‘Decades old problem’ exacerbates benefits backlog for veterans

[JakeStarkey]

Have you talked to your Patient Rights Advocate at the VA.

Ask at the front help desk where is that office.

 

[ThunderKiss1965]

You are talking about a scheduled appointment. I'm talking about waiting to get an appointment. I'm curious as to when and where you served.

So your scheduled appointment waits are OK?

Houston, Shreveport, Salt Lake City and some outpatient clinics, among others.

I have always been able to see someone as necessary, which has been very rare for me.

The fucking problem is waiting months for a doctors appointment. You are an exception to all the other Vets out their that have gotten nothing but BS from the VA.

That is merely your opinion, nothing more.

No its not do you ignore the news or what. People have died waiting on the VA. My next appointment is for a MRI on my back this will be the third time I don't know why maybe those idiots think its going to spontaniously heal. Had to wait 2 months for this one.

You have made a suggestion that the VA is worse than private care. No it is not. You cannot prove that because you don't have the numbers or the comparisons for the numbers. Where are you getting VA care?

I've never had to wait three hours in an emergency room in a civilian hospital but the two VA clinics in two different regions I've been to was the exact same problem. Every Vet I know has the same problems I do. Long waits for appointments, canceled appointments, lost paper work, it goes on and on.

 

[JakeStarkey]

Seems to me you better look in the mirror for the source of your problems.

I have not had problems like that, and I know very few who did have such.

So if you are having problems stop your whining and go talk to the Patients Advocate at your hospital.

 

[waltky]

VA Health Care Still Has 'Profound Deficiencies'...

Report: VA Health Care Still Has 'Profound Deficiencies'
Jul 06, 2016 | WASHINGTON -- Two years after a scandal over long wait times for veterans seeking health care, the Department of Veterans Affairs still has "profound deficiencies" in delivering health care to millions of veterans, a congressional commission says in a new report.

The Commission on Care says in a report to be released Wednesday that the VA delivers high-quality health care but is inconsistent from one site to the next, and problems with access remain. The panel says the VA needs to improve its service to veterans, adding that the VA's health care operations "require urgent reform. America's veterans deserve a better organized, high-performing health care system." Congress created the 12-member commission in 2014 after approving a landmark law overhauling the VA in the wake of the wait-time scandal, which also revealed that department employees were covering up chronic delays with false paperwork and secret waiting lists. As many as 40 veterans died while awaiting care at the Phoenix VA hospital, according to an investigation by the department's inspector general.

President Barack Obama said in a statement late Tuesday that the commission's report includes a number of specific proposals that he will review closely in the coming weeks. In the meantime, "We will continue to work with veterans, Congress and our partners in the veteran advocacy community to further our ongoing transformation of the veterans' health care system," Obama said. "Our veterans deserve nothing less for their sacrifices and their service." VA Secretary Bob McDonald also hailed the report and said he was pleased to see that many of the panel's recommendations are in line with ongoing efforts to transform the VA into what McDonald calls a "veteran-centric organization." Work on that effort has been underway for two years and has resulted in increased access to health care and a better experience for veterans, McDonald said.

In March, the VA set a new record for completed appointments: 5.3 million in hospitals and clinics, 730,000 more than in March 2014. The department also issued twice as many authorizations for government-paid, private care than in a comparable period two years ago, McDonald said. Nearly 97 percent of appointments are now completed within 30 days of the veteran's preferred date, McDonald said, a huge improvement over past performance. But the report said the VA has a long way to go and singled out a "Choice Program," authorized by Congress to make it easier for veterans to get private care, as significantly flawed. The report recommends replacing the program with community-based delivery networks that it said should improve access, quality and cost-effectiveness.

The commission also found that the long-term viability of VA health care is threatened by problems with staffing, facilities, capital needs, information systems and other problems. Rep. Jeff Miller, a Republican from Florida and chairman of the House Veterans Affairs Committee, said the 292-page report "makes it abundantly clear that the problems plaguing Department of Veterans Affairs medical care are severe. Fixing them will require dramatic changes in how VA does business, to include expanding partnerships with community providers in order to give veterans more health care choices."

Report: VA Health Care Still Has 'Profound Deficiencies' | Military.com

See also:

VA Stocking Up on Guns, Riot Gear, Tactical Equipment: Report
Jul 05, 2016 | The Department of Veterans Affairs bought more than $11 million worth of weapons, ammo and other security equipment between 2005 and 2014, according to a report released last month by a non-profit organization that tracks spending across the federal government.

The report, called The Militarization of America and published by OpenTheBooks, said the VA acquired a variety of pistols -- Berettas, Sig Sauers, Lugers -- and ammunition, as well as body armor, police batons, ballistic shields, riot shields and helmets, night gun sights, tactical equipment for crowd control and more. The $11.6 million in weapons and gear includes $200,000 for night vision equipment, $2.3 million on body armor, more than $2 million on pistols and about $3.6 million on ammunition, the report said. A chart included with the report also shows a variety of training weapons and a night gun scope. The department has 3,700 law enforcement officers guarding and securing VA medical centers.

The VA didn't respond to Military.com's request for comment, though in a Feb. 17 email to OpenTheBooks, the agency described its police officers as "the front line response forces for our facilities" and said its personnel "receive extensive training in active threat response. "While VA police work very closely with Federal, local and state law enforcement partners, VA police will be the first to have to deal with any active situation and are well trained accordingly," it stated. The department is not the only federal agency that has been stockpiling weapons in recent years, presumably against mass shooters and other security threats. The report found that non-military federal agencies spent nearly $1.5 billion on weapons and ammo from 2005 to 2014.

