Official: VA Should Do More to Reach Reservists

Thursday - July 23, 2009; Army Times; Author: Karen Jowers; Original URL: http://www.armytimes.com/benefits/health/military_reservetransition_072908w/

Department of Veterans Affairs officials should “burn up some shoe leather” to reach out to help National Guard and reserve troops, an Army Guard colonel in charge of an outreach program in Vermont told senators July 23. VA should aim for more personal contact, Lt. Col. John Boyd, deputy chief of staff for personnel for the Vermont Army National Guard, said at a Senate Veterans Affairs Committee hearing about the need to reach out to Guard and reserve members who are often isolated from the military community in their civilian lives. “There’s something to be said for burning up some shoe leather and going to find these people,” Boyd said. “They may not answer the phone or an e-mail, but if you knock on the door, 99 times out of 100, veterans will talk to you, and you’re going to find out what’s going on.”  In Vermont, officials have seen the effectiveness of using combat veterans as outreach team members, Boyd said. “Our program has observed that using fellow veterans helped allay anxiety some soldiers felt when first contacted,” he said. The program has a goal of contacting all reserve component veterans of Iraq and Afghanistan in Vermont. Outreach specialists focus on ensuring that veterans are receiving benefits, including early diagnosis and treatment of post-traumatic stress disorder and traumatic brain injury. In many cases, outreach specialists drive veterans to Vermont VA medical facilities for their first few visits, Boyd said.  “Unlike their active-duty counterparts, Guard and reserve veterans must transition from their civilian life and employment, to active-duty military service, and back again,” said committee chairman Sen. Daniel Akaka, D-Hawaii. “Despite VA’s best efforts to conduct outreach to this population, it seems clear that some are still unaware of all that VA has to offer and how to access those services and benefits.”   Army Reserve Maj. Cynthia Rasmussen, combat stress officer for the 88th Regional Readiness Command, said officials need to keep in mind that active-duty members separating from service may also need support when they come home to a rural area. She said VA staff workers must be “culturally competent.”  “You don’t have to wear the uniform, but you have to understand why we do what we do and why we think the way we do,” she said. Vet Centers are an excellent place for outreach, said Joseph Scotti, a licensed clinical psychologist and professor of psychology at West Virginia University. At the Morgantown, W.V., outreach center, for example, “they do a tremendous job, but they are overwhelmed.”  “A room full of 50 vets and one counselor … calling it group therapy — it’s not,” Scotti said. “They need more help. They’re still overwhelmed” with older veterans of Vietnam and other wars. Veterans in rural areas have been a longstanding concern. Veterans from rural counties in West Virginia had greater combat exposure than those from urban counties, according to the initial results of a study resulting from a survey mailed to West Virginia veterans of Iraq and Afghanistan, conducted by Scotti and his colleagues.

Results of the study also indicate:

• Veterans who served as members of the Guard and reserve are experiencing more problems with psychological and daily functioning than active-duty personnel.

• Veterans from rural counties are experiencing more problems with psychological and daily functioning than those from urban counties.

• While about 80 percent to 90 percent of veterans are aware of services and support available to help them deal with these issues, one-third to one-half are not using professional or VA-related services. And only about half the veterans reported that a service they used was helpful to them.

Still, progress is being made. Maryland Army National Guard Sgt. Roy Meredith said he saw significant improvement in the way VA accommodated him after he returned from his first deployment in early 2006 compared to when he got back from his second deployment earlier this year. After his first deployment, he said he got little information from VA at his demobilization site, and VA later erroneously ruled his injuries form a roadside bomb in Iraq as not combat-related. Two years later, VA counselors and claims processors were at the demobilization site to help troops. He was given e-mail address contacts, office numbers and even personal cell phone numbers of supervisors, and contacts for hospitals and clinics. “Supervisors called me to follow up,” he said. “It was 180 degrees difference. No longer do I wonder if I’ll be taken care of for wounds seen and unseen.”

Veterans Affairs Suspends Troubled Health IT Programs

Wednesday - July 22, 2009; Smart Brief; Author: E-Health Smart Brief;
Original URL: http://www.smartbrief.com/news/ehealth/storyDetails.jsp?issueid=E960C264-A0A3-46C5-AF37-25A38EBBDE16©id=262E3696-7473-47AD-9FA0-1E9B9328A84B

Forty-five health IT projects that are over budget or behind schedule have been temporarily halted by the Department of Veterans Affairs. The move to suspend the projects -- some considered major -- comes after the department established a Program Management Accountability System and reviewed its 300 IT projects "to bring about greater accountability and ensure that taxpayer dollars are being spent wisely."

