August 5 Veterans News

August 5 Veterans News


Report: Drug abuse, mental illness rise among veterans (
The number of Department of Veterans Affairs patients with diagnosed mental health or substance abuse issues increased between 2001 and 2014, according to a report on veteran suicide newly released by the VA. Between 2001 and 2014, the rate of mental health disorders and substance abuse disorders climbed from 27 percent to 40 percent, the Aug. 3 report states. Data on mental health and substance abuse were examined as part of the study, officials wrote, because those diseases are connected with a higher risk of suicide. But the study also found that the suicide rate among VA patients with those disorders decreased from 77.6 per 100,000 to 57 between 2001 and 2014 despite that correlation. The report, the most comprehensive study yet on veteran suicide, is based on a review of Defense Department records, records from each state and data from the Centers for Disease Control, VA officials said. Highlights from the report were released in early July. “The effort advances VA’s knowledge from the previous report in 2012, which was primarily limited to information on Veterans who used [Veterans Health Administration] health services or from mortality records obtained directly from 20 states and approximately 3 million records,” VA officials said in a release. Among early released findings was the conclusion that an average of 20 veterans take their lives each day, and that 65 percent of all veterans who committed suicide in 2014 were over age 50. Veterans, the report says, accounted for 18 percent of all suicide deaths among U.S. adults, down from 22 percent in 2010. The risk of suicide is 21 percent greater for veterans than for the U.S. civilian population, it says. Among a laundry list of actions the VA says it is taking to address the veteran suicide issue are expanding the Veterans Crisis Line, “predictive modeling” to determine which veterans are most at risk for suicide and “ensuring same-day access for Veterans with urgent mental health needs at over 1,000 points of care by the end of calendar year 2016,” it said in a release. … Officials with the Veterans of Foreign Wars (VFW) said they are happy with the report, but are still looking for continued treatment improvements. “We’ll be more happy as we see things rolling through they improve,” said Kayda Keleher, a legislative associate for the VFW. “Considering that nobody had to tell the VA to do this study, we definitely applaud the VA for taking the initiative.”

VA officials didn’t mislead Congress on wait times, investigation finds (USA Today)
Officials at the Department of Veterans Affairs did not mislead Congress when explaining wait times for health care last year, a new departmental investigation has concluded. The investigation had been requested by lawmakers in light of news stories suggesting veterans were waiting far longer for medical care than the VA had reported. VA executive Skye McDougall testified in a February 2015 congressional hearing that veterans were waiting only four days on average to get appointments at VA facilities she was overseeing in Southern California. But CNN later reported veterans there were waiting 10 times that long, spurring accusations from lawmakers that McDougall had deliberately misled them. VA Secretary Bob McDonald tried to set the record straight earlier this year, telling Congress that McDougall had inadvertently understated wait times by two to seven days. But the questions remained. The VA inspector general found in its investigation that McDonald’s assertions were accurate, that McDougall had understated wait times by a matter of days, but CNN likely was using an entirely different measurement. The allegations against McDougall have dogged her across the country. When the VA announced last year she would move from California to take over VA facilities in the Southwest, including the Phoenix facility at the center of the VA’s wait-time scandal, Sen. John McCain, R-Ariz., and other lawmakers decried the choice, given her flawed wait time testimony. McDougall opted not to take the job. She went instead to her current post overseeing VA medical centers in Louisiana, Arkansas, Mississippi, Oklahoma and Texas, and once again faced angry calls from members of Congress who said they didn’t want her there. Sen. David Vitter, R, and -La., and six other members of Congress from Louisiana said her appointment was “an insult to our veterans” while the entire congressional delegation from Mississippi signed a letter saying that given McDougall’s testimony, she “has proven to be, at the very least, untrustworthy.” VA Inspector General Michael Missal, who took over that post in April, agreed to investigate at the behest of Vitter. The findings demonstrate some fundamental issues with the way the VA reports how long veterans wait for appointments. His office found that during the period McDougall testified about, wait times for new patients at the Southern California facilities were between six and 11 days on average depending on the type of care — primary, specialty or mental health. That matched what McDonald had said in his letter earlier this year to Congress trying to set the record straight. Nevertheless, nearly 2,000 veterans were waiting more than two months for appointments at the time, and more than 500 were waiting up to six months. In addition, the agency reports the time between veterans’ desired appointment dates and their actual appointments but doesn’t include the full length of time veterans wait between scheduling an appointment and being seen. For example, if a veteran calls the VA today, asks for an appointment in a week and gets one in two weeks, that’s a seven-day wait by the VA’s publicly reported measure even though the total wait was two weeks. The inspector general concluded the wait times cited by CNN were likely based on the longer measure. The network, which reported average waits for new patients of 48 days for primary care and 36 days for mental health, declined to provide its data to the inspector general. But data from a few weeks after the CNN report shows the waits — according to the longer measure — were between 50 and 71 days, according to the VA inspector general’s office. … VA officials concurred with the findings and said they are “committed to improving access to care and to ensuring any veteran with the requirement for urgent care will receive the right care at the right time.” Some lawmakers, however, are taking issue with the investigation, saying it wasn’t comprehensive enough. Vitter told USA TODAY that he believes it was “an absolute waste of time and resources.” … Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, said the inspector general’s report seemed to be little more than “a cursory exercise in checking the box that was expressly designed to exonerate Skye McDougall rather than uncover the truth.” Missal said in a statement to USA TODAY on Friday that his office sought to fulfill Congress’s request for the investigation in an “accurate, thorough, objective, and fair manner.” But Missal said he would be happy to look further into the matter if Congress requests it.