The report states that the IRS spent $10.7 million on guns, ammo and gear over the same period. The Animal and Plant Health Inspection Service spent $4.7 million, the Social Security Administration $417,000, and the Department of Education $412,000. The Smithsonian Institution's arms purchases totaled just over $309,000. The arming of VA security personnel began in 1996 with a pilot program intended to extend firearms and arrest authority to the department's 2,393 officers, the report said. Two years later, only 262 department police officers had the authority to carry a weapon and make arrests. "However, by 2008, the VA officer corps grew to 3,175 and all were authorized to make arrests and carry firearms," OpenTheBooks' report found. Currently, it said, the VA has more than 3,700 personnel who may carry firearms and make arrests.

In a swipe at VA over its widely publicized problems with getting veterans in for appointments, the organization said it was "notable [that the arms and equipment] buildup occurred while the VA failed to provide critical care for thousands of veterans who would later on waiting lists." In its email to the group, the department said the gun purchases relate to a decision in 2008 to have VA police switch to a different firearm. It did not say what VA officers used before then. "This change has taken place over time in a phased approach. VA facilities began replacing the older pistol as funds became available and pistol service life limits are reached," the VA said. "Most of VA facilities have completed the transition to the new contracted firearm, with several still in that process." Night vision and other countermeasure equipment were acquired by field facilities to meet their local security and law enforcement needs, according to the department. The VA statement did not detail which facilities required the special gear.

VA Stocking Up on Guns, Riot Gear, Tactical Equipment: Report | Military.com

 

[JakeStarkey]

Yes, much to be fixed indeed.

However for this veteran I get superb care in Utah and Texas at the VA.

 

[waltky]

Granny says, "Dat's right - the Donald gonna build a wall to keep the jihadis an' Hispexicans out an' he gonna fix the VA...

Trump Promises to Fix a VA in 'Very Sad Shape'
Sep 01, 2016 | Donald Trump became the second presidential nominee in two days to quote Ronald Reagan, promising "peace through strength" if he were to win the presidency. The Republican presidential nominee addressed a crowd of thousands of veterans at the American Legion National Convention here on Thursday, speaking a day after Democratic nominee Hillary Clinton.

He told the crowd he planned to negotiate a system for the Veterans Affairs Department that would allow veterans to receive health care in a VA facility or at a private doctor of their choice. Trump also reiterated his plan to aggressively promote "Americanism," saying he would make sure American students recited the pledge of allegiance. Clinton invoked Reagan's "shining city on a hill" in her Wednesday address, promising to defend American exceptionalism. Trump continued the theme, saying he would enlist the American Legion's help in promoting American values. "We will stop apologizing for America and we will start celebrating America," he said. "We will be united by our common culture, values and principles, becoming one American nation. One country under one constitution, saluting one American flag." Trump's speech, which at 15 minutes was about half as long as Clinton's, limited discussion of veterans' policy to his plan to reform the VA.

While VA Secretary Robert McDonald told the American Legion on Wednesday that the department hoped to turn a corner in organizational reform this year, Trump said it was in "very sad shape," adding that he had spoken with a number of veterans who had received unsatisfactory care. Trump said he plans to carry out his VA overhaul by appointing a new secretary and firing anyone who failed to meet standards. "I'm going to use every lawful authority to remove anyone who fails our veterans and breaches the public trust," he said. Trump also said he would make sure female veterans got the best possible access to medical care. "We're going to get you fantastic service. It's going to happen, believe me," he said. "Never again will we allow any veteran to suffer or die waiting for care." The Republican candidate, who on the previous day delivered a speech in Mexico promising to crack down on illegal immigration, drew applause when he reiterated promises to defend American borders.

In what appeared to be a pivot from 2015 comments in which he made disparaging many Mexican immigrants as drug smugglers and criminals, Trump praised Mexican Americans for their service in the U.S. military. "I just came back from a wonderful meeting with the president of Mexico where I expressed my deep respect for the people of his country and for the tremendous contribution of Mexican Americans in our country," he said. "Many are in our armed services. You know how good they are. I want to thank him for his gracious hospitality and express my belief that we can work together and accomplish great things for both our countries." Trump also received applause when he promised to stop Syrian refugees, many of whom he has characterized as terrorists and extremists, from entering the United States, citing plans to build a safe zone overseas to house them. "Our country has enough problems," he said.

Trump Promises to Fix a VA in 'Very Sad Shape' | Military.com

 

[Moonglow]

The head of the VA has been asking Congress for a revamping of the VA, Congress be silent...

 

[waltky]

"I've dealt with extremist politicians like Rep. Jeff Miller long enough not to take his insults personally"...

Veterans Harmed as Lawmaker Wages Political Vendetta
Sep 08, 2016 | J. David Cox Sr. is national president of the American Federation of Government Employees, which represents 670,000 federal and District of Columbia government employees nationwide, including 220,000 in the Department of Veterans Affairs. The views expressed in this commentary are his.

I've dealt with extremist politicians like Rep. Jeff Miller long enough not to take his insults personally ("Opinion: Union Bosses, VA Bosses Rigging System for Failure," Sept. 5). But after spending 20 years caring for veterans as a psychiatric nurse, and the past decade representing more than 220,000 VA employees across the country, here's one thing I take very personally: our nation's sacred obligation to serve the women and men who have worn the uniform. Our members take that obligation seriously, too. That's why they were the first to come forward to blow the whistle on VA managers and executives who were falsifying appointment records to hide excessive wait times for veterans seeking care.

