases, facility leaders told investigators they clamped down the scheduling improprieties after the Phoenix scandal, but in others, investigators found they had continued unabated.The manipulation masked growing demand as new waves of veterans returned from wars in Iraq and Afghanistan and as Vietnam veterans aged and needed more health care. In 2014, The Arizona Republic, part of the USA TODAY NETWORK, and other media revealed scheduling manipulation at Phoenix VA Medical Center and that dozens of veterans died while waiting for care. Subsequent reporting that year showed that similar problems extended nationwide. Investigators had said manipulation was “systemic,” but they did not identify which facilities had problems and how serious they were. The inspector general soon launched investigations of more than 100 facilities. The newly released findings of those probes show that supervisors instructed schedulers to manipulate wait times in Arkansas, California, Delaware, Illinois, New York, Texas and Vermont, giving the false impression facilities there were meeting VA performance measures for shorter wait times. In some cases, the system encouraged manipulation even without explicit instruction from supervisors. A manager in West Palm Beach, Fla., sent out laudatory emails touting the shorter wait times the system showed. Schedulers in Harlingen, Texas, reported being berated by supervisors when they booked appointments showing longer wait times for veterans. (It was “not pretty,” one employee said.) In some cases — in Gainesville, Fla., White River Junction, Vt., and Philadelphia, for example — they found VA employees improperly kept lists of veterans needing care outside the scheduling system, a violation that also hid actual wait times. Roughly half of the 70 newly released reports are from investigations completed more than a year ago, and the VA says it already initiated discipline against 29 people — three of whom left the agency — because of the findings. The agency said it has retrained thousands of schedulers and is updating software to make it easier for them to book appointments properly. A pilot program at 10 facilities allows veterans to book their own appointments, and the VA expects to roll that out nationwide, according to David Shulkin, a physician who took over as undersecretary for health at the VA in June. Shulkin told USA TODAY he also initiated two massive, same-day efforts to try to provide care sooner for more than 100,000 veterans, and he said the agency also has increased capacity to get wait times down. … But VA whistle-blowers say schedulers still are manipulating wait times. Shea Wilkes, co-director of a group of more than 40 whistle-blowers from VA medical facilities in more than a dozen states, said the group continues to hear about it from employees across the country who are scared to come forward. … This is not the first time the VA has said it would fix problems with scheduling. When the inspector general found in 2005 that VA schedulers were improperly booking appointments — and wait lists were therefore underestimated by as many as 10,000 veterans — the agency initiated a “national education plan” to retrain schedulers and supervisors. In 2010, VA officials discovered schedulers were using “gaming strategies” to falsify wait times to meet agency performance targets, and they required all schedulers to undergo new training, once again. In the newly released reports, investigators found schedulers were using the same strategies. Most commonly, schedulers would start the wait clock on the day of the appointment they were booking rather than when the veteran wanted to be seen. The system then showed there was no wait time even if the veteran had to wait weeks or months for an appointment. … As recently as October, the Government Accountability Office said the VA’s wait-time system still is prone to scheduler error and produces unreliable data.

Read MoreOIG reports verify allegations at some VA medical facilities

VA promises veterans same day appointments (Syracuse.com)
The VA health system, which has been dogged by long patient wait times, will offer veterans same day appointments for primary care at each of its 168 medical centers nationwide by the end of the year. Same-day appointments and other steps to improve access to care for veterans were announced today by the VA’s top health care official at the annual Association of Health Care Journalists conference. “We are an organization that needs to regain the public trust,” said Dr. David J. Shulkin, the VA’s undersecretary for health. Since joining the VA in June, Shulkin has been leading efforts to speed up care for veterans. “I entered an organization in crisis,” he said. More than 70 recent reports by the VA’s inspector general found that supervisors at some VA facilities instructed employees to falsify patient wait time records. To reduce the patient backlog, the VA provided care to more than 130,000 veterans on two weekends in November and February, according to Shulkin. Over the next few months the VA will publish easy-to-understand wait time data on its website. It will also roll out a smart phone app that will allow veterans to schedule appointments.