'Happiness level' not so high at Veterans Affairs

Tuesday - July 21, 2009; OhMyGov.com; Author: Jenifer Reinhardt; Original URL: http://ohmygov.com/blogs/general_news/archive/2009/07/21/happiness-level-not-so-high-at-veterans-affairs.aspx

When the nation’s chief information officer, Vivek Kundra, was in the same position working for the District of Columbia, his way of measuring progress on IT projects was based on “happiness level.” Successful projects that were meeting their commitments had a high happiness level while projects that were missing the mark or deadlines carried a low happiness level. The announcement Monday that the Department of Veterans Affairs was putting 45 IT projects on hold sent the happiness quotient there into a frownie-face freefall. When Kundra introduced his new IT Dashboard last month he said, “Now, for the first time, the entire country can look at how we’re spending money and give us feedback.” Anyone who spent time perusing the dashboard, as we did, could easily see that VA’s graphs were remarkably red compared to the other federal agencies. That sea of red finally spilled over. The first inkling that changes were coming at the VA came one month ago when Secretary of Veterans Affairs Eric K. Shinseki, along with the CIO of the agency, Roger Baker, announced an aggressive new plan to look for technology project failures. “By halting programs that fail to meet their delivery milestones, we will prevent wasteful spending and demand accountability from everyone involved in delivering and supporting the technologies that will help transform the VA,” Shinseki said. VA is using a Project Management Accountability System (PMAS) to track all new IT programs at the agency. The fallout we are seeing this week is a direct result of the new policies put in place by Shinseki and Baker. Targeted projects range from prosthetics enhancements to the sharing of lab data sharing and interoperability. They are not being terminated outright. “We are going to change things and try and bring them back on track,” Baker said. “We still have a requirement for the things those projects are trying to accomplish.” The bad news here is that 45 VA projects worth about $200 million of the 2009 fiscal budget were so “unhappy” that they had to be put on hold. But there’s a silver lining… or at least a silver-plated one. The federal government now has new tools, personnel and leadership in position to root out problems and bring them into the light. According to Kundra, “The dashboard is an impetus and is a driver for looking deep into where the problems are with these projects.” “We were able to catch these contracts, in part, thanks to our new tool,” Kundra said.

Department Of Defense Pushes Ahead With E-Health System

Tuesday - July 21, 2009; Information Week;  Author: J. Nicholas Hoover; Original URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=218501641

A personal health records pilot test by the Department of Defense has been successful, and the military is now determining how to expand it more widely. The service, called MiCare, is still in pilot mode at Madigan Army Medical Center in Tacoma, Wash. Plans call for it to be expanded to the Hampton Roads, Va., area and then beyond. Defense is also working with the Department of Veterans Affairs to determine how the two agencies can collaborate on the initiative. "We want to make sure functional and clinical experts help decide what to do next and when," said Chuck Campbell, CIO of the Military Health System, during a panel discussion at the Open Government and Innovations Conference. MiCare will eventually give military members, their families, and veterans access to their personal health records via Internet services, including Microsoft HealthVault and Google Health. The military is also evaluating Relay Health.  The Defense Department opted to go with an online service for health records instead of an internally developed system largely due to cost and timing. "I could build all the servers, buy all the software to do that at probably a large cost and a long time, or I could do this," said Campbell. Privacy was a primary concern during the pilot. Patients will have the ability to opt into the system, so their healthcare records won't go online unless they approve. Users will also be able to decide what information to share and with whom.  During the pilot, MHS had to manage security, determine how to share medical information from its own e-health records system with public systems from Google and Microsoft, and revise processes in hospitals and clinics, including educating healthcare workers in how to use the new systems.  Campbell said MHS has "special arrangements, involving penalties" with Google and Microsoft around security. The military also requires that information on Department of Defense employees must be stored only in the United States and that personal information is immediately deleted from vendors' servers if an employee opts out after entering information into the system.  In addition to the personal health records pilot, Defense is overhauling a back-end electronic medical records system that pre-dates the Google and Microsoft pilots, but has garnered significant criticism from users and observers. Campbell admitted that the system is slow, not user-friendly and unreliable. As part of the overhaul, MHS plans to redesign some elements of the system's user interface and add redundancy.