Veterans omnibus hits ‘stumbling block’ in Senate (Federal News Radio)
Veterans Affairs Secretary Bob McDonald has described 2016 as a “make or break year” for the department. But the outcome largely depends on whether Congress can pass major legislation to change the disability appeals process, access to VA health care and accountability procedures for senior executives at the department. The Senate Veterans Affairs Committee and the department itself is touting the Veterans First Act as the best case scenario.  But the omnibus’ main sponsor said the bill still has a long way to go before it heads to the President’s desk. “It’s comprehensive and it’s sweeping, and because of that, it’s not going to be the easiest thing in the world to ever pass,” Senate Veterans Affairs Committee Chairman Johnny Isakson (R-Ga.) said at a July 31 discussion at the annual Disabled American Veterans national convention in Atlanta. Isakson had said his original hope was to have the bill to the President by Memorial Day. “We’ve hit a couple stumbling blocks in the Senate, so I have not yet gotten it to the floor for a debate,” he added. “I’m trying to get unanimous consent to do that when we get back. … We aren’t to the nobody objecting point yet. But it’s on varying degrees of change they want to make, not on being against the accountability portion.” House VA Committee Chairman Jeff Miller (R-Fla.) introduced an alternative bill that would significantly change the discipline and appeals process for VA senior executives and the secretary. The VA Accountability First and Appeals Modernization Act addresses the very provision that the VA announced it would no longer use following a recent decision on its constitutionality from the Justice Department. “Rank and file employees of the system have nothing to fear about accountability,” Isakson said. “The leaders of the organization ought to have everything to fear about accountability … The higher the expectation standards are of the organization, the higher the performance is going to be by the employees up and down the line.” Isakson said he hopes that either he or Miller can push one of their bills to a full vote, with the goal that the two chairman can come together for conference on both pieces of legislation. The Senate omnibus has 148 different provisions but doesn’t yet include the VA’s proposal to change the disability appeals process. McDonald said he hoped the Senate would add it as an amendment or pass it as a separate bill. “The problem is that perfection is never possible,” Isakson said. “We’re at a point where we have 80 percent of what we need to get to improve the veterans administration, give Bob McDonald the clout that he needs.” Both Isakson and McDonald encouraged audience members to call their congressman in support of the Senate omnibus. The House Veterans Affairs Committee is expected to review the VA Commission on Care report, which the group officially released at the end of June, during a hearing in September. McDonald, who said he detailed his view on the Commission’s recommendations in a report to President Barack Obama, offered a preview. Twelve of the 18 recommendations are consistent with the goals and proposals McDonald has outlined as MyVA transformation priorities, he said at the DAV convention. McDonald believes three of the commission’s recommendations need more study, such as the suggestion that VA trim and update its real estate portfolio. And there’s three recommendations that McDonald and the agency “totally disagree with,” he said. Specifically, McDonald opposes the commission’s proposed changes to the honorable discharge procedures, as well as its recommendations to shift more VA health care to private providers and add an 11-member governance board. “It appears to be almost a Trojan horse for privatization,” McDonald said of the commission’s report. Under the commission’s proposal, veterans would have the option to choose between the VA or a private provider, regardless of whether the Veterans Health Administration could provide that care or not. McDonald said the suggestion contradicts a concept he’s been trying to build on since he arrived at the department. … The VA secretary would also lose oversight over the VHA, according to another Commission proposal. The secretary would have a seat on the 11-member governance board, but the group itself would have ultimate control and oversight over the Veterans Health Administration, not the secretary. “I don’t think that’s necessary,” McDonald said. “The Veterans First Act shows very clearly that Congress can work with the VA on behalf of veterans. I don’t think a surrogate is required. I also question the Department of Justice’s question on the constitutionality of that, because it’s in a sense Congress controlling part of the Executive Branch.”