Air Force veteran plans VA Agent Orange fight in D.C. (WFLA)
As U.S. forces fought their way through Vietnam’s jungles, rice paddies and villages, enemy fire often pinned them down. That’s where the F-4 came in. The interceptor fighter-bombers often plowed the road for American troops. In 1970-71 Tom Jenkins, a U.S. Air Force mechanic and crew chief, readied F-4’s for the war. … Tom, now 71, was stationed at the Ubon Royal Air Force Base in Thailand. There he and others met a different enemy. “In fact they’d talk about you’re standing in Agent Orange, ‘Don’t worry about it. It’s not toxic. It won’t hurt you,’” Tom recalled. He claims Agent Orange was used to knock down the foliage around the perimeter of the base, where he stood guard and worked on engines. He says he also wore frayed asbestos suits and, while serving as a crew chief on the F-4’s, stood on or near the plane during radar checks, exposing him to radiation. U.S. forces sprayed Agent Orange to kill vegetation where the enemy hid. Exposure to it continues to kill Americans who served there. Tom, who now lives in Belleair Bluffs, has developed skin and prostate cancers, heart disease and peripheral neuropathy, which causes stabbing burning pain. … Those diseases and a list of others are tied to Agent Orange exposure. Tom applied for Department of Veterans Affairs benefits in 2013, submitting 50 pages of evidence. Eight months later he received a notice from the VA. “No evidence to support this claim has been received to date,” the notice said. The VA also said, “Because the required service in Vietnam is not shown nor is there evidence of exposure to herbicides during military service.” Tom claims he rushed to Bay Pines and demanded to see his file, which contained only his application. After climbing the chain of command, a supervisor eventually found his documentation. “I think they were mad because I caught them not submitting 50 pages of evidence into my file and they took offense to it,” Tom said. The VA did provide him a 10 percent disability for developing tinnitus, ringing in the ears, due to exposure to loud jet engines. “They hope I die or I give up. I’m not going to give up; I hope the hell I don’t die,” Tom said. Tom is appealing the decision. He showed 8 On Your Side a VA document that states Ubon Air Force Base was recently added to a list of bases where between 1961 and 1975, service members may have been exposed to Agent Orange. Tom plans to bring his fight to the VA in Washington, D.C. for an appeal hearing. He claims he is on a multi-year waiting list. 

Learn More: Agent Orange and Herbicides

Veteran charities get fraction of money raised by Trump event (Military.com)
More than two months after Republican presidential front-runner Donald Trump claimed to have raised $6 million for veterans’ charities at a fundraiser held on the eve of the Iowa caucuses, most of the organizations targeted to receive the money have gotten less than half of that amount. The Wall Street Journal, citing a survey of the 22 groups listed by Trump’s campaign as prospective recipients for the money, reported that 19 organizations had obtained a total of $2.4 million from Trump’s foundation or associates. Of the three other charities, one declined to disclose how much it had received, another said it needed to submit more paperwork before receiving any money, and the third didn’t respond to questions by the Journal. Trump held the Jan. 29 benefit in lieu of attending a GOP debate hosted by Fox News. The real estate mogul had declined to appear at the debate, claiming that he had not been treated fairly by the network. All 19 groups that confirmed receiving money from the Trump event got checks in the mail. Sixteen charities saw donations arrive in late February in increments of $50,000 or $100,000. The other three reported smaller donations in March, with those amounts averaging between $5,000 and $15,000. Keith David of the Task Force Dagger Foundation told the Journal that he was confused about whether a $50,000 check from Trump associate Stewart Rahr’s foundation was tied to the Iowa event. He said he had been informed by a Trump representative that it was. “It’s a little weird,” David said. “It looks like it’s from a totally separate organization.” Hope Hicks, a spokeswoman for the Trump campaign, told the Journal that Trump had “distributed many of the contributions to a number of worthy organizations, and will continue to do so.” She declined to say how much money raised at the event had been distributed, nor did she say how much each group had received. The Journal, citing the Trump Foundation’s tax returns, reported that the nonprofit had given just $180,000 to veterans’ charities over the past decade. Hicks said that amount did not include personal donations by the candidate. At least one prominent charity declined to receive any money from the January fundraiser. Iraq and Afghanistan Veterans of America (IAVA) founder Paul Rieckhoff called the event a “political stunt.”

