Retiree & Veteran Affairs News 26 April 2016
BUDGET INDECISION LEAVES A RESTLESS ARMY
April 12th, 2016 10:44 AM
By Gen. Gordon R. Sullivan, U.S. Army retired
Our nation’s security and the lives of our soldiers are being put at risk by clinging to the notion that playing political games with military spending is a harmless game of chicken. Our Army is holding on, hoping for a better day, and our troops are restless for a solution.
Because of outdated defense spending limits and the returning threat of sequestration, America’s Army is engaged in budgetary triage, attempting to increase combat readiness while facing inadequate budgets. Instead of having the best-prepared, best-trained and best-equipped fighting force in the world, our Army is finding ways to generate improved combat capabilities that seem to be barely enough to meet immediate demands, with little hope of significant Total Force improvements in the near future.
This “just in time readiness” works only if demands for forces remain modest. But an increasingly perilous world has an expanding number of hot spots that would require immediate and sustained response using Army forces and capabilities, although these assets will be diminished by budget-driven shortfalls in training, staffing and equipment.
It doesn’t have to be this way, and it shouldn’t be this way if our nation’s security truly is our highest priority.
Sequestration—automatic budget cuts taking effect if there is no political agreement on spending—was a flawed idea from the beginning. First, it was a mistake to believe the threat of cutting federal spending would be enough to overcome the deep political divide over our nation’s priorities. Second, putting defense spending at risk created a situation where our troops are hurt and our potential adversaries helped by political inaction. In what amounts to a game of budgetary chicken, our Army and the rest of our nation’s national security elements should never have been put on the table.
While budget caps on defense spending were slightly relaxed for two years, this is temporary. We return in 2018 to a situation where we face a world of unrest and increasing deployments with a budget that handcuffs our military and an Army that keeps getting smaller.
We cannot kid ourselves about the impact of a constant downward trend on the ability of any military formation to perform their tasks at maximum effectiveness. Further reductions make for more risk. If faced with multiple crises, an overtaxed Army could face the difficult requirement of disengaging from one commitment to respond to another.
Improving readiness remains difficult because of the combination of declining troop strength and increased operational deployments, but troop morale also is a major factor because having a ready Army requires more than just weapons and training. For that reason, we should tread carefully when taking any steps to reduce that quality of life and the compensation package of our soldiers and their families.
It may be unrealistic to hope for quick and clear budget decisions that could free the Army to chart the right course to reduce national security threats. The best we might hope for is to at least not do anything that makes things even worse. The Army and our nation will be best served by slowing or even stopping further reductions in troop levels until a new national security assessment is done that takes into account the increasing risks we face, and by providing as much money as possible so the Army can accelerate efforts to restore readiness across all components.
The downward manpower trend, combined with scarce dollars for training, make the Army less effective—a simple equation that cannot be denied. Political unwillingness to face up to the real and immediate national security needs of our nation does not diminish the threats. It only puts us all at greater risk.
AUSA ON THE HILL
With Congress about to start writing the 2017 defense budget, the president and CEO of the Association of the U.S. Army met April 14 with a key House subcommittee chairman to talk about Army priorities.
Retired Army Gen. Gordon R. Sullivan, AUSA’s leader since 1998, met with Rep. Rodney Frelinghuysen, R-N.J., chairman of the defense subcommittee of the House Appropriations Committee. Frelinghuysen, an Army veteran who served in Vietnam, has been a member of AUSA since 1984.
In a discussion about the challenging global strategic situation and the current funding environment on Capitol Hill, Sullivan asked for the congressman’s help in providing budget stability for the Army. Sullivan urged an end to sequestration, the budget mechanism that cuts spending when Congress and the White House cannot agree on budget priorities, and he also requested help finding $2.5 billion to cover added personnel costs if the Army temporarily stops the drawdown.
AUSA supports the POSTURE Act, a bill that would stop reductions in the Regular Army, Army Guard and Army Reserve. Army leaders have expressed support for the bill, but are worried about how to cover the costs of having more soldiers than budgeted.
While making no specific promises, Frelinghuysen said his subcommittee would attempt to find money for the Army if the House Armed Services Committee stops or slows cuts.
Frelinghuysen cautioned there are many competing needs across the joint force, and there are limited resources. He would not make any commitments, but he assured Sullivan that the subcommittee works very closely with the authorizing committees. If the House Armed Services Committee bill pauses the end- strength drawdown, the defense appropriations subcommittee will look at it in detail to determine the necessary resources to keep the Army strong.
HOUSE DEFENSE PANEL RELEASES DRAFT POLICY BILL
The subcommittees of the House Armed Services Committee marked up their respective portions of the fiscal 2017 defense authorization bill this week ahead of the full committee’s consideration next week.
We know that the Personnel Subcommittee’s mark would increase the Army’s active duty end strength by 20,000 to 480,000, up from the 460,000 requested by the administration. The Army National Guard would get 15,000 new troops while the Army Reserve would increase by 10,000. The president’s budget requested 335,000 for the Guard and 195,000 for the Army Reserve.
The subcommittee would provide a 2.1 percent pay raise for military personnel. That is a half percentage point higher than the president’s request.
Much of the language released by the subcommittee dealt with changes to the Uniform Code of Military Justice. If it became law, retaliation for reporting sexual assaults and other offenses would be a crime. The bill would also expand the statute of limitations for child abuse offenses and fraudulent enlistment.
Language in the report would authorize the Secretary of Defense “to develop and implement a comprehensive strategy to optimize practices across the defense commissary and exchange system that reduce the reliance of the system on appropriated funds without reducing the benefits to the patrons of the system.”
In his opening statement, Subcommittee Chairman Rep. Joe Heck, R-Nev., said that the proposal would, “Reform the Commissary system in a way that preserves this valuable benefit, while also improving the system so it remains a good value for the shoppers, a good value for the taxpayer dollars invested within it, and can continue to support morale, welfare, and recreational activities.”
We don’t know what the highly anticipated military health care reform will be. Heck said the subcommittee was still “working to complete our reform of the military healthcare system” and that “I believe the health care reform package you will see next week reflects our commitment to ensure the military health system can sustain the readiness of both our military healthcare providers and the overall force while providing a quality health benefit that is valued by its beneficiaries.”
Members of the Tactical Air and Land Forces Subcommittee agreed with the report recently released by the National Commission on the Future of the Army who recommended that the National Guard be allowed to keep four of its eight AH-64 Apache battalions, instead of losing them all to the regular Army, as initially proposed in the Army Aviation Restructuring Initiative.
The committee also agreed to authorize multiyear procurement authorities for UH-60 Black Hawk helicopters and AH-64 Apache attack helicopters and support the realignment of funds within the European Reassurance Initiative to allow the Army to procure the most modernized and upgraded versions of Abrams tanks and Bradley Fighting Vehicles, as requested by the Army.
