Beleaguered VA fails to implement many recommendations (The Washington Post)
Since the scandal over the coverup of long patient wait times broke two years ago, Department of Veterans Affairs officials have touted a reorganization dubbed “MyVA” as the road to excellence. Earlier this year, a department news release called the 2014 changes “the most significant culture and process change at VA in decades, with the primary goals of putting Veterans first and becoming the top customer service organization in government.” But for those changes to work, VA needs to evaluate and implement them. That’s a problem. The Veterans Health Administration, the section that runs VA’s health system, “does not have a process that ensures recommended organizational structure changes are evaluated,” according to a Government Accountability Office (GAO) report. The GAO found cases in which VHA’s responses to recommendations “were incomplete, not documented, or not timely.” The lagging effort conflicts with federal standards requiring agencies to fix problems on “a timely basis.” This comes as no surprise to House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.), who has led a dogged congressional probe into the department. “This report documents an approach that has become commonplace at VA, in which the department announces initiatives with great fanfare and expends tremendous amounts of time and resources to achieve them, while failing in implementation due to a complete lack of oversight and accountability,” he complained in an email to The Washington Post. He accused VA Secretary Bob McDonald of pursuing the MyVA organizational restructuring “with no intent of evaluating its outcomes and impact on agency performance.” He called that “baffling.” In its response to the GAO, VA said the department is working to reorganize “for success, guided by ideas and initiatives from Veterans, employees, and all of our stakeholders.” Caring for about 7 million veterans in 168 hospitals and more than 1,000 outpatient facilities, VHA runs the nation’s largest health-care system and has a $51 billion budget. Although veterans have complained about long waits for service, they also have praised the care once they get it. But how much better would that be if VHA followed recommendations for improvement? The GAO cited an unnamed senior official on a governance task force who said that Undersecretary of Health David Shulkin “did not approve 13 of the 21 recommendations, so they would not be implemented.” Furthermore, his decisions were not documented because “they were communicated verbally.” Shulkin told the GAO that “his immediate priorities were to focus on improving access to care and hiring officials for vacant senior-level positions, and as a result he did not want to make significant changes to VHA’s organizational structure,” according to the report. VA statement to the Federal Insider elaborated: “all facilities will be able to provide same day access for primary care and mental health by the end of 2016.” The experience of the governance task force was an example of VHA devoting “significant time and effort” to restructuring proposals, the GAO said, but the health agency then “either did not act or acted slowly to implement recommendations.” VHA did agree to implement the GAO’s recommendations, although the report provides reason for skepticism. Among its recommendations, the GAO said VHA should develop a process for recommendations to be evaluated for implementation. VHA agreed with the GAO. Will VHA now develop a process to evaluate GAO recommendations about evaluating other recommendations before any recommendations are implemented? Something needs to be done sooner rather than later. Rep. Mark Takano (Calif.), the acting ranking Democrat on VA committee, said he was glad the agency accepted the GAO’s suggestions. “Structural deficiencies are a root cause of inconsistency across the VHA,” he said. “For meaningful and needed improvements to take place, the VHA’s organizational structure must be capable of implementing and evaluating efforts to transform and modernize its operations.” But that’s difficult when VHA provides limited monitoring of those efforts and “little implementation guidance,” according to the report. Without adequate monitoring, the GAO added, “VHA cannot be certain that the changes being made are effectively addressing deficiencies; nor can it ensure lessons learned can be applied to future organizational structure changes.”
