May 24 Veterans News

May 24 Veterans News


VA secretary McDonald clarifies comment comparing wait times to Disneyland (NBC News)
Veteran Affairs Secretary Bob McDonald on Tuesday took an “opportunity to correct” a comparison he made of the long wait for medical care at his agency’s facilities to lines at Disneyland. “If I was misunderstood, if I said the wrong thing, I’m glad that I have the opportunity to correct it,” he told MSNBC’s Andrea Mitchell. “I’m only focused on one thing, and that’s better caring for veterans. That’s my job, that’s why I’m here.” The remarks were his first interview since the controversial remarks he made a day prior. “The days to an appointment is really not what we should be measuring. What we should be measuring is the veterans’ satisfaction,” McDonald had told reporters at a Christian Science Monitor breakfast in Washington on Monday. “When you go to Disney, do they measure the number of hours you wait in line? What’s important? What’s important is: What’s your satisfaction with the experience?” Swift backlash followed from both sides of the aisle. When asked on MSNBC if he was sorry, McDonald stopped short of an apology, but said the VA was undergoing its largest transformation ever, saying, “We still have work to do.” “Wait times are important, but they’re not the only measure of veterans’ experience, and that’s what veterans are telling us,” he said. In a Senate Veteran Affairs hearing later Tuesday, Deputy VA Secretary Sloan Gibson offered an apology on behalf of the agency. “Bob and I deeply regret the distraction from the Veterans work that’s been caused by these remarks, and the perception that was created that veterans’ access to care is anything other than our absolute top priority,” Gibson said. McDonald was excoriated by veterans and lawmakers for the comparison. “The mere suggestion that a child waiting in line to meet Mickey Mouse is a similar experience to a veteran waiting for a PET scan or prosthetic fitting is offensive and shameful,” said Sen. David Perdue, R-Ga. “I call on Secretary McDonald to apologize for his offensive comments, and to show our American heroes the respect they deserve instead of making excuses for failed results.” “These wait times can be a life or death matter for our veterans. We’ve seen the devastating results of delays in treatment, from veteran suicide to veterans dying while awaiting care,” said Rep. Loretta Sanchez, D-Calif., senior member of the House Armed Services Committee. The scandal over long wait times at VA hospitals and clinics nationwide broke in 2014, when a whistleblower at a Phoenix facility alleged that up to 40 patients may have died while waiting for appointments. The accusations prompted Congress to pass a law enabling vets to get care outside of the VA network if they experience delays and led to firings of multiple senior executives. Eric Shinseki, the head of the VA at the time, resigned. The agency has remained under scrutiny. In an audit last month, the Government Accountability Office found wait times were grossly underestimated by those doing the scheduling, and it criticized the VA for taking a “piecemeal approach” to addressing wait time issues. American Legion National Commander Dale Barnett slammed McDonald’s comments in the wake of the ongoing problems: “People don’t die while waiting to go on Space Mountain,” he said in a statement. Vietnam vet and former POW Sen. John McCain, R-Ariz., called the comparison “outrageous and completely inappropriate.” “Secretary McDonald’s comparison further erodes what little confidence the American people have left in the Department of Veterans Affairs and its commitment to our veterans,” he said. And Rep. Tammy Duckworth, D-Ill., a combat veteran who receives her own health care at the Hines VA Hospital in Illinois, called the remark “tone-deaf.” “Comparing abhorrent wait times to a trip to Disneyland is unbelievably tone-deaf and hurtful to American heroes desperately in need of care. Our troops didn’t make us wait before putting their lives at risk to keep us safe, and it is simply not acceptable for the VA to make them wait for the care they have earned,” she said. The comparison also drew a flurry of angry tweets from House Speaker Paul Ryan, who wrote, “This is not make-believe, Mr. Secretary. Veterans have died waiting in those lines.”