Again this year, the Subcommittee on Readiness will reject the administration’s request for a new round of base realignment and closure. However, we expect to hear more about it as the bill moves forward because Rep. Adam Smith, D-Wash., the ranking Democrat on the House Armed Services Committee has been very outspoken on the need to shed unneeded military assets.
Bolstering his argument is a Defense Department report recently provided to Congress that stated that DoD’s excess infrastructure is 22 percent. The report said that the Army’s infrastructure is 33 percent more than needed.
However, Committee Chairman Mac Thornberry, R-Texas, questioned the report. He said, “No one believes that the current military force structure is adequate to meet the threats we face. Just this month, senior commanders testified that our military is too small. Assessing our capacity based on an inadequate force structure makes no sense. It would lock in a future where our stressed military becomes permanently gutted.”
Another item sure to be included in the authorization bill is language from H.R. 4741, The Acquisition Agility Act, H.R. 4741. Introduced by Chairman Thornberry in March, the bill includes “foundational reforms that are intended to help get better technology into the hands of the warfighter faster and more efficiently. It does that by simplifying the process and expanding the avenues of competition for suppliers of all sizes. Building on the lessons from successful military innovation of the past, these critical reforms will promote experimentation and prototyping, not only to field capability, but to learn and develop new operational concepts,” a statement released by the committee states.
The full committee markup of the defense authorization bill is scheduled for Wednesday, April 27.
POSTURE HEARING SEASON WINDS DOWN. MARKUP BEGINS.
House Armed Services Committee Chairman Mac Thornberry, R-Texas and Ranking Member Adam Smith, D-Wash., officially started the fiscal 2017 National Defense Authorization Act process by introducing H.R. 4909, which will serve as the placeholder bill ahead of the markup that begins next week.
With just a week away, there is no budget resolution and no relief from the defense spending caps that resulted in a more than $3 billion reduction in the Army budget.
Without relief, the House Armed Services Committee will have subcommittees start piecing together the legislation with limits on how much money they can spend and what changes they can make.
The Army’s expected topline is $148 billion including $25 billion in overseas contingency funding. At that level of funding, it is unlikely the committee would be able to either slow or stop the continued reduction in Regular Army, Army National Guard and Army Reserve troop strength and also unlikely they’ll be able to make much headway giving the Army any of the $7 billion in unfunded programs on a wish list provided to the committee last month.
The Senate is scheduled to markup their version of the defense policy bill about two weeks after the House.
SENATE PANEL ADVANCES MILITARY CONSTRUCTION LEGISLATION
The Senate Appropriations Subcommittee on Military Construction and Veterans Affairs (VA) has advanced a draft spending bill that would provide $83 billion in discretionary funding, a raise of $3.1 billion over fiscal 2016 enacted levels.
The bill provides $7.93 billion for Military Construction which is $241 million below the fiscal 2016 level and $486 million above the president’s request.
· Military Family Housing – $1.3 billion for construction, operation and maintenance of military family housing.
· Military Medical Facilities – $350 million for construction or alteration of military medical facilities.
· Department of Defense (DoD) Education Facilities – $272 million for essential safety improvements and infrastructure work at four military school facilities located within the United States and overseas.
· Guard and Reserve – $673 million to support the construction needs of the Guard and Reserve, an increase of $122 million above the fiscal 2016 enacted level.
· NATO Security Investment Program (NSIP) – $178 million for infrastructure necessary for wartime, crisis, and peace support and deterrence operations, and training requirements. The funds will support responses to the challenges posed by Russia and to the risks and threats emanating from the Middle East and North Africa.
The legislation includes a record level of $177.4 billion in both discretionary and mandatory funding for the Department of Veterans Affairs (VA), an increase of $14.7 billion above the fiscal 2016 level.
Discretionary funding for VA programs totals $74.9 billion. As requested by the administration, the bill makes an additional $1.6 billion in medical care funding available to improve patient access to care, and to support additional health care services including hepatitis C treatments, veterans’ caregiver services, and homeless veterans’ assistance.
· VA Medical Care – $65 billion to support treatment and care for approximately 9.2 million patients in fiscal 2017. The bill provides: $7.2 billion for the new Medical Community Care account to provide non-VA care; $1.5 billion for the treatment of Hepatitis C; $675 million for medical and prosthetic research; $535 million for health care specifically for women veterans; $5.7 billion to care for Iraq and Afghanistan veterans; $284 million for traumatic brain injury treatment; $735 million for the Caregivers Program; and $250 million for rural health initiatives.
· VA Electronic Health Record – $260 million for continued modernization of the VA electronic health record system. The bill includes language restricting the use of this funding until the VA demonstrates functional improvements in the interoperability of a system to seamlessly exchange veterans’ medical data among the VA, DOD and the private sector.
· Disability Claims Processing – $180 million for the paperless claims processing system, $143 million for digital scanning of health records, and $27 million for centralized mail. To prompt greater national and regional progress in reducing VA claims backlogs, the bill maintains strict reporting requirements.
· Construction – Nearly $900 million for major and minor construction associated with VA hospital replacement, continued correction of seismic deficiencies, scores of projects to improve access to VA health care, and the VA’s National Cemeteries.
· VA Mandatory Funding – $103.9 billion in advance fiscal 2018 funding for veterans’ mandatory benefits. The bill fulfills mandatory funding requirements such as: veteran disability compensation programs for 4.4 million veterans and 405,000 survivors; education benefits for nearly 1.1 million veterans; guaranteed home loans for 429,000 veterans; and vocational rehabilitation and employment training for more than 141,000 veterans.
· Advance Appropriations – $66.4 billion in advance fiscal 2018 funding for veterans’ medical programs, the same level as the president’s request, to support VA medical services, medical community care, medical support and compliance, and medical facilities.
The legislation also includes $241.1 million in funding for: American Battle Monuments Commission – $75.1 million; US Court of Appeals for Veterans Claims – $30.9 million; Arlington National Cemetery – $70.8 million; and Armed Forces Retirement Home – $64.3 million.
What’s next: The full Senate Appropriations Committee is scheduled to markup the legislation today.
Wait Times for VA Healthcare are up to 71 Days
Last week the General Accountability Office (GAO) released a report that found unacceptably long wait times persist at Department of Veterans' Affairs (VA) facilities, two years after the waitlist scandal that rocked the VA and led to the passage of the Choice Act.
Fierce Healthcare reported last week that the audit by the GAO found the VA's method of calculating wait times often conceal the actual time it takes before a patient sees a clinician.
The analysis of 180 veterans at six VA centers found average wait times between 22 and 71 days. Twelve veterans who had eventually been seen had faced waits of more than 90 days. Sixty vets still hadn't been seen by the time the GAO concluded its investigation. Investigators attribute those delays to clerical errors or lack of follow-up from the VA.