Rather than proposing real solutions to the problem of veterans not getting timely access to care, Rep. Miller chose to exploit the wait list scandal to serve his own political agenda. Miller has introduced a bill that would gut the workforce protections that empowered whistleblowers to come forward in the first place. Miller's bill is part of a concerted effort by the congressman to strip all federal employees -- not just those at the VA -- of their due process rights, allowing employees to be demoted or fired at will without any protections from partisanship or favoritism. He also has waged an intense campaign to implement the extreme proposal by the Concerned Veterans for America to privatize the VA and dismantle the patient-centered system that veterans have endorsed time and time again.

Chairman of U.S. House Veterans Affairs Committee Rep. Jeff Miller.​

Miller's obsession with gutting employees' rights and stripping the VA for parts has distracted the House Committee on Veterans Affairs, which he chairs, from focusing on staffing shortages and underfunding issues that, if addressed, stand to make a tremendous difference for the veterans he claims to serve. Tell me, Congressman Miller, how is silencing health care providers and shutting down VA hospitals going to improve veterans' access to health care? A far better VA reform bill has the bipartisan support of Senate Committee on Veterans' Affairs Chair Johnny Isakson of Georgia and ranking member Richard Blumenthal. Even though we do not agree with provisions attacking the due process rights of VA executives, we support his Veterans First Act because it will provide real accountability at the VA without hanging an ax over the heads of honest employees who choose to blow the whistle on mismanagement.

The Veterans First Act is far from a boondoggle for labor unions, as Rep. Miller suggests -- which is why many employee groups still oppose it. Yet we believe that our veterans deserve quality health care and that they indeed must come first, which this bill would accomplish by empowering VA employees to hold bad managers and opportunist politicians in check. With its vast network of more than 160 medical centers and 1,000 community-based outpatient clinics across the country, the VA provides its 5.8 million veteran patients the best health care our nation has to offer. If Congressman Miller would focus on providing the VA with the resources it needs to serve more veterans, instead of scapegoating the very employees who deliver that care, our nation's war heroes would reap the benefits they so justly deserve.

Veterans Harmed as Lawmaker Wages Political Vendetta | Military.com

 

[waltky]

What they need to do is hire more doctors to see more vets...

VA Responds to Phoenix Failures with more Funding and Training
Oct 15, 2016 | The Department of Veterans Affairs announced Friday that more money, training and employees would be part of an effort to correct the Phoenix VA Health Care System after an inspection found veterans continue to suffer with long waits for appointments with specialists.

The Phoenix VA was at the center of a scandal in 2014, when it was discovered veterans died while waiting for care. Staff had manipulated wait-time data there and at other VA hospitals across the United States. After the U.S. government poured billions of dollars into reform efforts in following years, 215 patients died while waiting for treatment at the Phoenix VA, according to a report released Oct. 4 by the VA's Office of Inspector General. One patient was unable to see a VA cardiologist, which "may have contributed" to his death, the report stated. "The sustained and continued improvement of the Phoenix VA Health Care System is a department priority," VA Deputy Secretary Sloan Gibson said in a news release. "There are best practices and expertise from across the nation that we are bringing to bear in order to deliver more consistent, high-quality care to veterans."

The VA announced it would allocate $28 million to the Phoenix VA in addition to its annual budget. Most of the funds will be used to hire more employees, said VA Press Secretary Victoria Dillon. Leadership at the Phoenix VA is attempting to open two new facilities in early 2017, expanding its number of community-based clinics from seven to nine. "One of the big challenges in Phoenix was not enough medical center staff, doctors and nurses, and not enough clinical space," Dillon said. They're also providing more training on scheduling medical appointments. All new employees will be required to take a two-week course, while current employees will go through a three-day course, according to the release.

The inspector general's office has issued a half-dozen reports in the past two years citing ongoing problems in Phoenix, despite new VA policies and increased training in scheduling appointments, the new report stated. Inspectors found the number of active patient cases in Phoenix had grown from 32,500 in March to 38,000 by July. The additional cases were caused partly by staff not scheduling patient's appointments in a timely manner, according to inspectors. "As a result, patients attempting to get care at [the Phoenix VA] continued to encounter delays in obtaining such care," the report read. "We substantiated that one patient waited in excess of 300 days for vascular care."

Several lawmakers reacted to the findings, including Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs; Sen. John McCain, R-Ariz.; Sen. Jeff Flake, R-Ariz., and Rep. Ann Kirkpatrick, D-Ariz., who is running against McCain in the November election. "More than two years after the Phoenix VA Health Care System became ground zero for VA's wait-time scandal, many of its original problems remain, and this report is proof of that sad fact," Miller said in a written statement. "...it's clear veterans are still dying while waiting for care, that delays may have contributed to the recent death of at least one veteran and the work environment in Phoenix is marred by confusion and dysfunction."

MORE

 

[waltky]

VA screwin' over Gulf War Vets with Brain Cancer...

Gulf War Vets with Brain Cancer Denied Fast-Track to Compensation
Nov 19, 2016 | Hundreds of veterans with terminal brain cancer and their families were close to being fast-tracked toward millions of dollars in government benefits and compensation -- before a White House decision this fall prevented it.

The White House denied a recommendation from the Department of Veterans Affairs that would establish a connection between brain cancer and service in the Persian Gulf War, fast-tracking VA benefits and compensation. As it stands, veterans and families have the burden of proving the connection - a process that can take years and require hundreds of pages of military and medical records. "What it means is years more of struggling," said Ron Brown, president of the National Gulf War Resource Center. "I just find that unacceptable. It's like leaving veterans and their families behind."