Roy Blunt calls on VA secretary to resign over ‘Disney’ comment (The Washington Times)
Veterans Affairs Secretary Robert McDonald faced calls to resign Tuesday after he compared wait times at VA health care facilities to waiting lines at Disneyland. “Secretary McDonald’s preposterous statement is right out of Never Never Land,” said Sen. Roy Blunt, Missouri Republican. “I call on him to resign because it’s clear he cannot prioritize getting our veterans the health care they deserve and have earned in a timely manner. Dismissing wait times when veterans can often wait months for an appointment is negligent and a clear sign that new leadership is needed at the VA.” An official at the Concerned Veterans for America, Dan Caldwell, said the group would be calling for Mr. McDonald’s resignation if his likely replacement, deputy Sloan Gibson, weren’t considered equally bad by the organization. Mr. Caldwell said the secretary’s misguided comment and his performance in office show that the next president shouldn’t keep him on at the VA. “There’s a much larger issue here,” Mr. Caldwell said. “You can make a pretty compelling argument that things are actually worse than when he took over.” In a meeting with journalists Monday, Mr. McDonald said that Disney does not measure how many hours customers wait in line, and that the VA should move away from wait times as a primary measure of how the agency is caring for veterans. Mr. McDonald refused to apologize Tuesday for his comments. “If I was misunderstood, or if I said the wrong thing, I’m glad that I’ve had the opportunity to correct it,” he said on MSNBC. He defended his efforts since 2014 to improve the VA and its hospitals. “Look, we get it. Wait times are important,” Mr. McDonald said. “There’s no question wait times are important. But there’s more to the veteran experience than just wait times.”

More post-9/11 veterans have considered suicide, survey says (MilitaryTimes)
A new survey of post-9/11 veterans finds an increase over a previous study in the number who contemplated suicide since joining the service and a belief among this group that the Veterans Affairs and Defense departments aren’t doing enough to address the problem. A majority of these former service members also say DoD and VA are not adequately addressing mental health injuries, with 80 percent believing their peers aren’t getting the care they need. The findings, from a survey of Iraq and Afghanistan Veterans of America members, are troubling given the number of programs and initiatives launched by the Pentagon and VA to encourage mental health treatment and reduce suicides, according to veterans advocates. “It shows that mental health challenges and access to care continue to impact veterans in all facets of their lives,” IAVA CEO Paul Reickhoff said in a release accompanying the survey results. The poll of 3,000-plus IAVA members is not representative of all post-9/11 veterans, but it is one of the largest surveys available of this population, according to IAVA research director Jackie Maffucci. The survey found that 40 percent of veterans polled had considered suicide at least once after they joined the military, up from 30 percent in 2014, and roughly a third said the VA and DoD are not being proactive in addressing the problem. Nearly 60 percent said they have a service-connected mental health condition, and, on a positive note, 82 percent were receiving treatment, with more than three-quarters getting their care at the VA. Nearly 60 percent said a family or friend suggested they seek mental health treatment and 77 percent said they sought help because of these suggestions. The VA does not have exact figures for the number of post-9/11 veterans who have died by suicide. A 2012 VA report estimated that an average of 22 veterans commit suicide each day but that number, which encompasses all generations of veterans, was derived from incomplete death reports. VA officials have said they expect to have more firm data this summer, when the department completes its analysis of death records from the DoD and Centers for Disease Control and Prevention. Phillip Carter, director of the Military, Veterans and Society Program at the Center for a New American Security, called the lack of information on veterans suicide “scientific malpractice,” given the amount of information gathered on individual troops and veterans. He said the information is key to understanding the scope of the problem in this population and addressing it. “We ought to know this. We ought to be forcing the DoD and VA and the academic sector to get this right,” Carter said during a panel discussion on the survey results. According to the poll, more than three-quarters who responded said they have post-traumatic stress and only a third say their health is as good now as it was before they joined the military. Maffucci said this should be a wake-up call for the VA and veterans groups as they plan care for this aging population. “The thing we are most worried about is what happens in decade, two decades, three decades from now. We don’t know what these injuries are going to look like then and what the resources will be,” Maffucci said. The annual survey this year also polled members on a variety of current topics, including their thoughts on medical marijuana, environmental exposures and transgender service members. According to the survey:

  • 68 percent support legalization of medical marijuana in their states and 75 percent believe VA should allow it as a treatment where applicable;
  • 74 percent said they were exposed to burn pits during deployment and 60 percent say they have associated symptoms;
  • Nearly half said that allowing openly transgender individuals to serve will have a negative affect on readiness.