Report: VA access improves, work still needed (
A new independent report on Department of Veterans Affairs hospitals and clinics found that although improvements have been made on issues such as access to care, there is still work to do. The Joint Commission, which conducts organization health care audits, began unannounced surveys on hospitals in the VA system between September 2014 and August 2015 at the VA’s request, VA officials said. Some of the surveyed hospitals were then visited again through April of this year as part of a separate, previously scheduled round of visits, and their progress on key issues was examined, they said. The program looked at problems such as access to care, leadership and staffing. “Phones were inconsistently answered when patients called to make appointments, even though insufficient staffing did not appear to be the reason,” the investigation found. “Staff absenteeism also caused problems with access. There were often no plans for coverage. As a result, veterans would arrive with no one to see them and no process in place to assist them in rescheduling their appointment.” The initial review looked at 139 medical facilities and 47 community-based clinics nationwide, the VA said, while the follow-up surveys revisited 57 of those locations. More than 220 requirements for improvement were identified at those sites, according to the report. Seventy-one of those were related to care access, coordination or timeliness, some of which was caused by staff confusion about expectations, the report says. While some of the scheduling issues were improved by a clarification given to the clinics from top VA officials during the survey period, problems lingered, the report says. However, improvements were made at the 57 locations that received follow-up visits, the report says. Of those, only three received a repeat citation for access, coordination and timeliness issues. To address those continued problems, the report recommends that officials continue to monitor appointment scheduling timeframes and have better patient engagement, among other suggestions. “Their analysis shows that VA as national health care leader is making progress in improving the care we provide to our Veterans,” said Dr. David Shulkin, a VA under secretary for health, in a statement on the report. “This affirms our commitment to providing both excellent health care and an exceptional experience of care to all Veterans served.”

Disabled vets to get new leave benefit (FederalTimes)
The Office of Personnel Management is expected to release new regulations on Aug. 5 to create a leave category exclusively for disabled veterans. The new leave policy, implemented under the Wounded Warriors Federal Leave Act of 2015, would apply to any veteran hired after Nov. 5, 2016, and has a service-connected disability rating of 30 percent or more. The regulation would provide new employees with a one-time leave benefit in their first year of government employment. The leave can only be used for medical treatment on a qualified service disability. The leave has to be less than less than 104 hours and is only for newly hired veterans, or National Guard members and military reservists who have returned to their civilian jobs. Acting OPM Director Beth Cobert said in a statement that the new leave policy provides a needed benefit for veterans who are just entering the civil service. “We know this is something they need,” she said. “We want these veterans to have sufficient leave during their first year of Federal service in order to take care of any medical issues related to their service-connected disability.” OPM said it would be offering further information sessions about the new regulation for agencies to implement.