'An extreme burden'

Laura Edwards, 54, knows the struggle of trying to obtain VA benefits. After a recent phone conversation with a VA representative, she felt so frazzled she "couldn't remember my own phone number," she said. Her husband, retired U.S. Air Force Sgt. 1st Class David Edwards, died at 53 of glioblastoma -- a form of brain cancer -- in 2013. In the conversation with the VA that November morning, she had attempted to take another small step in a years-long process to prove her husband's brain cancer was a result of his service in the Persian Gulf War. "It's really stressful," she said. "It's a real sappy, horrible day." In 2015, the VA established a work group to decide whether there was a clear connection between brain cancer and servicemembers in Southwest Asia in 1990 and 1991, when troops were exposed to hazards such as oil-well fires and nerve agents.

An American servicemember tends a burn pit in the Saudi Arabian desert in 1991.​

David Edwards had worked on generators at U.S. bases in Saudi Arabia with the 323rd Civil Engineering Squadron. Her late husband used to talk about the chemical alarms going off at the bases, Laura Edwards said, and he said their superiors told them the alarms were false. Later, studies would show that in some cases wind carried nerve agents from Khamisiyah in southern Iraq, triggering the alarms. Laura Edwards, now living alone in small Warrensburg, Mo., submitted her first claim to the VA in 2014 but it was quickly denied. According to a copy of that denial letter, she didn't provide enough supporting evidence. She has struggled, even with help from Brown and a local veterans service officer. In the ongoing effort to make her case, Edwards recently arranged the exchange of about 170 pages of medical records.

If the VA determines that Edwards' death stemmed from his service, Laura Edwards would be eligible for dependency and indemnity compensation. Those payments go to survivors of veterans whose deaths resulted from a service-related injury or disease. The current basic monthly payment is set at $1,254.19, or about $15,000 annually. For each child under 18, $310.71 is added to the payment. Brown, a Gulf War veteran, served with three men in the 1st Battalion, 504th Infantry Regiment, who were later diagnosed with brain cancer, he said. As president of the National Gulf War Resource Center, he's heard from spouses, including Edwards, asking for help to qualify for compensation. "It's very hard; there have been a very small number of veterans who have been successful at it," Brown said. "It places an extreme burden on the families."

Lacking evidence

 

[JakeStarkey]

"It was felt that at this time the data, the evidence are just not strong enough to really support a presumption," he said. "In the end, the decision was made by the executive branch that we need to do more research."

 

[waltky]

Feds lookin' into Congress' Claims VA Lied About Hospital Costs...

FBI Looks into Congress' Claims VA Lied About Hospital Costs
Dec 14, 2016 — The Justice Department is considering whether to investigate allegations that Veterans Affairs Department executives lied to Congress to conceal massive cost overruns at a $1.7 billion VA hospital under construction outside Denver.

The FBI's Washington field office is reviewing the allegations, the Justice Department said in a letter to Congress. The letter was dated Dec. 9 and made public Tuesday. The FBI is part of the Justice Department. Lawmakers accuse VA executives of lying when they testified before the House Veterans Affairs Committee in 2013 and 2014 about the cost of the hospital in suburban Aurora. The current projected price tag is nearly triple the 2014 estimate. The VA declined to comment on the lawmakers' allegations. In a written statement, the department said it has already acknowledged mistakes on the project and made changes to its construction practices.

A bipartisan group of 21 lawmakers on the Veterans Affairs Committee asked for an investigation in September. The request came after the VA's internal watchdog office said Glenn Haggstrom, formerly the department's top official in charge of construction projects, knew the hospital cost was soaring but didn't tell Congress. The lawmakers also asked the Justice Department to look into congressional testimony by Stella Fiotes, director of the VA's Office of Construction and Facilities Management. Neither Haggstrom nor Fiotes immediately return phone messages Tuesday. Haggstrom and Fiotes told the committee that no cost overruns were expected and that the project would be finished at or near its budget of about $604 million, according to transcribed excerpts from the committee.

A construction crew works on concrete forms at the Veterans Administration hospital complex construction site, in Aurora, Colo.​

Haggstrom retired in 2015, one day after he was questioned by VA officials about what went wrong, department officials have said. Veterans Affairs Committee chairman Jeff Miller, R-Fla., said the Justice Department should investigate the two officials' testimony. "This case is a slam dunk, and it's imperative for Department of Justice officials to ensure justice is served," Miller said in a written statement. "It is an absolute fact that numerous VA officials repeatedly misled Congress regarding cost overruns," he said.

Rep. Mike Coffman, R-Colo., a member of the committee, also said the FBI should investigate. "If they don't, and there are no consequences for federal officials of the executive branch to lie when they're under oath, then Congress simply cannot exercise its oversight," he said. Investigations into the hospital project have said mismanagement, delays and lax oversight by the VA added hundreds of millions of dollars to the cost and delayed it by years. Construction on the 184-bed facility is expected to be done in January 2018. It will replace an aging, overcrowded facility still in use in Denver.

FBI Looks into Congress' Claims VA Lied About Hospital Costs | Military.com

 

[waltky]

VA Disability Claims Backlog Still Growing...

VA Disability Claims Backlog Grows Despite Paperless Fix
Feb 14, 2017 | The VA's new electronic system for processing disability claims has faced initial problems in reducing backlogs

Officials from the Veterans Affairs Department were pressed Tuesday to explain how the paperless fix to the disability claims process has initially resulted in growing backlogs. The claims backlog stood at about 76,000 last May before the VA solution called the National Work Queue was fully implemented, but the backlog last week was at 101,000 cases, said Rep. Mike Bost, an Illinois Republican and chairman of the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs.