Report: Care options still elusive for wounded vets (MilitaryTimes)
Getting access to mental health care and other medical appointments continues to be a serious problem for some of the most severely disabled troops from recent wars, according to a new Wounded Warrior Project membership survey released this week. More than a third of survey respondents said they had trouble getting mental health appointments in the last year, and more than 43 percent said they had similar problems scheduling appointments for physical injuries. The survey — the seventh annual membership poll by WWP officials — offers a snapshot into the struggles of troops and veterans still dealing with the wounds of the wars in Iraq and Afghanistan. Nearly 32,000 WWP alumni participated in this year’s report, 85 percent of whom are receiving disability benefits through the Department of Veterans Affairs. More than half reported a disability rating of 80 percent. VA officials in recent years have placed an emphasis on expanding care options and medical appointments, but those results haven’t had much of an impact on WWP members in recent years. The 35 percent of veterans who struggled to get mental health care mirrors figures from the 2015 survey, and is down only slightly from 40 percent in 2014. Of those who sought help, 36 percent said their personal schedule conflicted with hours of help available at local VA facilities. About the same percentage of folks said they “do not feel comfortable” with existing VA or Defense Department mental health offerings. And despite a national effort to end stigma surrounding troops seeking mental health, roughly 21 percent of the WWP survey population believed “they would be considered weak for seeking mental health treatment.” The numbers hint at the difficulty still facing public policy planners as they consider the long-term costs of war, both financial and cultural. Defense Department estimates put the number of veterans with obvious physical injuries from the recent more than 52,000 individuals, tens of thousands more struggle with post-traumatic stress disorder and other unseen wounds. More than 75 percent of the WWP members said their physical or mental health problems affected forced them to miss work, school or other planned routine activities at least one day in the month prior to the survey. More than a third said they feel their health has gotten worse in the last year. But 82 percent of veterans surveyed said they have a stable support system to help handle those problems, and 77 percent said they have someone to call immediately if a problem occurs. WWP officials said those numbers have stayed around that level in recent years, indicating that wounded veterans are finding ways to cope with their injuries by reaching beyond just VA or Defense Department resources.
Mistake by the VA costs Navy veteran thousands in benefits (NBC Los Angeles)
A veteran of the U.S. Navy veteran is owed thousands of dollars in benefits and back pay because of a clerical error made at by an employee with the Veterans Administration (VA). The typo, which cost Kelvin Lewis $1,500 a month in housing payments, was brought to his attention by a Veterans Affairs counselor after Lewis he graduated from college last year. Lewis first signed up to serve in the U.S. Navy in 2003, when the U.S. was at war in both Iraq and Afghanistan. He says the decision was the best he ever made: to service his country, and better his life. “I figure why not join the military, get responsibility and then I can get free education,” Lewis said. Veterans like Lewis, who joined after September 11, 2001, became eligible for Post 9-11 GI Benefits from the VA. So when the 33-year-old left the Navy in 2008 after four deployments, including to the Persian Gulf, he qualified to receive money to pay for college and housing while in school. Lewis said he enrolled at Southwestern College in August 2009, and he later switched schools to continue his education. He says he checked his account at the time, which showed he had no more days of credit under the GI Bill. At the time, he didn’t question it. But after graduating from National University in 2015, he met with a VA counselor who urged him to verify the dates on his account. Lewis was stunned by what he found. He said someone at the VA entered the wrong dates when inputting his start date: Aug. 7 instead of Aug. 17. “When I contacted the regional office in Oklahoma, they let me know someone there forgot to enter a one in front of the seven for the 17th instead of the 7th,” says Lewis. But for Lewis, a typo by the Oklahoma VA office turned that benefit into an ordeal. A costly mistake caused Lewis to miss out on more than $1,500 a month in housing payments for a year and a half, he says. The VA acknowledged the error. “I mean we are human, people make careless mistakes, but once they are acknowledged and corrected you should act upon them accordingly,” the VA said. But the response Lewis got from the VA was only a letter showing he owed $672 because of the date correction; it said nothing about back pay for housing, or BAH as it is called in the military. “I was shocked,” Lewis said. “How do I owe you money when you owe me back-pay.” Lewis is more than willing to pay back the $672, but the father of two says he is hoping the VA will live up to their part of the contract and send him the more than $27,000 he earned for his education when serving his country. “That’s some money I could definitely use right now,” Lewis said. He has two girls, one of them a newborn. NBC 7 San Diego contacted the local VA benefits office, who told us they would look into the situation. They added that they are now fully aware of the issue and plan to reach out to Lewis immediately.