The report found that according to the most generous estimate, the official VA wait times underestimate wait times by a factor of two.
In a House Veterans' Affairs Committee hearing last week committee chairman Jeff Miller (R-FL) blasted the VA for failing to protect whistleblowers from retaliation and for failing to penalize that retaliation, noting that VA records indicate only six people have been disciplined for retaliating against whistleblowers in recent years, none of whom were fired.
Update on Commissary Reform
Last Thursday we participated in a conference call with Defense Department Officials regarding DoD’s plans for the commissary system. Congress has directed the commissary system to implement pilot programs to find ways to reduce the costs of commissaries to taxpayers and commissary officials have pledged to try and determine which reforms can be put into place that will keep the benefit for commissary customers but also reduce commissary dependence on taxpayer support.
The officials in the call repeated their pledge that their priority is to save the benefit while running commissaries as efficiently as possible. This is very different from past DoD proposals that would have raised commissary prices, reduced operating hours and reduced the number of days commissaries would be open. Instead, they want to initiate pilot programs to test what they call “variable pricing” and introducing their own generic products, like virtually every grocery store now offers, as do AAFES exchanges. They also want to institute common back office procedures within all commissary stores with the aim of achieving financial savings. Finally, they will be looking at ways to expand the business. Unfortunately, that last point did not get discussed, so we are going to go back to them and ask what they have in mind for business expansion.
They are going to implement two types of tests, one involving several stores and variable pricing, and the other involving testing generic products across the whole system.
They also said they have no plans to close any commissaries that are not already scheduled to be closed.
While we are cautiously optimistic about how DoD is approaching the commissary issue, we have concerns about the continuing issues of consolidation of commissaries and exchanges and privatization. The officials we spoke with gave their assurances that those would not be considered, but they are getting strong pressure from Congress to look at those alternatives.
In addition, implementing their plans for variable pricing needs to be watched closely to make sure that, in fact, the overall commissary benefit is saved and that it will not result in patrons having to pay higher prices.
TREA is active in a coalition of military and veterans groups to save the commissary benefit and we will continue our active and close involvement as the process goes forward.
Report Calls for Closing VA Hospitals
Two years ago Congress directed the establishment of a Commission on Care to look at the health care services of the Department of Veterans Affairs. The Commission was created in the Veterans Access, Choice, and Accountability Act of 2014 to evaluate access of veterans to health care and strategically examine how to best deliver health care to veterans throughout the VA health care system. The 15 member commission is composed of three appointments each to the President and the bicameral Congressional Leadership.
Recently 7 of the 15 commission members released what they call the “strawman report.” The report called for the closure of all VHA facilities and the transfer of patients to private care. The Proposed Strawman Assessment and Recommendations report asserted that “the current VA health care system is seriously broken, and because of the breadth and depth of the shortfalls, there is no efficient path to repair it.” The report called for immediate closure of “obsolete and underutilized facilities” and the eventual transfer of all VA patients to local providers within the next 2 decades.
The official final report of the commission is not due for nearly three months and we will be monitoring this issue closely and fighting to stop any attempt to close VA health care facilities. At the same time, we continue to push for accountability within the VA system and for improvements in access to care that must happen as quickly as possible. There is no question that things need to be fixed in VA health care. But that doesn’t mean we should throw out the baby with the bath water.
We thought it might be helpful to our readers to give you excerpts from an editorial VA Secretary Bob McDonald write in the Baltimore Sun about a year and a half ago. In the editorial he reminded everyone of just what services the VA provides and how it is crucial for veterans and for health care in general.
From the Baltimore Sun: VA is critical to medicine and vets
By Robert A. McDonald
October 24, 2014
During preparation for my confirmation as secretary of Veterans Affairs (VA), I was repeatedly asked, "Why doesn't VA just hand out vouchers allowing veterans to get care wherever they want?" For a department recovering from serious issues involving health care access and scheduling of appointments, that was a legitimate question.
Veterans need VA, and many more Americans benefit from VA.
Almost 9 million veterans are enrolled to receive health care from VA — a unique, fully-integrated health care system, the largest in the nation. The VA stands atop a critical triad of support — three pillars that enable holistic health care for our patients: research, leading to advances in medical care; training that's essential to build and maintain proficiency of care; and delivery of clinical care to help those in need.
VA's accomplishments on all three pillars and contributions to the practice of medicine are as broad, historically significant and profound as they are generally unrecognized.
VA is affiliated with over 1,800 educational institutions providing powerful teaching and research opportunities.. Few understand that VA medical professionals:
•Pioneered and developed modern electronic medical records;
•Developed the implantable cardiac pacemaker;
•Conducted the first successful liver transplants;
•Created the nicotine patch to help smokers quit;
•Crafted artificial limbs that move naturally when stimulated by electrical brain impulses;
•Demonstrated that patients with total paralysis could control robotic arms using only their thoughts — a revolutionary system called "Braingate";
•Identified genetic risk factors for schizophrenia, Alzheimer's and Werner's syndrome, among others;
•Applied bar-code software for administering medications to patients — the initiative of a VA nurse;
•Proved that one aspirin a day reduced by half the rate of death and nonfatal heart attacks in patients with unstable angina;
No single institution trains more doctors or nurses than VA. More than 70 percent of all U.S. doctors have received training at VA. Each year, VA trains, educates and provides practical experience for 62,000 medical students and residents, 23,000 nurses and 33,000 trainees in other health fields — people who go on to provide health care not just to veterans but to most Americans.
Our 150 flagship VA Medical Centers are connected to 819 Community-Based Outpatient Clinics, 300 Vet Centers providing readjustment counseling, 135 Community Living Centers, 104 Residential Rehabilitation Treatment Centers, and to mobile medical clinics, mobile Vet Centers and telehealth programs providing care to the most remote veterans.
And since 2004, the American Customer Satisfaction Index survey has consistently shown that veterans receiving inpatient and outpatient care from VA hospitals and clinics give a higher customer satisfaction score, on average, than patients at private sector hospitals.
Finally, VA is uniquely positioned to contribute to the care of veterans with traumatic brain injury (TBI), prosthetics, PTSD and other mental health conditions, and the treatment of chronic diseases such as diabetes and hepatitis.
Fixing access to VA care is important; we have a plan to do that and are dedicated to implementing it. That process will take time — but it must be done, and we will be successful.
Robert A. McDonald is secretary of Veterans Affairs.
Former Top DOD Official Says that TRICARE Cuts Don't Work
Michelle Flournoy, co-founder and CEO of the Center for a New American Security (CNAS) and formerly the Undersecretary of Defense for Policy earlier in the Obama Administration, along with Dr. Stephen Ondra, the chief medical officer of Health Care Service Corp. and an adjunct senior fellow at the CNAS, wrote an op-ed in Politico last week that took aim at the Department of Defense's relentless push to raise TRICARE fees.