2 years post-scandal, what’s really changed at the Phoenix VA hospital? (KJZZ)
Two years ago, headlines about delays in care and secret waiting lists dominated newspapers and airwaves across the country. The story broke wide open after retired Veterans Affairs (VA) physician Dr. Sam Foote blew the whistle publicly with accusations of secret waiting lists and months-long delays in care. The news was the catalyst for probes into facilities across the country, and later the resignation of then VA Secretary Eric Shinseki. Lawmakers got involved shortly thereafter, and in August of 2014, President Obama signed legislation known as the Veterans Access, Choice and Accountability Act, designed to reform the scandal-plagued agency. The $16 billion in reforms attempted to do a lot. It gave the agency funding to hire more staff and allowed veterans to seek care outside of the VA if they lived far from a facility or waited more than 30 days for an appointment. It also gave the agency more leverage to fire employees accused of wrongdoing. So has it helped? For Arizona Sen. John McCain, not as much as he had hoped. “There has been some improvement,” McCain said. “But there is still an enormous amount that needs to be done.” McCain said while he’s happy that veterans now have the option to see providers outside the VA, there are still hundreds of veterans contacting his office with problems. “I think the first proof of progress will be a reduction in the number of veterans who have to contact our office,” he said. He’s also disappointed in the amount of time it’s taken to fire VA employees implicated in cases of whistleblower retaliation and other issues. A sentiment echoed by other lawmakers in response to the recent news that the Phoenix VA had proposed to fire three high level employees. Dr. Katherine Mitchell is a Phoenix VA whistleblower who faced retaliation after bringing up issues with understaffing in the ER. She was transferred out of the Phoenix ER and now works in the VA Southwest Regional Office. While she couldn’t comment on specific personnel actions, she said any move to change management is a benefit to veterans. “I’m still incredibly disappointed,” she said. Mitchell said the hospital still has a long way to go. And while it does provide millions of high quality appointments to veterans each year, she said, “unfortunately the cracks in the system are pretty big and pretty deep. So that when someone falls through, the result is not just a delay in care. The result is often death and that’s unacceptable.” She said there are still reports of ER wait times longer than six hours and instances of the VA trying to downplay its problems. But there are some improvements to report. … Outpatient visits are also up. In 2015, hospital staff completed 60,000 more outpatient visits than the previous year. And as of Feb. 29, the VA reports the average wait time to complete a primary care appointment was about nine days. “I think there’s no question that we still have things we need to improve at the facility,” said Phoenix VA Director Deborah Amdur. “But I think people are very committed to doing that.” Amdur is another noticeable change at the facility and the first permanent director since the agency fired her predecessor in 2014. Amdur said she’s instituting several changes including more process audits and increasing communication with staff. … She said changing the culture at the hospital so that employees feel safe to come forward with concerns is a priority, too. It’s been four months since Amdur started. Whistleblowers, veteran service organizations, and members of Congress say they’re hopeful she can actually institute positive change at the troubled facility, but all of them conclude it’s still too early to tell if that will happen.

Uber has 50,000 drivers with ties to the military (Stars and Stripes)
Uber boasts 50,000 drivers who are veterans, service members or military spouses — and it wants to recruit even more. The San Francisco company announced Thursday plans to offer bonuses for veteran referrals, expand its ride-hailing service to military bases, and donate $1 million to organizations that support veterans and their families. The move is part of an initiative announced 18 months ago called UberMilitary, in which the ride-hailing company proactively reached out to veteran support agencies to recruit drivers. “When I got to Uber, I knew it was one of the perfect income opportunities for veterans making the transition (out of the military) … because they could turn on and off work for whatever reason,” said Emil Michael, Uber’s senior vice president of business. Prior to joining Uber, Michael was the special assistant to the U.S. secretary of Defense, a job in which he says he learned of the challenges veterans face once they leave the military. Marine Robert Isaac Jr., 35, of San Francisco said he was able to rely on Uber as a source of income while he retrained to be a user experience software designer. He now drives for Uber full-time as he searches for a job in that field. “The biggest challenge for me was the uncertainty of what I was going to do after I got out (of the military),” Isaac said. “Once you’re out and those paychecks stop coming through, what are you going to do to support yourself and your family?” He says Uber alleviated that uncertainty for him and his peers. As part of the recruitment effort, Uber said it plans to lobby base commanders to give drivers access to military bases and provide bonuses to those who make those trips. The company also is donating $1 million to organizations such as the U.S. Chamber of Commerce Foundation’s Hiring Our Heroes, Homes for our Troops, and Iraq and Afghanistan Veterans of America.