At a hearing of the panel, Ronald S. Burke Jr., the VA assistant deputy secretary for Field Operations National Work Queue, didn't dispute Bost's numbers but said one of the problems is that "this is a relatively new initiative." Willie C. Clark Sr., deputy under secretary for Field Operations, said the new system has improved efficiency for veterans and the result is that "they submit more claims." The queue was described by Thomas J. Murphy, acting under secretary for benefits at the Veterans Benefits Administration, as an electronic records system "to ensure veterans receive a more timely decision on their disability compensation claims."

Claims piled up at the VA Regional Office in Winston-Salem, N.C.​

With the technology, the VA now has the ability to shift overloads in the system from one regional VA office to another. "This new environment allows VA the flexibility to move claims around the country that have the capacity to take the next action on a veteran's claim," Murphy said. "On its face, this is common sense," Bost said. "NWQ allows VA to distribute its workload evenly across the nation to reduce waiting times for veterans who file claims for benefits. However, there are some concerns about whether NWQ is actually performing as it should." The claims backlog was at about 99,000 cases as of Tuesday, Murphy said, and he acknowledged that "we're never going to get to zero. That's not going to happen."

Some claims, particularly those involving radiation disability, simply take more time, and it would "not be the right thing to do" for the veteran to speed up the process, he said. Rep. Elizabeth Esty, a Connecticut Democrat and the acting ranking member on the subcommittee, said she is concerned that the electronic system allows too many VA claims processors to become involved, or have "touches," on a particular case. Burke said that a claim in the new system normally involves five or six involvements by processors. "We need to reduce the number," Esty said.

MORE

See also:

Bill Would Expand Access to National Parks for Disabled Vets
Sen. Jeanne Shaheen and Sen. Susan Collins have introduced a bill to expand access to national parks for disabled veterans.

The bill would make all veterans with a service-connected disability eligible for a free, lifetime pass allowing entry to the parks and other recreational lands and waters held by the United States.

Grand Teton National Park​

Shaheen, a Democrat, and Collins, a Republican, said under a 2004 law, individuals must be permanently disabled in order to be eligible for a free pass, creating uncertainty on whether all wounded veterans have access to the program. The new bill clarifies the language.

Bill Would Expand Access to National Parks for Disabled Vets | Military.com

 

[waltky]

Waits longer than 30 days for medical care...

Report: VA Inaccurately Tracking Veteran Wait Times in N.C., Va.
7 Mar 2017 | WASHINGTON — Thousands of veterans in the Mid-Atlantic region waited longer than 30 days for medical care at Department of Veterans Affairs facilities last year but were excluded from private-sector treatment due to errors in VA wait-time data, government inspectors have found.

The VA inspector general's office issued a report Thursday detailing wait times for veterans at 12 facilities in North Carolina and Virginia that stretched beyond the 30-day goal established by the VA. Because of inaccuracies in tracking how long veterans waited for an appointment, inspectors estimated approximately 13,800 veterans attempting to get an appointment at those facilities should've been granted the option of private-sector care but were not. When veterans were referred to the private sector through the Veterans Choice Program, they still faced delays, the report states. Inspectors estimated 82 percent of appointments made through program from April 2016 to January 2017 in those states had wait times longer than 30 days.

The report identified ongoing problems similar to ones discovered in 2014, when the VA was rocked by news of veterans suffering long delays for medical care. "VA data reliability continues to be a high-risk area," Assistant Inspector General Larry Reinkemeyer wrote in the report. "[The Office of Inspector General] has reported that access to health care has been a recurring issue in [the Veterans Health Administration] for over a decade. This audit demonstrates that many of the same access to care conditions reported over the last decade continued to exist… in 2016."

The inspector general's report found 33 percent of primary care appointments had wait times longer than 30 days, but VA records showed only 17 percent faced delays that long. For mental health care, inspectors determined 16 percent waited longer than 30 days, though VA records showed 5 percent did. Inspectors found 39 percent of specialty care appointments had wait times longer than 30 days, but the VA scheduling system showed only 8 percent. Errors were made when staff entered "incorrect" or "unsupported" information that "made it appear as though the wait time was 30 days or less," the report states.

The report gave one example of a veteran requesting a mental health care appointment in July 2015 and not receiving an appointment until Nov. 20 of that year. A scheduler marked Nov. 20 as the veteran's preferred appointment date, so VA records reflect a zero-day wait. VA Secretary David Shulkin was undersecretary for health at the time of the inspector general's review. In a written response to the report, he said the VA had made "tremendous strides" since the review was conducted, including faster access to veterans needing urgent care needs, more overall medical appointments and new rules for schedulers. Shulkin has recently acknowledged issues with access to care, and with the Veterans Choice Program. He will testify before the House Committee on Veterans' Affairs on Tuesday during a hearing on the future of the program.

MORE

See also:

2 Vets Win Agent Orange Exposure Cases from Okinawa
6 Mar 2017 | There have long been rumors that Agent Orange was stored or used on Okinawa, but no one has been able to find proof. Now two servicemembers who served on the Japanese island during the Vietnam War era have won court cases claiming they developed ailments from exposure to the toxic defoliant.

Judges in the separate lawsuits cited specific diseases that have been linked to Agent Orange and a lack of proof that the chemical compound wasn't on Okinawa, based on a two-year gap in records and other evidence. The judges were careful to limit their rulings to the specific cases, likely to avoid opening the door for hundreds of former servicemembers to seek class-action status for physical problems that may be linked to Agent Orange. Pentagon officials referred requests for comment to the Department of Veterans Affairs, which declined to answer questions or discuss how many similar cases there have been in recent years.