The survey also asked the veterans about gun ownership, and according to the results, 57 percent own a firearm, with just over half storing them locked, unloaded and without the ammunition. Nearly 20 percent said they store their guns unlocked and loaded. “This is a taboo topic that no one wants to address but it’s a really important,” Maffucci said. “In the veteran community, men and women are dying by suicide by firearms. In the civilian community, men are dying by firearms and for women, it’s different. This is vital information for [mental health professionals] working with these people.” According to Maffucci, IAVA uses its survey results to steer policy goals in the coming year.

VA opposes any expansion of Choice program (MilitaryTimes)
The Veterans Affairs Department opposes efforts to expand the Veterans Choice program and instead wants permission from Congress to roll several private care programs into the Choice benefit, VA Deputy Secretary Sloan Gibson said Tuesday. Addressing members of the Senate Veterans Affairs Committee in a legislative markup, Gibson said a bill sponsored by Sen. John McCain, R-Ariz., to let any enrolled veteran use the Choice program would “erode the VA’s ability to address the special needs of veterans.” “If veterans who currently do not use the VA health care system begin to seek community care through the Choice program, VA will have to divert resources from … internal VA care, dramatically undercutting our ability to provide care tailored to the unique needs of veterans,” Gibson said. McCain’s proposed bill would make permanent the Choice program, which is set to expire next year. It would allow any veteran who uses VA health services to use the program, which currently lets veterans get care at a private health facility if they live more than 40 miles from a VA facility or have to wait more than a month for an appointment. The proposed legislation also would require VA to expand pharmacy hours let veterans be seen at commercial walk-in clinics without preauthorization or a co-payment. McCain said the legislation is needed because some doctors are refusing to see veterans under the Choice program, knowing it has an expiration date. “I’ve heard testimony from a number of veterans who have sat in the ER for 14 hours without being seen. Veterans would just like to see a provider on the same day. This legislation would do that,” McCain said. A VA medical facility in California on Tuesday began letting enrolled veterans get health services care at walk-in clinics with a referral. Gibson said implementation of a similar program nationwide would be cost-prohibitive with the current VA budget. “This provision is too broad and does not include any feature such as the inclusion of copayments that would ensure it is used in a measured way that would not overrun the fund appropriated by Congress,” Gibson said. Veterans groups that testified, including the Veterans of Foreign Wars, Paralyzed Veterans of America, Disabled American Veterans and American Legion, also said they oppose McCain’s bill, adding they believe issues must be fixed with the current program before it is expanded. “The Choice Program … has yet to achieve what Congress envisioned when it passed Veterans Access, Choice and Accountability Act,” said Carlos Fuentes, senior legislative associate with the VFW. McCain urged the Senate Veterans Affairs Committee to consider the bill, which he said will improve the original legislation co-written in 2014 by McCain and then Senate Veterans Affairs Chairman Sen. Bernie Sanders, I-Vt.