The article pointed out that raising fees will not cure the underlying problems that both DOD and beneficiaries have complained about for decades:
“For too long, efforts to undertake much needed reforms in the DOD health care system have been derailed by focusing almost exclusively on cutting costs by decreasing provider reimbursement and increasing copays from beneficiaries. This approach has not only failed to control health care spending, it has also led to lower satisfaction for DOD beneficiaries, especially our active duty members. Going forward, we need to ensure that our service men and women, military retirees and families, receive the best quality of care available and that unsustainable growth in defense health care costs does not increase risk to the DOD’s core national security mission.
“By adopting value-based health care approaches and benefit designs, DOD can keep faith with those who serve by improving the both the consumer experience and quality of care they receive, while also ensuring that burgeoning health care costs do not undermine the DOD’s ability to provide the best possible equipment and training to those sent into harm’s way to defend us.”
The beginning of the article was filled with talking points that DOD has used for years to justify their proposals to have military retirees and active duty families pay more for their earned benefits. The numbers cited were cherry-picked to show an exponential growth in healthcare costs that DOD has been shouldering for over a decade and a half. However, it goes on to note that there are other ways to control costs, many of them contained within the Affordable Care Act (Obamacare) that have worked to constrain healthcare spending in the private sector: namely, changing over to “fee for outcome” based care instead of “fee for service” care.
“Traditional fee-for-service models reimburse providers according to the total number and kind of patient encounters (e.g., how many tests run or procedures performed), rather than according to the health care outcomes those encounters produce (e.g., how functional the outcome is and how satisfied the patient is with the treatment). Fee-for-service tends to incentivize and drive ever-greater quantity of care instead of increasing the value (outcome quality and patient experience/cost) of that care.”
“To address this problem, many private sector health care providers, including well-known brands such as Blue Cross, Aetna and UnitedHealthcare, have accelerated their integration of value-based care reimbursement. Federal agencies, such as the Centers for Medicare & Medicaid Services are catalyzing this transition.”
Fee-for-service can result in unnecessary and duplicative medical tests and procedures; doing the right test or the right procedure the right way can cut healthcare expenditures without negatively affecting patient outcomes, which is something everybody should be able to get behind. Hopefully Congress agrees.
Follow-up on VA employee re-instatement after robbery conviction
In our March 28th Update we told you about a VA employee in Puerto Rico who was reportedly re-instated in her job after being convicted for being involved in an armed robbery. Below is VA Under Secretary for Health Dr. Shulkin formal explanation of the situation. This will clearly not satisfy the HVAC (Their press office referred to this as: VA Top Doc Admits It's Impossible to Fire Employees Who Participate in Armed Robberies) If we hear more we will pass it on.
Message from the VA Under Secretary for Health
David J. Shulkin, M.D.
VA Under Secretary for Health
April 22, 2016
On April 19, I testified before the House Veteran Affairs Committee during a hearing related to delays in Veteran’s Access to Healthcare. In the course of that hearing, a member of the Committee said that it was his understanding that the Department of Veterans Affairs refused to fire a VA Caribbean Health Care System employee who was convicted of an armed robbery in Puerto Rico. The member further asked what VA was doing to “take care of the situation.”
My response to the member was “If I misspeak on this, I will commit I will get back to you by the end of the day, but it is my understanding that person is not currently working at the VA in San Juan.”
I have clarified my statement, and will be formally responding to the Committee, but it is equally important to me that I provide the facts and set the record straight for our Veterans, employees and the general public who entrust us with the care of the Nation’s Veterans and who expect us to be open and honest with them.
On June 15, 2015, an employee of the VA Caribbean Health Care System was arrested and charged with aggravated robbery. The facility’s management took appropriate administrative action during the pendency of the criminal proceedings. The criminal matter was resolved in November 2015 and resulted in a misdemeanor charge and probation only. The employee was not convicted of armed robbery and was subsequently returned to work as a clerk at VACHS following administrative processes and court approval. There was never any indication that the employee posed a risk to Veterans or VA property.
When it is learned that an employee has been charged with a criminal offense, VA takes action within the scope of the law and its Federal authority to implement appropriate disciplinary actions. In accordance with Federal law, criminal prosecution or conviction for off-duty misconduct does not automatically disqualify an individual from Federal employment. As is true in private-sector employment, a Federal employee generally cannot be terminated for off-duty misconduct unless there is a clear connection between the misconduct and the individual’s employment.
We want to assure the public and the Veterans whom we serve that the Department of Veterans Affairs and its Veterans Health Administration is diligent in its efforts to protect the safety of Veterans, visitors and employees in our facilities – nothing is more important to us.
David J. Shulkin, M.D.
VA Under Secretary for Health
The Testimony on Veterans Preference
On Wednesday, views on veterans’ preference in federal hiring were presented. Over the past several years, veterans in the federal workforce has grown to 30 percent, with 25 percent being preference eligible. While veterans are finding their way into federal employment, there are opportunities for improvement. To read testimony and to view the hearing, click here.
Views Presented to Commission on Care
A VSO panel to discuss the future of VA health care with the Commission on Care presented their views. Discussed was the importance of VA coordinating and guaranteeing the quality of care, regardless if that care is provided by the VA or a community provider. Discussion continued around the arbitrary 30-day and 40-mile rules for accessing care in the community, and he reinforced the idea that how far veterans travel or how long veterans wait for needed care must be a clinical determination made by doctors in consultation with their patients. To see all the recommendations for improving access to quality health care, click here. To learn more about the commission and to provide them with your feedback on VA health care, click here.
House Hearing on VA Health Care Delays
On Tuesday, the House Veterans’ Affairs Committee held a hearing to discuss recent VA Office of Inspector General and Government Office of Accountability (GAO) reports on weaknesses in the way the VA measures and reports appointment wait times. Committee members questioned the validity of the VA’s wait time data following a GAO report that highlighted how the VA’s wait time metric only measures a fraction of the time veterans wait for their care. Under Secretary for Health Dr. Shulkin testified that the VA is working to eliminate manipulation of wait time data and is working on better ways to report health care outcomes and patient satisfaction. View a webcast of the hearing.
House Hearing on Pending Health Care Legislation
On Wednesday, the House Veterans’ Affairs Subcommittee on Health held a hearing to discuss legislation to expand adult day care services, increase informed consent for potentially dangerous prescription drugs, require VA medical facilities to comply with appointment scheduling directives, and improve the Caregivers Program. Support offered for many of the bills being considered and recommendations to improve others. It was urged that the subcommittee consider reviewing and reforming the VA clinical appeals process to ensure veterans who have been discontinued from the Caregivers Program are given the opportunity to have their doctor’s clinical decision reviewed by other doctors who understand veterans’ health care needs. To read the testimony or view the webcast, click here.