GAO: VA Failing to Serve Women Warriors

Monday - July 20, 2009; TPM.com;  Author: Paul Reickhoff; Original URL: http://tpmcafe.talkingpointsmemo.com/2009/07/20/gao_va_failing_to_serve_women_warriors/?ref=c2

If you blinked, you could've missed it. With the media's obsession over Michael Jackson's death and Sotomayor's confirmation hearings plastered across cable news shows, an important story might have skipped your radar. Last week, the Government Accountability Office (GAO), the investigative arm of Congress, released a stunning new report detailing significant barriers that many female veterans face in accessing healthcare at the Department of Veterans Affairs. Not just for policy wonks, this report should be required reading for every American. Some of the critical findings include:  Privacy standards for women veterans at VA facilities aren't being met. The GAO found women's exam room tables that faced doors instead of walls, and instances where women patients had to walk through waiting rooms to use the restrooms, as opposed to next to the exam room as required by VA policy. Some hospitals under review also did not guarantee access to private and secure bathing areas or visual and auditory privacy at check-in.

Comprehensive primary care is not available for women veterans at all hospitals and clinics. Despite its commitment 8 months ago, the VA has still not establish a deadline for facilities to meet its requirement of complete primary care and basic gender-specific services available to all women veterans by one provider at one site. Some VA officials were even unclear on the steps needed to implement this new plan. The availability of services for women veterans continues to vary by hospital and clinic. The VA still has shortages of qualified women's health and mental health care providers. The VA's ability to provide consistent and timely care to female vets is also being compromised by difficulties hiring providers that specialize in women's health and mental health. For the female veterans coming home from war everyday and those suffering from mental health injuries or who have experienced Military Sexual Trauma, these shortages could not come at a worse time.

But the GAO isn't the only one voicing concern. We recently asked female vets to share their experiences at the VA. And their responses were alarming: "I tried several times to use the mental health services. I was told that women don't go to combat so we shouldn't need counseling."--Female Iraq and Afghanistan Veteran "The VA hospitals are used to dealing with male Vietnam, Korea and WWII vets -- the quality of care for a female at a VA hospital is very low."--Female Iraq Veteran

"The [local] VA is supposed to have 4 women's doctors, but there is only 1 full-time doc and 1 semi-retired (her knowledge is outdated and she's made serious mistakes on basic women's health problems that were already in my military medical record). With all the women veterans, this is ridiculous...Also I get annoyed because everyone calls you "Mr." until they realize you're female, they assume all vets are guys."--Female Iraq Veteran

This is absolutely unacceptable. The VA must ensure that women veterans receive the care they deserve. With more women serving in combat than ever before, action should have happened yesterday. Thankfully, some advocates in Congress aren't waiting. A bipartisan group of lawmakers lead by Senator Murray and Congresswoman Herseth Sandlin are championing legislation to improve VA services for women veterans. "The Women Veterans Healthcare Improvement Act" (S.597/H.R.1211) would help assess, expand, and improve VA care for women veterans, especially those who have served in Iraq and Afghanistan. With the female veteran population growing daily, it will also equip the VA with the tools necessary to plan long-term for this historic growth. And it's just steps away from the President's signature.

Like their male peers, women veterans have shown incredible dedication and courage in defending their country. It's about time they get the same recognition and support.

P.S. Next month, IAVA is releasing a groundbreaking Issue Report on women in the military, based on extensive research and the experiences of female IAVA Member Veterans. Want to be the first to hear about it? Sign up for mobile updates by texting REPORT to 69866. We'll send you a text message as soon as the report launches, so you can be among the first to read it.

Vets Group Challenges Shinseki to Beef Up Budget, Staff

Monday - July 20, 2009; Army Times; Author: Kelley Kennedy; Original URL: http://www.armytimes.com/benefits/health/military_woundednumbers_022409w/

A new report from Veterans for Common Sense comes as a reminder of what the Veterans Affairs Department needs to fix: backlogged disability cases, too many suicide attempts and patients waiting weeks to see mental health providers. But it’s also a predictor of what’s ahead: In a bad economy, fewer veterans will have good civilian health care plans.