Each case is heard on its own merits, the agency said in a statement to Stars and Stripes. "VA can grant a claim and award disability compensation if there is evidence of a current disability, an in-service exposure, and a medical nexus or link between the in-service exposure and the subsequent development of the illness," the statement said. "VA has no credible evidence of Agent Orange use, storage, testing, or transportation in Okinawa, and thus no evidence to support claims of exposure to Agent Orange during military service in Okinawa."

Former Marine lieutenant colonel Kris Roberts and dozens of men under his command came into contact with more than 100 leaking barrels that were unearthed at Marine Corps Air Station Futenma, Okinawa, in 1981.​

The U.S. military began using plant-killing chemicals called herbicides in the 1950s to defoliate military facilities. Agent Orange is a blend of "tactical herbicides," according to the VA's website, that was used in Korea to deprive the enemy of cover and in Vietnam to defoliate jungles and kill crops. The toxic mixture has been blamed for a slew of veterans' health problems, from cancers to heart disease, and has been known to cause birth defects in the offspring of those exposed.

The military discontinued use of Agent Orange in 1970, and veterans have battled the VA for benefits regarding exposure ever since. The VA has recognized the claims of some veterans who served in Vietnam, Korea, Thailand, on some ships and in some aircraft, while denying others. Guam and Japan -- most notably Okinawa -- have been left off the list despite claims. In January, Guam Gov. Eddie Calvo ordered the Environmental Protection Agency to investigate claims made by U.S. military veterans who served there in the 1960s and '70s that Agent Orange was sprayed on the island. That investigation is ongoing.

Disability awarded

 

[waltky]

Tragic paralyzed vet death...

Paralyzed Army Vet Bled from Feet, Found Dead in Wheelchair
18 Apr 2017 — Virginia authorities are investigating the death of an Army veteran, paralyzed from the waist down, who was found early Monday.

Virginia authorities are investigating the death of an Army veteran, paralyzed from the waist down, who was found early Monday in a wheelchair outside his apartment complex. Paul Chisholm, 38, showed no signs of trauma other than to his feet, which apparently dragged under his wheelchair, leaving a trail of blood from his apartment, Goochland County Sheriff Jim Agnew said. The blood pooled outside other apartment doors, where he may have sought help. A newspaper carrier found his body.

U.S. Army vet Paul Chisholm​

Chisholm's mother said he suffered from post-traumatic stress disorder and was medically discharged after he was injured in Afghanistan, where he served with the 101st Airborne. After returning from Afghanistan, he was struck by a car, leaving him paralyzed from the upper chest down, Alice Farley said. She described her son as a sweet, thoughtful person who played piano by ear, loved to fish and appreciated a good haircut. "It's a really tragic time for the family," Farley told The Associated Press on Monday evening.

Army service records show he received six awards during just over two years of service. Agnew said the sheriff's office is not looking for any suspects. The medical examiner was working to determine how Chisholm died. Farley said she had no idea what happened to Chisholm. "It's all speculation right now," she said. "The family is waiting to hear, ourselves."

Paralyzed Army Vet Bled from Feet, Found Dead in Wheelchair | Military.com

See also:

VA Tests Partnership with CVS to Reduce Veterans' Wait Times
18 Apr 2017 | WASHINGTON — Some ailing veterans can now use their federal health care benefits at CVS "MinuteClinics" to treat minor illnesses and injuries, under a pilot program announced Tuesday by the Department of Veterans Affairs.

The new program, currently limited to the Phoenix area, comes three years after the VA faced allegations of chronically long wait times at its centers, including its Phoenix facility, which treats about 120,000 veterans. The Phoenix pilot program is a test-run by VA Secretary David Shulkin who is working on a nationwide plan to reduce veterans' wait times. Veterans would not be bound by current restrictions under the VA's Choice program, which limits outside care to those who have been waiting more than 30 days for an appointment or have to drive more than 40 miles to a facility. Instead, Phoenix VA nurses staffing the medical center's help line will be able to refer veterans to MinuteClinics for government-paid care when "clinically appropriate."

Shulkin has made clear he'd like a broader collaboration of "integrated care" nationwide between the VA and private sector in which veterans have wider access to private doctors. But, he wants the VA to handle all scheduling and "customer service" — something that veterans groups generally support but government auditors caution could prove unwieldy and expensive. On Wednesday, President Donald Trump plans to sign legislation to temporarily extend the $10 billion Choice program until its money runs out, pending the administration's plan due out by fall. That broader plan would have to be approved by Congress. "Our number one priority is getting veterans' access to care when and where they need it," said Baligh Yehia, the VA's deputy undersecretary for health for community care. "The launch of this partnership will enable VA to provide more care for veterans in their neighborhoods."

Sen. John McCain, R-Ariz., a long-time advocate of veterans' expanded access to private care, lauded the new initiative as an "important step forward." "Veterans in need of routine health care services should not have to wait in line for weeks to get an appointment when they can visit community health centers like MinuteClinic to receive timely and convenient care," he said. The current Choice program was developed after the 2014 scandal in Phoenix in which some veterans died, yet the program has often encountered long waits of its own. The bill being signed by Trump seeks to alleviate some of the problems by helping speed up VA payments and promote greater sharing of medical records. Shulkin also has said he wants to eliminate Choice's 30-day, 40 mile restrictions, allowing the VA instead to determine when outside care is "clinically needed."

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[waltky]

Veterans Waiting 60 Days or More for New Appointments at 30 Locations...

VA Secretary: Veterans Waiting 60 Days or More for New Appointments at 30 Locations
May 31, 2017 - Veterans Affairs Secretary David Shulkin said Wednesday that while the VA has significantly improved access to care for veterans, there's still more work to be done with veterans waiting 60 days or more for new appointments at 30 of its locations nationwide.