Senate Armed Services Subcommittee Hearing on PTSD, TBI
The Senate Armed Services Subcommittee on Personnel held a hearing on Wednesday regarding the research, diagnosis and treatment of PTSD and TBI. During the hearing, concerns for MST, suicide and other comorbidities of psychological health were also discussed. Senator Kristen Gillibrand (D-NY) raised gender-specific questions asking, “…I’d like to know if PTSD presents itself differently in male survivors versus female survivors and how treatment for PTSD meets the unique needs of male survivors of sexual assault.” Doctors from the VA agreed research is heading in the right direction for PTSD and TBI, but with nearly 25 percent of veterans transitioning from DOD to VA receiving mental health care during their last year of service, there is still much work that needs to be done. In the future, the VA foresees research innovations for diagnosis and treatment progressing with more neuroimaging and the finding of biomarkers. To read witness testimony or view the hearing, click here. Learn more about PTSD/TBI research.
Senate Confirms VA Inspector General
On Tuesday, the Senate confirmed President Obama’s nominee, former federal and congressional investigations counsel, Michael J. Missal, to be the next VA Inspector General. The position has been vacant for more than two years, but the office has played an integral role in exposing system-wide wrongdoing and data manipulation issues that have contributed to the VA health care access crisis. We are hopeful that permanent leadership in this important position will lead to better accountability at the VA.
Brain Trust Conference
The VA hosted a groundbreaking two-day summit in Washington, D.C., this week focused on brain health. “Brain Trust: Pathways to InnoVAtion,” is a public-private partnership that brings together a number of VA brain researchers with some of the most influential voices in the field of brain health to help identify and advance solutions for mild Traumatic Brain Injury and Post-Traumatic Stress Disorder. A number of representatives from the sports community were also present, since issues related to brain health and head trauma impact all Americans.
Higher Pay Raise Proposed
Draft legislation released this week by the House Armed Services Personnel Subcommittee calls for a 2.1 percent military pay raise in 2017––a half percent higher than what the Administration requested. If enacted, it would be the largest percentage increase since 2010 (which was then 3.4 percent). Military pay increases are supposed to match increases in private sector wages, as measured by the Employment Cost Index (ECI), but the Administration can request more or less than the ECI, with Congress having final approval. Congress erased a double-digit pay gap of the 1990s by directing military pay raises from 2000-2006 to be a half percent above private sector wage increases, and raises from 2007 forward to match the ECI, although more could be authorized. The 1.7 percent increase in FY2013 was the last time military pay matched the ECI. The draft legislation is just a first step in a very long process before the FY2017 National Defense Authorization Act is signed into law.
V-E Day Commemoration
A public ceremony to commemorate the 71st anniversary of Victory in Europe Day will be held at the National World War II Memorial in Washington, D.C., on Mother’s Day, May 8, at 11 a.m. All WWII veterans are invited to attend and be recognized for their service and sacrifice. The WWII Memorial has very few disability parking spaces, and street parking could be limited since it’s the tourist season. Taxis to the memorial are plentiful and recommended. The two closest Metro stations, Federal Triangle and Smithsonian, are both about a half-mile away. Learn more about this and other events here.
The Defense POW/MIA Accounting Agency announced the identification of remains of three servicemen who had been missing in action since World War II. Being returned home for burials with full military honors on a date and location yet to be announced are:
- Navy Fireman 3rd Class Kenneth L. Jayne, of Suffolk County, N.Y., had been missing since Dec. 7, 1941, when the battleship USS Oklahoma he was aboard suffered multiple torpedo hits and capsized as it was moored off Ford Island in Pearl Harbor, Hawaii.
- Army Cpl. George G. Simmons, of Hamilton, Mont., had been missing since Nov. 19, 1942, while fighting in the Philippines. It would be later learned he died in a Japanese prison camp. He was assigned to Battery H, 60th Coastal Artillery Regiment.
- Army Pvt. John P. Sersha, 21, of St. Louis County, Minn., had been missing since Sept. 27, 1944, while fighting in the Netherlands. He was assigned to Company F, 325th Glider Infantry Regiment, 82nd Airborne Division.
FOR IMMEDIATE RELEASE April 19, 2016
VA Convenes Leaders in Brain Health to Advance Solutions for TBI and PTSD at Brain Trust Summit
WASHINGTON – The Department of Veterans Affairs (VA) is leading a groundbreaking two-day event focused on brain health, Brain Trust: Pathways to InnoVAtion. The first annual public-private partnership event will take place April 20-21 at the National Press Club and the IBM Institute for Electronic Government in Washington, DC. Building on the extraordinary leadership and trailblazing efforts of a number of distinguished VA brain researchers, VA is convening many of the most influential voices in the field of brain health – to include the Department of Defense, the sports industry, private sector, federal government, Veterans and community partners - to identify and advance solutions for mild traumatic brain injury (mTBI), and Post Traumatic Stress Disorder (PTSD). Issues related to brain health and head trauma transcend the Veteran and military community, impacting all Americans. By highlighting the themes of collaborative research, medical technology, and sports innovation for player safety, Brain Trust participants will discuss the prevention, diagnosis, treatment, rehabilitation and reintegration of Veterans, athletes, and Americans in general - suffering from head trauma related injuries. The event will also serve as a showcase for many of the advancements that VA is pioneering to improve brain health for Veterans, the military and for the American public at large. In addition to many of the world’s most accomplished brain research scientists, other confirmed participants in the summit include sports commentator Bob Costas, Gen. Peter Chiarelli (CEO of One Mind, and the former Vice Chief of Staff of the Army), Briana Scurry (former U.S. Women’s Soccer Player), Jeanne Marie Laskas (author of the GQ article that inspired the movie Concussion), Terry O’Neil (16-time Emmy award winner), representatives from the NFL Players Association, the NFL, the NCAA, DARPA, DOD, NIH, CDC, and many more. During the summit a special announcement will be made by Chris Nowinski co-founder of the Concussion Legacy Foundation (CLF) and former WWE professional wrestler. Joining Chris will be a former Super Bowl champion and an Olympic gold medalist, each of whom will be using this Summit to announce that they will be donating their brains to the CLF for the purposes of advancing brain health. CLF has partnered with VA and Boston University to establish the VA-BU-CLF Brain Bank, directed by VA’s own Dr. Ann McKee, now the largest sports mTBI and chronic traumatic encephalopathy (CTE) repository in the world with over 325 brains donated, and over a thousand more pledged. “VA is uniquely positioned to contribute to the care of Veterans with traumatic brain injury (TBI),” said VA Secretary McDonald. “The work we do produces results and life changing improvements in care for Veterans — as well as for all Americans, and for people around the world who suffer from these brain related injuries.” The following organizations are teaming up with VA as event partners: Amazon, Booz Allen Hamilton, Comcast, GE Healthcare, IBM, Johnson & Johnson, Optum Health, and Philips. To learn more about Brain Trust: Pathways to InnoVAtion, please visit: www.va.gov/p3/braintrust.asp #VABrainTrust.