Blumenthal pushes bill that includes housing for homeless veterans (The Day)
Proposed federal legislation would make it easier for states like Connecticut to convert temporary housing for homeless veterans into permanent housing. U.S. Sen. Richard Blumenthal, D-Conn., was in Hartford on Monday to promote the Veterans First Act, a reform package that he and Sen. Johnny Isakson, R-Ga., say will improve accountability within the Department of Veterans Affairs and improve health care and benefits for veterans, among other overarching provisions. Isakson is chairman and Blumenthal is the ranking member of the Senate Veterans’ Affairs Committee, which unanimously passed the bill. At a news conference at Cosgrove Commons, a 24-unit apartment building that’s currently housing 18 formerly homeless veterans and six young adults, Blumenthal said that the bill takes “some of the success stories from Connecticut and makes them models for the nation.” Earlier this year, Connecticut became the second state in the nation to end veteran homelessness. “But what that means is not that we will never see another veteran homeless, as much as we wish that were the case. What it means is that we have built a system in Connecticut whereby any veteran we identify as homeless, we can house appropriately in 90 days,” said Lisa Tepper Bates, executive director of the Connecticut Coalition to End Homelessness. While Connecticut has “a lot” of transitional housing for homeless veterans, Tepper Bates said, under current regulations it’s a “complicated” process to convert that transitional housing into permanent housing. “One of the provisions is to create that opportunity for some of this long-term transitional housing to be converted to permanent housing that we really need to provide for any veteran exiting homelessness,” she said. The legislation would make changes to allow long-term transitional housing, funded by the VA’s Homeless Providers Grant and Per Diem program, to be converted into permanent housing. It’s a small but important part of the bill, Tepper Bates said. In New London, the Homeless Hospitality Center, through the grant and per diem program, provides housing to veterans on Mountain Avenue for up to two years. The center is working to make the Mountain Avenue residence interim housing rather than two-year transitional housing with the goal of securing permanent housing for the veterans within 90 days. That’s a goal all GPD housing programs — 16 different sites consisting of 165 beds — throughout the state are looking to achieve, John Chiechi, with the state VA, told The Day in February. Cosgrove Commons, which is operated by the nonprofit Chrysalis Center Inc., provides its residents with permanent housing in addition to case management and employment services. There’s also “a lot of referral and linkage” to other programs, Sharon Castelli, CEO of Chrysalis Center, said. The Commons was established two years ago this fall, and Marine Corps veteran Gregory Bethea, 63, has lived there since “day one.” Bethea was in the Marines from 1969 through 1970. All of the units are one-bedrooms, and Bethea gave attendees of the news conference a tour of his unit on Monday. He said he enjoys cooking spaghetti and roasts, and often spends time with the other residents. On Sunday, he and eight other residents went fishing nearby. His grandchildren live just down the street, and come by “all the time.” “They’re always checking on me,” Bethea said. The Veterans First Act is expected to be taken up by the full Senate in June, and Blumenthal is challenging the full Congress to pass it by July 4.

Trump campaign will give between $5.5 – $6 million to veterans groups (CBS News)
Donald Trump’s campaign manager Corey Lewandowski said Tuesday that the presumptive GOP nominee has given $1 million from his personal account to charities focused on veterans’ issues and that the remainder raised from a January fundraiser will be distributed by next Monday. “He’s taken a million dollars out of his personal account, he’s given it to charities that he felt was worthy and any remaining money would be distributed before Memorial Day,” Lewandowski said in an interview on “CBS This Morning.” Asked if Trump will release exactly where the $1 million has gone, Lewandowski said, “I mean, I’ll ask him to do that.” But Trump and his campaign have made confusing, contradictory statements about how much the campaign raised during the Jan. 28 fundraiser the presidential candidate held during the night of the GOP debate Trump opted out of. “We just cracked $6 million, right? Six million,” Trump said the night of the fundraiser. A report last week in The Washington Post said that Lewandowski said that the fundraiser actually netted about $4.5 million because some donors had backed out of their pledges and gave nothing. Lewandowski told CBS News on Tuesday that $4.5 million has already been “attributed” and that the total amount the campaign will give to veterans’ groups will be “somewhere between $5.5 and $6 million total, which would be given to the veterans.” He also said that Trump had pledged $1 million, which was donated “through his personal accounts” and “not through his foundation.” On April 26, CBS News’ Major Garrett asked Trump at one of his election night events at Trump Tower if he would promise to look into whether the funds were distributed. “I don’t have the final numbers, but the money we raised for veterans has been mostly distributed. We’re looking for some other really worthy places to distribute the final [funds],” Trump said. “But for the most part, it has been distributed. We raised millions of dollars.” CBS News reached out repeatedly to every veterans organization the Trump campaign said the money would initially go to and the groups confirmed they received $2,015,000. That’s the amount as of April 28. Some groups said the money was specifically from Carl Icahn, Phil Ruffin and Stewart Rahr. On Monday, Trump tweeted three times about the funds. David Fahrenthold, a Washington Post reporter who has been tracking all of the donations, provided a recap of the situation. He said that the January fundraiser raised at least $3.1 million because he found that was the amount received by veterans groups. He said he found seven out of nine donors paid $3.75 million and that online donors provided $670,000, which adds up to $4.45 million. But it’s still unclear where the $1 million from Trump’s personal account went and still unclear how much was actually raised in total.