The VA is providing same-day service in all of its medical centers with over 22 percent of veterans seen on a same day basis. "We've done a significant job in improving access to care for clinically urgent veterans, so people with clinically urgent needs are now being addressed in a much more efficient way. We've developed same day services in every one of our 168 medical centers for primary care and mental health. In fact, today over 22 percent of veterans are seen on a same-day basis," Shulkin said.

Furthermore, in an effort of transparency, the VA has posted its wait times for all to see - something no other health system has done. "What we've done recently is we've posted our wait times for every single one of our medical centers across the country in a public forum for everybody to see what's good and what's not good in terms of wait times. There is no other health system in the country that has done anything like that, and there is no comparison to what the VA's doing in terms of transparency and wait times. Yet, veterans are waiting 60 days or more for new appointments in primary care and mental health at 30 of our locations nationwide. So we still have more to do," Shulkin said.

There's still work to be done in the area of community care, specifically with follow-up visits and paying providers. "And while as I mentioned, we've done well with meeting the urgent needs of veterans, 10 percent of the time when a provider wants a follow-up appointment in a specific time frame, we're not meeting that provider's clinically assessed time for a veteran to come back, and that's something we have to address," Shulkin said. "Sixteen percent of our primary care clinics are over 100 percent capacity. When that happens, we can't fully meet their needs in terms of access to care. 10 percent of our outpatient centers do not offer same-day service today. Now we are committing by the end of this year that all of our outpatient centers will offer same-day services and primary care mental health, but today 10 percent are not meeting that," he said. "We have 500,000 community care providers … who participate in our network, but providers are increasingly frustrated with the VA's ability to get them payments to the point that some of them are actually leaving our network, and that's obviously working against us," Shulkin said. "It takes more than 30 days to process 20 percent of our clean claims at VA, and that affects about 25,000 providers across the country. In addition, we have about $50 million in outpatient bill charges that are six months or older. As of April this year, only 65 percent of our claims are handled electronically," he said. "That's far below what you'd find in the private sector, and so we need private sector help in order to find new solutions to get that number well above 65 percent, so we can have faster adjudication of payments to our community providers," Shulkin added.

In terms of quality of care, the VA identified 14 medical centers with 1 Star Ratings, meaning they are below the community standard of care. To date, over 90,000 disability claims are taking more than 125 days to process. The goal is to cut this time in half over the next two years. The VA has initiated the Decision Ready Claims process to move toward a paperless process for claims to shorten the disability and appeals backlog process.

VA Secretary: Veterans Waiting 60 Days or More for New Appointments at 30 Locations

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VA Secretary 'Interested' in Looking at Benefits of Medical Marijuana Use Among Veterans
May 31, 2017 - Veterans Affairs Secretary David Shulkin said Wednesday that there may be evidence that medical marijuana may be helpful in reducing the suicide problem among the nation's veterans, but until federal law changes, the VA won't "be able to prescribe marijuana for conditions that may be helpful."

During a White House press conference, Shulkin was asked about an op-ed that leaders of the American Legion wrote last week suggesting that increased medical marijuana use could be "a promising solution" to combat the suicide problem among veterans. When asked whether Congress should reclassify marijuana from a Schedule I drug to allow for it to be better used for medical purposes, Shulkin said, "I believe that everything that could help veterans should be debated by Congress and by medical experts, and we will implement that law, so if there is compelling evidence that this is helpful, I hope the people take a look at that and come up with the right decision, and then we will implement that."

When asked what his opinion is as a physician, Shulkin said, "My opinion is, is that some of the states that have put in appropriate controls, there may be some evidence that this is beginning to be helpful, and we're interested in looking at that and learning from that, but until time that federal law changes, we are not able to be able to prescribe medical marijuana for conditions that may be helpful."

The American Legion requested a meeting with the White House to discuss clearing the way for clinical research in medical marijuana use, according to Politico. American Legion's National Director of Veteran Affairs and Rehabilitation Louis Celli said the Legion is not asking for marijuana to be legalized. "There is overwhelming evidence that it has been beneficial for some vets. The difference is that it is not founded in federal research because it has been illegal," Politico quoted Celli as saying.

VA Secretary 'Interested' in Looking at Benefits of Medical Marijuana Use Among Veterans

 

[waltky]

But will it speed up wait times?...

VA Switching to Same Electronic Health Records System as DoD
June 6, 2017 | Veterans Affairs Secretary David Shulkin announced Monday that the VA will be switching to electronic health records and adopting the same electronic health records system as the Department of Defense.

“Having an electronic health record that can follow a veteran during the course of his health, and treatment is one of the most important things I believe you can do to ensure the safety and the health and well-being of a veteran, so that's why this is so important,” Shulkin said. The secretary said the VA will be moving away from its “internal product to an off-the-shelf commercial product.” “I told Congress recently that I was committed that VA would get out of the software development business; that I did not see a compelling reason why being in the software development business was good for veterans, and because of that, I made a decision to move away from our internal product to an off-the-shelf commercial product,” he said.

“As you may know, almost all of our veterans get to us from one place, and that's the Department of Defense,” Shulkin said. He was able to “trace back at least 17 years of congressional calls and commission reports” calling on the VA to modernize its system and also work closer with the DoD. “But actually, to this date, the Department of Defense and the Department of Veterans Affairs have gone separate ways. We each have separate systems, and each are supporting separate electronic systems, and while we've been able to advance interoperability at the cost of hundreds of millions of dollars to the taxpayers, today we still have separate systems that do not allow for the seamless transfer of information,” he said.