FOR IMMEDIATE RELEASE April 18, 2016
VA Secretary and Deputy Secretary tell Commission on Care: Transformation is Underway and Already Delivering Measurable Results for Veterans
WASHINGTON – Today Secretary of Veterans Affairs Robert A. McDonald and Deputy Secretary of Veterans Affairs Sloan D. Gibson updated the Commission on Care laying out the current state of VA and the transformation that is underway to deliver better customer service and results for America’s Veterans. In laying out the key pieces of the transformation underway – MyVA – Secretary McDonald said, “MyVA is our framework for modernizing our culture, processes, and capabilities – combining functions, simplifying operations, providing Veterans a world-class, customer-focused, Veteran-centered enterprise. I know transformational change is not easy but it is our commitment to the Veterans we serve in order to bring them the customer service and the care and benefits they have earned.” Secretary McDonald outlined the five MyVA strategies focused on customer-service excellence: improve the Veteran experience, improve the employee experience, improve internal support services, establish a culture of continuous improvement, and expand strategic partnerships. He also provided updates on progress made to date of VA’s 12 breakthrough priorities. “We have challenges in VA and we own them, but the transformation that Bob talked about is well underway and already delivering measurable results for improving access to care and improving the Veterans experience,” said Deputy Secretary Gibson. Deputy Secretary Gibson laid out the roadmap for VA to transform from a loose federation of regional systems to a highly integrated enterprise and integrated provider and payer model and presented the following metrics showing that transformation is underway and having positive impact on Veterans care. In a nationwide, one-day Access Stand Down VHA staff reviewed the records of more than 80,000 Veterans to get those waiting for urgent care off of wait lists and into clinics. They identified just over 3,300 patients waiting for more than seven days on the Electronic Wait List (EWL) for an appointment in a Level One clinic. By the end of the day, 80 percent were given an appointment immediately, and 83 percent were given an appointment within two-and-a-half weeks. Real-time customer-satisfaction feedback collected in our medical centers through VetLink—our kiosk-based software—tells us that about 90 percent of Veterans are either “completely satisfied” or “satisfied” getting the appointment when they wanted it. Annual clinical work has increased among VA providers seeing Veterans by almost 18 percent in the last three years; 20 percent when VA and non-VA providers are calculated together. With changes already underway to leverage our scale and build a world class end-to-end supply chain, we have already redirected $24 million back towards activities providing better Veteran outcomes. These results build on the elements of excellence already in place in VA’s health care system that must be maintained and, in many cases, expanded upon. According to the American Customer Satisfaction Index, VA has outperformed the private sector in customer service for a decade. According to a February article in the Journal of American Medicine, 30-day risk-standardized mortality rates are lower in VA than those of non-VA hospitals for acute myocardial infarction and heart failure. The American Journal of Infection Control found that in five years methicillin-resistant Staphylococcus aureus (MRSA) infections declined 69 percent in VA acute care facilities and 81 percent in spinal cord injury units thanks to VA’s aggressive MRSA prevention plan. The Independent Assessment found that VA performed the same or significantly better than non-VA providers on 12 of 14 effectiveness measures in the inpatient setting. The Independent Assessment also found that VA performed significantly better on 16 outpatient HEDIS measures compared with commercial HMOs and significantly better on 15 outpatient HEDIS measures compared with Medicare HMOs. A 2015 study found that VA mental health care was better than private-sector care by at least 30 percent on all seven performance measures, with VA patients with depression more than twice as likely as private-sector patients to get effective long-term treatment. Another 2015 study found that outcomes for VA patients compared favorably to patients with non-VA health insurance, with VA patients more likely to receive recommended evidence-based treatment. Secretary McDonald and Deputy Secretary Gibson were joined by VHA’s Assistant Deputy Under Secretary for Community Care, Dr. Baligh Yehia, who outlined the history and evolution of VA’s partnering with medical providers in the community to include the Department of Defense, Indian Health Service, several academic medical partner hospitals, and a growing number of private sector providers. He outlined the path forward for the Veterans Health Administration to become an integrated payer and provider, much of which depends on a legislative proposal currently working through Congress. VA offered demonstrations of three management tools showcasing new technology to improve the way Veterans schedule appointments and how VA health care practitioners can see and interact with patient data, all of which improve outcomes for Veterans and take into account feedback from Veterans and employees. This includes a cell phone app currently in development that will allow Veterans to schedule their own appointments as well as a program that has existed in all VA medical centers for a year-and-a-half that allows VA physicians to view a patient record that integrates information from VA, the Department of Defense and community health partners in one screen.
Today’s presentation to the Commission on Care follows a presentation less than a month ago from VA’s Under Secretary for Health, Dr. David Shulkin who laid out actions already underway at the Veterans Health Administration and the vision to move it into the future that embraces an integrated community care model.
Key Resources: Readout of Under Secretary for Health Meeting with the Commission on Care on March 23, 2016 Secretary McDonald addresses suggestions to “shut down VA health care altogether” in a speech to the United Veterans Committee of Colorado last week Under Secretary for Health, Dr. David Shulkin’s vision for an integrated payer and provider system in the New England Journal of Medicine: Beyond the VA Crisis — Becoming a High-Performance Network The announced launch of MyVA Access outlining systemic improvements and results for Veterans wanting increased access to care Secretary McDonald makes the case for the importance of VA health care to American Medicine in the Baltimore Sun
FOR IMMEDIATE RELEASE April 18, 2016
New Members Appointed to VA Advisory Committee on Women Veterans
WASHINGTON – Five new members were recently appointed to the Department of Veterans Affairs (VA) Advisory Committee on Women Veterans (Committee), an expert panel that advises VA’s Secretary on issues and programs impacting women Veterans. Established in 1983, the Committee makes recommendations to the Secretary for policy and legislative changes. “The Committee’s guidance is instrumental in shaping VA policy for women Veterans, and providing insight on their diverse needs,” said Secretary of Veterans Affairs Robert A. McDonald. “VA anticipates the important contributions and fresh perspectives the newest members will offer to this invaluable Committee.”
New Members VA Advisory Committee on Women Veterans
- Kailyn Bobb, Plumas Lake, CA. A U.S. Air Force Veteran; currently pursuing a doctoral degree in clinical psychology from California School of Professional Psychology, Alliant International University.
- Keith Howard-Streicher, Alexandria, VA. A Veteran of the U.S. Army; currently serves as Assistant Director, Veterans Affairs and Rehabilitation Division, at The American Legion.
- Edna Boyd Jones, Norcross, GA. A retired U.S. Army Colonel, with service in the Gulf War and Operation Iraqi Freedom; currently serves as the Assistant Professor of Nursing at Albany State University.