New council to advocate for needs of Massachusetts veterans (WWLP)
Governor Charlie Baker swore-in several people Friday to explore ways to help veterans to better access critical services, such as health care. Veterans in western Massachusetts face a unique set of challenges in this respect. Public transportation is limited in parts of western Massachusetts, and that can make it difficult for veterans to get to doctor’s appointments and to find jobs once they return to civilian life. The state hopes to change that. Governor Charlie Baker swore in 12 people to his Advisory Council on Veterans’ Services Friday. The group will explore ways to improve access to veterans’ benefits: from education and employment to housing and health care. The Baker administration is also reviewing existing laws and regulations to help vets live a more comfortable life. Victor Nunez-Ortiz, Vice President of Veterans’ Advocacy Services, told 22News that veterans’ resources are limited in the western part of the state. He hopes to address issues surrounding post-traumatic stress disorder. “I think it stems from not enough jobs, not enough resources for homeless veterans, and I think we can tackle those,” Nunez-Ortiz said. Friday’s swearing-in ceremony comes just a week before Veterans Day.
Maine gets high marks for supporting veterans (Maine Public)
A New York personal finance technology company is giving Maine high marks for its efforts to encourage veterans to re-enter the work force and take advantage of veterans programs. Asees Singh, of SmartAssets, says that Maine ranks sixth in the country when it comes to several key programs. “When veterans come back from serving, the process to adjusting to civilian life can be really difficult for them,” Singh says. “A survey from Pew Research Center found that 27 percent of veterans had a difficult time re-acclimating to civilian life.” SmartAssets’ survey concluded that Maine should be proud of the fact that 10.5 percent of all private businesses in the state are owned by veterans. Singh said Maine also boasts a high percentage of veterans enrolled in the Veterans Health Administration. However, she said other metrics indicate areas for improvement. Close to 5 percent of Maine veterans are unemployed and around 7 percent fall under the poverty line.
Service dogs give veterans, inmates second chance (WBAL)
Melanie Monts De Oca said the 10 years she spent in the Navy were the best years of her life. However, Monts De Oca’s time in the military were marred by serious health problems as she suffered a series of mini strokes. After her naval career ended, Monts De Oca said her strokes became more frequent and debilitating. “I didn’t want to go out in public,” Monts De Oca said. “If something happened to me it was embarrassing. But I didn’t want to be alone because it was scary. So it just got to where I was not living.” What brought Monts De Oca back to living was her service dog, Liberty. When Monts De Oca is too sick, Liberty is trained to take over. The dog is also trained to open doors and retrieve items like the phone in case Monts De Oca needs to call 911. “It was like this instantaneous sense of relief that I knew I wasn’t alone if something happened,” Monts De Oca said. Combat didn’t injure Monts De Oca, so finding a veteran service dog did not come easily. Liberty is from a nonprofit called America’s Vet Dogs. Their purpose is to give veterans freedom, and many of their dogs are trained by people trying to get their freedom back: inmates. The inmates are housed at the Maryland Correctional Institution in Hagerstown. Inside the prison, the inmates are training the next crop of canines for America’s Vet Dogs. A select group of inmates train the dogs to do a long list of commands. This includes picking up a debit card, opening refrigerators, turning on lights and opening file cabinets. The training process lasts a little more than a year. Being a part of this program means a lot to inmate Terry Dorsey. “It’s something I can be proud of, even in this setting,” said Dorsey, who is also a veteran. “At least the time I spent here wasn’t all in vain.” Dorsey said this program allows him to give back to his country again. “This is close to my heart,” Dorsey said. “A vet helping another vet.” For inmate Scott Daily, training service dogs allows him to think about life after prison. “Working with a dog is something I want to pursue, whether it’s training pets or even a service dog,” he said. James Dyson has been incarcerated for 17 years. He said that being part of this program has given him second chance. “I’ve never been a part of something that wasn’t about myself and my own gratification,” Dyson said. “I’m actually a part of something that’s really part of someone’s life, an important person’s life.” Correctional officer Chad Basore said helping train the dogs is rewarding work for the inmates. “America’s Vet Dogs sends down a dog trainer that works for them,” he said. “They shows them what to do, work on different tasks.” Despite the training, the dogs are given plenty of time to play between sessions. The dogs stay with their trainers Monday through Friday. Volunteers then come in on the weekends and take them to different environments so they can adjust to life outside the prison. All of this training leads to dogs being placed with veterans like Monts De Oca, who is grateful for her dog. “She gave me redemption in life,” Monts De Oca said of Liberty. “And for (the inmates), I know for them, that’s what they’re getting for this as well. It’s amazing what a dog can do.”