A variety of factors will add to the pressure on VA’s patient load. Congress just awarded veterans who deploy five years of free health care after they leave service; more people are seeking mental health help; VA is catching more problems by screening veterans for brain injuries and mental health issues; and President Barack Obama just announced a troop surge in Afghanistan.  VA’s 2010 budget proposal is due out in April, and new VA Secretary Eric Shinseki will have to break his department’s habit of budgeting low and claiming it can make do with what it has if he wants to impress the veterans groups that have been pushing for more funding since the wars in Iraq and Afghanistan began.

“He will have to streamline processes,” said Paul Sullivan, executive director of Veterans for Common Sense. “He needs to hire more staff. He needs to ask for more money. He needs to remove top leaders who are bogging down the claims process.”  In his confirmation hearing in January, Shinseki said he planned to come up with a “credible budget” and acknowledged that VA needs to move past barriers to care, such as backlogs and too few doctors. “I intend to be a forceful advocate for veterans,” he said at the time.

After filing several Freedom of Information Act requests with VA and the Defense Department, as well as gaining information from lawsuits against VA, Veterans for Common Sense issued the report “Looking Forward: The Status and Future of VA.” “VA has repeatedly sat in front of Congress and said, ‘We are sufficiently resourced.’ And Congress says, ‘You keep telling us that; tell us what you need.’ People kept asking us for more information about what’s needed.”  The report, Sullivan said, gives legislators the data they need to ask specific questions and get specific answers. “If [Shinseki] doesn’t take advantage of this golden moment to address these problems, the door will close,” Sullivan said. “If Congress hadn’t forcibly pumped money into VA over the past few years, VA’s crises would have already become a catastrophe.”

BY THE NUMBERS According to a report by Veterans for Common Sense:

• In January, VA had a backlog of 625,000 disability claims.

• Those claims take an average of six months to process, with post-traumatic stress disorder cases taking longer.

• As of September, VA had treated more than 400,000 patients from the wars in Iraq and Afghanistan.

• Of those, 105,000 were diagnosed with PTSD.

• Of those 105,000, about 25 percent had to wait more than 30 days to see a doctor.

• In 2008, 12,000 veterans in VA care attempted suicide — about 33 a day.

• There were 154,000 homeless vets in 2008, according to VA.

• The Rand Corp. has estimated that 320,000 vets are at-risk for traumatic brain injuries, and another 338,000 will need to be treated for PTSD or depression.

• Among VA patients from the current wars, 45 percent had one or more mental conditions.

• If the wars were to end today, VA should plan for 750,000 patients from among the 1.83 million people who have deployed to Iraq or Afghanistan.

Support Grows to Widen VA Health Care for Women

Monday - July 20, 2009; Army Times Author: Rick Maze  Original URL: http://www.armytimes.com/benefits/health/military_womenhealth_060909w//

Momentum is gathering to expand health care services for female veterans, with one of the few remaining disputes — over the number of days of neonatal care for those receiving maternity care at Veterans Affairs Department facilities — now resolved. Two similar bills, one passed by the Senate Veterans’ Affairs Committee on May 21 and the other by the House Veterans’ Affairs Committee’s health panel June 4, try to make VA more accessible and relevant to women, the fastest-growing segment of the veteran population.

Lawmakers agree on the key details, including:

• More access to mental health counseling.

• A three-region pilot program in which women who are primary caregivers could use VA employee child care centers while receiving outpatient treatment.

• Internal and external reviews of VA programs to determine whether women face any barriers to care.

The Senate committee included women’s initiatives in a larger veterans health bill, S 252, while the House is working on a free-standing women’s health bill.

The original House bill, HR 1211, included the promise of up to 14 days of neonatal health care from VA, either directly or by contract, for female veterans receiving VA maternity care. The number of days was scaled back to seven under an amendment sponsored by Rep. Steve Buyer of Indiana, ranking Republican on the full House Veterans Committee, based on input from VA showing that 95 percent of women are released from the hospital within seven days after birth and that most private health insurance plans cover only 48 hours of post-maternity hospitalization. The Senate bill also provides seven days of care. Rep. Michael Michaud, D-Maine, chairman of the House health panel, said he believes studies of health care for female veterans called for in the legislation are among the most important provisions because they will look at whether the stigma of seeking mental health services, clinic operating hours, the distance of care and low gender sensitivity are factors discouraging women from getting the treatment they have earned. Michaud said their needs should not “fall by the wayside as we explore ways to improve health care for our veterans.”