- Leslie N. Smith, King George, VA. A retired U.S. Army Captain; currently serves as co-founder and spokesperson for Fatigues to Fabulous, a non-profit women Veterans organization.
Janet M. West, Jacksonville, FL. An active duty U.S. Navy Lieutenant Commander, with service in Operation Enduring Freedom and Iraqi Freedom; currently serves as senior medical officer at Jacksonville Naval Air Station Branch Health Clinic.
Mary Westmoreland (Retired U.S. Army Colonel), who has diligently served on the Committee since 2012, was appointed as the Committee’s new chair. Committee members Sara McVicker (U.S. Navy Veteran) Washington, DC, and Tia Christopher (U.S. Navy Veteran), Dallas, TX were reappointed for an additional term.
For information about VA’s benefits and services for women Veterans, visit www.va.gov/womenvet or contact the Women Veterans Call Center at 1-855-829-6636. The Women Veterans Call Center is available to address concerns of women Veterans, their families and caregivers, Monday through Friday from 8 a.m. to 10 p.m., ET, and Saturday from 8 a.m. to 6:30 p.m., ET.
Appeals Court Decision Says VA Improperly Refused to Reimburse for Vets' Emergency Medical Expenses
Last week Stars and Stripes reported that the U.S. Court of Appeals for Veterans Claims ruled that the Department of Veterans Affairs “ignored 'plain language' of a 2010 statute meant to protect VA-enrolled veterans from out-of-pocket costs when forced to use non-VA emergency medical care.”
The case revolved around a Board of Veterans’ Appeals (BVA) decision to deny Air Force veteran Richard W. Staab's request for a $48,000 reimbursement after he was forced to pay out of pocket following emergency open-heart surgery in December 2010. The board “failed to properly apply the statute and relied on an invalid regulation” to deny Staab’s claim; the Court of Appeals for VA Claims ordered the BVA decision vacated.
For now, the decision only applies to Staab. There are possibly hundreds of other VA-enrolled veterans who had alternative health insurance, and so got stuck paying some of their outside emergency care costs. The decision does not apply to medical claims that occurred prior to Feb. 1, 2010, when the law took effect. Those veterans who have had claims for reimbursement denied since then, however, have new legal ground on which to re-file their claims for VA reimbursement.
These vets should cite the appeals court’s April 8, 2016 Staab v. McDonald decision. Make sure you argue “clear and unmistakable error” in deciding previous claims. This should force VA claim adjudicators to determine if there was error.
The problem arose from VA’s interpretation of a law regarding its obligation to cover non-VA emergency care costs when veterans have other health insurance, including Medicare. Traditionally, VA has claimed that it is obligated to pay emergency costs only for veterans who have no alternative health coverage. The perverse incentive of that position is that VA-enrolled veterans are better off having no other insurance when a health emergency arises than in having some coverage.
For those without insurance, VA has always agreed it must cover all costs. For those with insurance, VA decided long ago that it would cover no costs, forcing veterans to pay whatever expenses Medicare or their health insurance plans, will not pay.
Recognizing how unfair that is, Congress voted in 2009 to clarify the law, specifically to “allow the VA to reimburse veterans for treatment in a non-VA facility if they have a third-party insurance that would pay a portion of the emergency care.”
Make sure you tell every veteran you know about this decision! There are hundreds of people who have been wrongfully denied reimbursement for emergency medical care by the VA; the news needs to be spread!
VA Opposes Bill to Allow Secretary to Recoup Travel Expenses
Last week the Department of Veterans' Affairs (VA) came out and stated its opposition to legislation that would allow the secretary to recoup relocation expenses from employees.
“VA agrees federal employees should be held accountable and supports actions taken to collect debts when employees have been paid incorrectly, and [VA] has established a strong internal policy implementing the Federal Claims Collection Act,” said Curtis Coy, deputy undersecretary for economic opportunity at the Veterans Benefits Administration, during a Thursday hearing on H.R. 4138 and eight other separate bills related to veterans’ employment and education benefits.
But the VA’s support for more employee accountability tools from Congress doesn’t extend to H.R. 4138, which Coy on Thursday said the department opposed.
The bill was introduced by House Veterans’ Affairs Committee Chairman Jeff Miller (R-FL).
The legislation would give the secretary broad authority to claw back all, or a portion of, moving costs paid to or on behalf of any department employee when warranted; it is also retroactive, and would require the department to provide notice to employees of decisions to recoup relocation expenses. It would give employees the opportunity
to appeal the decision to recoup to a third party before they would have to repay the money.
Only in DC would an organization refuse the ability to closely guard and control the money that it pays to its employees. We will keep you informed about this legislation as it winds its way through the legislative process.
DoD and VA can Finally read Each Other’s Health Records
According to Federal News Radio.com, the Department of Veterans Affairs has finally certified that it has met the demand that Congress included as part of the 2014 National Defense Authorization Act for the VA and the DoD to put their electronic records into a data format that can be read by both departments.
One of the major shortcomings that became apparent since before the start of the wars in Iraq and Afghanistan is the inability of the two departments to be able to seamlessly pass along the electronic health records of servicemembers to each other. That was because they had developed two different systems for the records and they weren’t compatible with one another.
The two departments spent over a $564 million in an attempt to come up with an electronic record system they could both use but they eventually gave up. That’s when Congress became frustrated and ordered them to come up with a way in which both departments could at least read each other’s records.
While DoD certified they had met the demand of Congress a year ago it took the VA until now to accomplish it.
However, the system they have in place now is only a temporary one because while they can read each other’s records, they can’t seamlessly pass the records on and work on them. They remain committed to working toward a system that is seamless and usable for both departments.
The ability to do so is a crucial step in improving the health care that is available to servicemembers once they separate, especially for those with VA-rated disabilities
Congress, White House, VA Agree: Appeals Process Must be Fixed
In response to the outcry from veterans' groups that have been watching in horror at the ballooning VA claims appeals backlog, White House officials are currently pushing Congress to overhaul the appeals process for veterans benefits claims this year, noting the shrinking legislative window and calling the system a disaster.
According to Veterans Affairs Deputy Secretary Sloan Gibson, “We're failing veterans.... This process is failing veterans. Nobody can defend the status quo here.”
More than 440,000 veterans have appeals cases pending in the benefits system. The average appeals decision takes three years to reach at the VBA level from beginning to end. The average wait time for decisions that have to go to the Board of Veterans' Appeals. The appeals backlog has risen steadily in recent years as officials have focused on pulling down the number of backlogged first-time claims.
VA officials have insisted the dwindling initial claims backlog and the growing appeals backlog are not connected, much to the disbelief of outside groups. VA claims that the percentage of cases appealed has remained steady, even as the number of total claims from veterans has risen.