Transparency key to VA IG’s plans to restore trust (Federal News Radio)
Restoring trust to the embattled Office of the Inspector General at the Veterans Affairs Department is a full-time job. The man who accepted that job in April, Michael Missal, has a plan to do just that, and it relies on an increase in transparency. “Transparency can be defined a couple of different ways: One is internal transparency,” Missal told the Federal Drive with Tom Temin. “I want to make sure the staff understands decisions from leadership, our priorities, and make sure we’re all working toward the same goal.” He began working toward that end immediately after his confirmation. “Given the significance of the work of this office, I decided I was going to hit the ground sprinting, not running,” Missal said. He made it a priority to meet every employee that worked for the OIG that he could, including those outside the Washington  area. He also sent out a survey to find out exactly what employees thought about the work the office was doing. “What do we do well? Where can we improve?” he asked. “What else do you think I should know as the new IG here?” Employees’ responses told Missal that they were highly dedicated to their mission, but the main issue was that the office needed to be better aligned with how the VA spends money and serves veterans. The office needs to be paying more attention to high risk areas, where the most money and services are spent. Missal said there are three main principles he’s conveyed to the staff that the OIG needs to be operating under to do their job better. “First, we have to make sure that we’re independent, and that we even have the appearance that we’re independent, and there’s nothing going to challenge that,” Missal said. “Secondly, we’re as transparent as possible. The public and the veterans are entitled to know all of the work of this office, and the reasons why we reach certain conclusions. The third thing is the quality of our work. All of our work needs to meet at least five standards: needs to be accurate, needs to be timely, needs to be thorough, needs to be objective and it needs to be fair.” Having an inspector general who was nominated by the President and confirmed by the Senate will make a big difference within the office, Missal said, because employees understand that person has the confidence and weight of those stations behind him, which conveys more authority than an acting IG can. The Senate confirmed  Missal as frustrations with the office reached a peak. A series of high-profile IG investigations ended in failure, only to be capped off by the revelation from the Office of Special Counsel — one week after Missal was confirmed to the position — that  the OIG mishandled three separate cases of whistleblower allegations as well. That’s why whistleblowers are another group Missal is trying to regain the trust of. “Whistleblowers are critical to our work,” he said. “We do get a significant amount of leads from whistleblowers. We assess each and every allegation that comes in through either whistleblowers or anyone else. What we want to do is make sure that they recognize this is an agency where they can feel comfortable coming to us, that we’re going to look at things fairly and objectively and thoroughly, and if they want to be protected, their identity wants to be protected, they’re going to be protected.” While he works on improving transparency within the OIG and the VA as a whole, he also wants to ensure accountability with the only people the OIG actually reports to: veterans and citizens. “With respects to external transparency, we have essentially been given a fiduciary duty to look and do oversight of VA and it’s the public’s right to know what we’re doing and why we’re doing it,” Missal said. ”So we’re making sure that all the work that we do that can be disclosed publicly is.” He said that health records and ongoing criminal investigations can’t be disclosed due to legal protections. But he wants to ensure the public knows anything that isn’t otherwise protected by law.

Goodwill helps homeless veterans find a home (ABC News)
Timothy Hogan told officials with the Goodwill of Northeast Iowa that he had never in his life had his own bedroom. Now the 20-year-old Iowa resident and U.S. Marine veteran has both a job and a bedroom of his own, thanks to Goodwill officials. Hogan is the first of four U.S. veterans to move into a four-bedroom home in Cedar Falls, Iowa, leased by the local Goodwill office. He also now has a job at the local Goodwill donation center. Steve Tisue, vice president of human services for Goodwill of Northeast Iowa, said the goal is to help Hogan and the three other veterans, whose names have not been released, to get back into the game of life. “It’s not a handout but a hand up,” Tisue told ABC News. “They can get established, get a permanent address and work history under their belts.” Hogan, who could not be reached by ABC News, was honorably discharged from the military due to medical issues, according to Tisue. He had been living in various homeless shelters before being selected for the Goodwill home after a screening process. “Timothy has been very grateful,” Tisue said. “Our focus with him will be what his next step will be.” Tisue said there is no time limit on how long the veterans may stay in the home. The nonprofit which typically focuses its services on helping people with disabilities is grateful to be able to give back to servicemen and women. “I think it’s very rewarding serving veterans who have served us so well over the years, to pay that back a little,” Tisue said. “Goodwill is grateful as well.”