Shulkin said as of now, the VA and DOD are able to “reach each other’s records right now.” “That's called interoperability, or at least that's our certification, but what you're not able to do is actually work together to plan a treatment, to be able to go back and forth between the Department of Defense and VA, and so we've not been able to obtain that to this point,” he said. That’s why Shulkin decided that the VA will adopt the same electronic health record as the DoD so that they will have “a single system” known as “the MHS GENESIS system, which, at its core, is Cerner Millennium.” The benefits of having a single system are that it will “allow all patient data to reside in a common system so you will have this seamless link between the departments without the manual or electronic exchange of information,” he said.

The DoD took about 26 months to implement its electronic medical records system back in 2014. “I will tell you, in government terms, that's actually a pretty efficient process. I don't think we can wait that long when it comes to the health of our veterans,” Shulkin said. Shulkin said he’s not willing to put off the decision for the VA any longer. “And so under my authority as the secretary of VA, I am acting to essentially do a direct acquisition of the EHR currently being deployed by the Department of Defense that will be across the entire VA enterprise. That's going to allow the seamless health care for veterans and the qualified beneficiaries,” he said. “Once again, because of the health of our veterans, I’ve decided that we're going to go directly into the DOD process for the next generation electronic health record,” Shulkin said.

VA Secretary: VA Switching to Same Electronic Health Records System as DoD

 

[Camp]

So, veterans health care is getting worse under trump, but the promises for improvement are getting bigger?

 

[JakeStarkey]

Heath care under VA has improved dramatically since Bush's admin and is improving under Trump's. Let's not lose the forest focusing on individual trees.

 

[waltky]

Choice out, CARE about to be in place...

Congress Gets Plan to Replace VA ‘Choice’ with ‘CARE’ Plan
June 9, 2017 - Military Update: The nation’s largest veteran groups joined key senators Wednesday to endorse conditionally a plan from VA Secretary (Dr.) David J. Shulkin to replace the unpopular 2014 VA Choice program, which critics contend often has failed to provide timely access to private sector care when VA healthcare isn’t readily available.

However, veteran groups adamantly oppose VA’s plan to fund the Choice replacement plan by cutting disability compensation paid through the Individual Unemployability (IU) program to 208,000 severely disabled veterans, those ages 62 and older who also are eligible for at least minimum social security benefits. In testimony before the Senate Veterans Affairs Committee, Shulkin unveiled his replacement for Choice, titled the Veterans Coordinated Access and Rewarding Experiences (CARE) Program. CARE would have the familiar features of a managed care program, with VA healthcare providers assigned to patients and deciding, based on clinical needs, whether to treat patients inside VA or refer them to an outside network of private sector care providers under contract to VA.

VA is asking Congress to scrap the “arbitrary” mandates established under Choice to offer access to private sector healthcare if veterans reside more than 40 miles from a VA hospital, or a VA clinic staffed by a primary care provider, or if they must wait longer than 30 days for access to VA care after seeking an appointment. Shulkin insisted under intense grilling by Sen. Mike Rounds (R-S.D.) that patient choice to seek community care or to stay in VA would be preserved under CARE because, he said, VA care providers wouldn’t be implementing the program properly if they simply mandated the source of care for patients. Rounds suggested veterans in his rural state finally are seeing the Choice plan work for them, relying now local healthcare providers because they reside more than 40 miles from a VA facility, “which is a lot of South Dakota.”

If those same veterans are required again to consult with a VA provider, either in person or by phone, to get permission to seek outside care, “it doesn’t sound like it’s a joint decision,” Rounds said. Shulkin insisted it will be. VA will give guidance to providers to make it so. “When I treat patients,” said Shulkin, an internist who still sees patients as a VA physician, “I listen to my patients and I understand what their needs are…I think what good doctors and providers do is they recognize it is a joint decision.” Also, under the CARE plan, if a local VA facility can’t treat a patient, the VA provider would grant permission to use the outside provider network, either inviting the patient to find a community care provider or providing help with a referral.

Rounds wasn’t persuaded that patients under CARE wouldn’t be pulled back into VA and have to rely again on long trips to VA hospital or clinics. He noted that Congress enacted a law that, starting in 2010, required VA to cover private sector emergency care of veterans enrolled in VA, even if they had other health insurance. Appellate courts have ruled in the Staab case that VA ignored the law and kept regulations in place that denied emergency care reimbursements to thousands of veterans because they had other health insurance. Many of those treated for emergency conditions not related to their time in service got stuck with hefty bills. The fact that VA continues to appeal the Staab decision suggests that the department will seek to control community-based healthcare costs, regardless of the impact on patients, Rounds told the VA secretary.

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Police Identify Veteran Found Dead in VA Parking Lot
9 Jun 2017 | WASHINGTON -- The man found dead in the parking lot of the Washington Veterans Affairs Medical Center was Navy veteran Woodrow C. Reed.

The man found dead last month in the parking lot of the Washington Veterans Affairs Medical Center was Navy veteran Woodrow C. Reed, according to police. Reed was 61 and a resident of Alexandria, Va., said Rachel Reid, a spokeswoman for the Metropolitan Police Department.

Reed's sister found him in his vehicle at the hospital about 8:30 p.m. on May 16. He had been reported missing May 15 when he didn't return from an appointment at the facility, according to The Associated Press. The veteran was found "slumped over and unconscious," according to a DC police report. A VA medic pronounced the veteran dead before police arrived, according to the report. The VA chief of police and a VA investigator also responded to the scene.

The VA and the House Committee on Veterans' Affairs said they are investigating the circumstances of Reed's death. A medical examiner is still determining the cause of death. The examiner's office could not be reached by phone Thursday.

Police Identify Veteran Found Dead in VA Parking Lot | Military.com