California VA health system pairs with walk-in clinics to serve veterans (MilitaryTimes)
A Veterans Affairs health system in Northern California has enlisted the help of the largest U.S. provider of walk-in medical care to expand treatment options for veterans. Beginning May 24, veterans who have a minor illness or injury and are enrolled in the VA Palo Alto Health Care System may be able to seek care at a MinuteClinic, the walk-in health facility available at many CVS pharmacies. Under a regional pilot program, veterans who call the VA Palo Alto nurse advice line may be referred to a MinuteClinic. Dr. Stephen Ezeji-Okoye, VA Palo Alto deputy chief of staff, said the $330,000 one-year pilot program could serve as a model for other VA facilities nationwide. The program, he said, is designed to give veterans access to medical treatment closer to home and when VA hospitals and clinics are closed or at capacity. “This really does help push VA’s movement to integrate care more seamlessly in the community,” Ezeji-Okoye said. “[VA leaders] are interested to see how this goes and what potential implications it might have.” Two years ago, the VA was the center of a scandal that showed some VA hospitals maintained appointment schedules outside the official system and that lengthy appointment delays contributed to veterans’ deaths. As recently as April, the Government Accountability Office released a report saying the same issues — including scheduling errors and appointment date revisions or padding — continue to be a problem across the Veterans Health Administration. Ezeji-Okoye said the new program for the 60,000 veterans enrolled in care at the VA Palo Alto Health System is not a response to the system’s ability to meet access standards. Instead, he added, the MinuteClinic partnership will be an option for veterans to get care closer to home and on nights and weekends when VA care may not be available. “We see this as augmenting the care we provide,” he said. There are 1,137 MinuteClinics in 32 states, according to MinuteClinic president Dr. Andrew Sussman. The facilities employ nurse practitioners and physician assistants who treat minor medical issues such as ear and throat infections, sinus issues, sprains and minor injuries. According to Sussman, 14 MinuteClinics in the region will participate in the program. “We see this as a collaboration with the existing system and helping provide another choice for patients to go to for their care. We are proud to be working with VA,” Sussman said. Raising concerns last month among veterans service organizations, a blue-ribbon commission studying the future of VA health care planned to recommend that veterans receive the bulk of their health care through private physicians paid for by VA. Currently, veterans who live more than 40 miles from a VA facility, or cannot get an appointment at VA within 30 days, are supposed to be referred to the private health system through the Veterans Choice program. Both Ezeji-Okoye and Sussman said the MinuteClinic agreement is not part of the Veterans Choice program or any larger effort to outsource veterans to private health care. “Partnering with the community really allows us to be able to provide more convenient and more accessible care. Really, it’s a question of how we fold community care into VA. It’s really an extension of VA care,” Ezeji-Okoye said. Veterans enrolled in VA care at Palo Alto or its affiliated hospitals and clinics who want to use the benefit must get a referral from the nurse advice line. No copayment will be needed at the time of care, and veterans can order any VA formulary medications prescribed by a MinuteClinic provider at the clinic’s CVS store. VA officials said MinuteClinic has agreed to send any medical records generated by the visit to VA to ensure they are included in the veteran’s health history.

VA wants to forecast vets benefits with predictive analytics (NextGov)
The Veterans Affairs Department may soon be using algorithms to make decisions about veterans benefits. The VA is looking for information about predictive analytics technology and how it could be used to forecast the demand for certain benefits. The approach could help the agency understand the gap between demand for those benefits and the VA’s capability to provide them, as well as the “consequences to the veteran of not closing the gap,” according to a new FedBizOpps posting. Having a better understanding of demand, based on factors including the state of the economy, could help the VA ensure that “workforce capabilities are optimized” across various lines of business, the posting said. It could also predict the VA’s capacity under various circumstances to deliver those. The Veterans Benefits Administration’s request for information notes its need for predictive and simulation modeling, as well as consultative services to support leadership decisions. The predictive model would incorporate factors such as veteran demographics, including age, sex, and race or ethnicity; time since active duty and the location of service; economic indicators such as the labor and housing market conditions; and the “value of the benefit or service” to specific veterans. It would also use data from VBA’s own operational databases, Census data and other surveys. Though the project is still in the early stages — the posting is just a request for information — the forecast would need to be developed using VBA’s statistical software and would also need to be compatible with VA IT. A contractor would have 11 months after the project officially began to submit their final predictive models.