Veterans get their game on to fight depression, anxiety and PTSD (The Cougar)
Video games are often attributed for killing brain cells, but for veterans, video games may help fight off mental disorders. A recent study suggests that Virtual Reality Exposure Therapy and focus-based video games may help veterans who have been diagnosed with post-traumatic stress disorder, anxiety or depression. Clinical psychology doctoral candidate Simon Lau, who is also a veteran and studies psychological effects of deployment on military families, stands by these findings. “Focus-based and virtual reality games can be extremely beneficial when aimed at providing relief from trauma,” Lau said. VRET works by placing a veteran in an interactive environment controlled by a therapist. During treatment, veterans are placed in scenarios that try to recreate past traumatic events. The idea is that by repeating these exposures, veterans will began to decrease their perception of threat. “When certain fears are avoided they tend to become stronger, but if you confront that fear in a controlled environment, that fear will usually decrease or (even) extinguish,” Lau said. Virtual reality treatment has been around since the 1990s, but many therapists have been hesitant to use the therapy, despite its success. According to the Journal of Cyber Therapy and Rehabilitation, most studies have indicated a 66 to 90 percent rate of success in treatment when VRET replaced or supplemented traditional cognitive treatments. The games that are being used for VR treatments are specifically designed for veterans. Games like Virtual Iraq and Virtual Afghanistan were created and evaluated by the Office of Naval Research and are used at UH in the the Michael E. DeBakey Veterans Affairs Medical Center in Houston. “(Houston VA) uses Virtual Iraq to expose vets with PTSD to reminders of trauma to cause extinction of the symptoms,” DeBakey Veteran Affairs psychiatrist Tom Newton said. Some veterans who suffer from anxiety, depression or PTSD credit console video games in their recovery. … Although some veterans have been able to deal with diagnoses on their own, professionals like the director of Veteran Services Celina Dugas warn that these self-help methods may not be suitable for all. “I would caution any one of our student veterans to not go out and start playing video games to treat mental illness without consulting a professional to discuss all treatment options,” Dugas said. Dugas said that while video games have been known to help, she would also ask that veterans refrain from playing games too much. “I can imagine that it could be just like anything that makes you ‘feel better’,” Dugas said. “(But) can too much lead to another addiction?”

One of the largest VA health centers in the country opens in North Carolina (WSOCTV)
Charlotte will celebrate the grand opening of a new facility Friday that will help veterans across the area get the care they need. A little more than two years ago, VA officials broke ground for the health care center on West Tyvola Road and they will be officially opening it Friday afternoon with a ribbon-cutting. The new 6-story outpatient center will mark a huge change for providing services to veterans in the Charlotte area. The facility will be able to serve approximately 35,000 patients a year and will be one of the largest VA health care centers in the country. It’s a big upgrade for veterans who currently have to go to a much older facility in north Charlotte. The facility is not a hospital, so for major issues, veterans will still have to go to the VA hospital in Salisbury. The new center will be expanding outpatient services though, which will allow thousands of vets in the region to come for same-day surgeries, physical therapy and dialysis. In addition to regular office visits, one of the biggest improvements will be the space that’s available — not just the building, which is four times bigger, but also the parking lot, which has 1,900 spaces.

Family seeks damages over VA suicide hotline failure (Reuters)
The family of a U.S. Army veteran who killed himself last year after calling a Department of Veterans Affairs suicide crisis hotline and being sent to voicemail is seeking $18 million in damages from the government and a private contractor. Mindy Murillo, the widow of Thomas Young, filed a claim for wrongful death against the VA on Tuesday under the Federal Tort Claims Act, which allows veterans and their families to seek damages from the department. If the VA denies or does not respond to the claim in six months, Young’s family can sue.