VA leaders have floated a plan to get that process down to under a year and a half for most cases, but they need congressional help to rework filing timelines and evidence submission rules.
They’re hoping the veterans omnibus looming in the Senate will include those changes. Senate Veterans’ Affairs Committee Chairman Johnny Isakson (R-GA) has said that appeals reform will be included in the upcoming omnibus, but warned it might not be the comprehensive plan floated by VA officials in recent months. It may take additional, stand-alone legislation to get the changes enshrined in law, but then Congress will be running up against the fact that election season will take everybody's focus away from legislating in the very near future.
We will keep you updated on this crucial issue.
Top VA Health Care Official Announces Initiatives and Progress Made to Improve Access to Care
VA Press Release:
New Initiatives Chart Roadmap to Access-to-Care Improvements
The Department of Veterans Affairs’ (VA) top health care official announced recently the progress and new steps VA is taking to improve Veterans access to health care. Dr. David J. Shulkin, Under Secretary for Health, announced the measures during a briefing to a group of more than 100 journalists attending the Association of Health Care Journalists’ conference April 8 in Cleveland, Ohio.
“We are working to rebuild the trust of the American public and more importantly the trust of the Veterans whom we are proud to serve,” said Dr. Shulkin. “We are taking action and are seeing the results. We are serious about our work to improve access to health care for our nation’s Veterans. We want them to know that this is a new VA.”
During the briefing, Dr Shulkin discussed a new initiative, MyVA Access. MyVA Access represents a major shift for VA by putting Veterans more in control of how they receive their health care. It is a top priority for VA’s Veterans Health Administration (VHA).
MyVA Access is a declaration from VHA employees to the Veterans they care for; it is a call to action and the reaffirmation of the core mission to provide quality care to Veterans, and to offer that care as soon as possible to Veterans how and where they desire to receive that care. The initiative ensures that the entire VA health care system is engaged in the transformation of VA into a Veteran-centered service organization, incorporating aspirational goals such as same day access to mental health and primary care services for Veterans when it is medically necessary. At present, 34 VA facilities offer same-day appointments, and as a practicing physician, Dr. Shulkin currently sees Veterans needing same-day appointments at the VA Medical Center in Manhattan. VA is hoping to be able to offer same day appointments when it is medically necessary at all of its medical centers by the end of 2016.
In addition, Dr. Shulkin introduced a new smart phone app called the Veteran Appointment Request App. This app allows Veterans to view, schedule and cancel primary care and mental health appointments as well as track the status of the appointment request and review upcoming appointments. It is currently available in 10 locations and has received positive feedback from the vast majority of Veterans using the app. VA expects to make the app available to all Veterans by early 2017.
Other efforts underway include a website enhancement that will allow Veterans to check wait times in real time where ever they live – this includes new and existing patients and a new, easy-to-use scheduling software program. The new program is being piloted in 10 sites and is expected to reduce scheduling errors and enhance VA’s ability to measure and track supply, demand and usage.
MyVA Access is part of MyVA, introduced in 2014 by VA Secretary Robert McDonald following one of the most challenging times in the history of VA. MyVA is centered around the needs of Veterans by putting them first in everything VA does. Since that time, VA has made significant progress in addition to the new initiatives announced by Dr. Shulkin.
Among the health care progress made:
- Nationally, VA completed more than 57.36 million appointments from March 1, 2015 through February 29, 2016. This represents an increase of 1.6 million more appointments than were completed during the same time period in 2014/2015.
- VHA and Choice contractors created over 3 million authorizations for Veterans to receive care in the private sector from February 1, 2015 through January 31, 2016. This represents a 12 percent increase in authorizations when compared to the same period in 2014/2015.
- From FY 2014 to FY 2015, Community Care appointments increased approximately 20 percent from 17.7 million in FY 2014 to 21.3 million in FY 2015.
- VA completed 96.46 percent of appointments in February 2016 within 30 days of clinically indicated or Veteran’s preferred date.
- In FY 2015, VA activated 2.2 million square feet of space for clinical, mental health, long-term care, and associated support facilities to care for Veterans.
- VA held two Access Stand Downs, focusing on patients with the most urgent health care needs first. During a nationwide Access Stand Down that took place on February 27, the one-day event resulted in VA reviewing the records of more than 80,000 Veterans to get those waiting for urgent care off wait lists; 93 percent of Veterans waiting for urgent care were contacted, with many receiving earlier appointments.
- VA increased its total clinical work (direct patient care) by 10 percent over the last two years as measured by private sector standards (relative value units). This increase translates to roughly 20 million additional provider hours of care for our Veterans.
- VA is also working to increase clinical staff, add space and locations in areas where demand is increasing and extending clinic hours into nights and weekends, all of which have helped increase access to care even as demand for services increases.
- VA is addressing critical components necessary for the delivery of a seamless community care experience by consolidating all purchased care programs into one Veterans Choice Program (New VCP). The New VCP will clarify eligibility requirements, strengthen VA’s high-performing network, streamline clinical and administrative processes, and implement a care coordination model across the continuum of care.
- VHA offers an extensive community provider network of over 257,000 providers through the PC3/Choice Programs and more are joining each month.
- VA Telehealth services are critical to expanding access to VA care in more than 45 clinical areas.
- In FY2015, 12 percent of all Veterans enrolled for VA care received Telehealth based care. This includes 2.14 million telehealth visits, touching 677,000 Veterans.
TRICARE Improves Mental Health Care and Treatment
People in distress may hesitate to reach out for help due to perceived stigma associated with seeking mental health treatment. This perception and the belief that care may be hard to get, may prevent some people who need care from getting it. TRICARE has worked hard to eliminate potential barriers to mental health care by removing day limits for certain mental health services.
When a behavioral health condition requires more intensive treatment than outpatient care, partial or full-time hospitalization may be required. The in-patient psychiatric hospitalization benefit was limited to 30 days per benefit year for adults and 45 days for children or adolescents. You could request a waiver for additional treatment days if needed. Now however, inpatient mental health hospital services, regardless of length or quantity, may be covered as long as the care is considered medically or psychologically necessary and appropriate. Likewise, the psychiatric partial hospitalization benefit previously had a 60 day per benefit year limitation that could be extended with a waiver. This 60 day limitation has been removed to ensure that beneficiaries receive care for as long as needed.
In addition, the 150 day limit on residential treatment care for beneficiaries under 21 has been removed. Although medical determination is still required, there is no day limit.
If you or someone you know requires mental health care, get help. If you believe emergency care is required, you can get emergency psychiatric care without pre-authorization. However, you must get authorization within 72 hours of admission and the 72 hours starts the day after admission.
Medical or surgical care does not and has not historically had day limits on care. Now, thanks to the federal mental health parity law, which requires that mental health benefits be equal to medical or surgical healthcare benefits, the same is also true for mental health care. For more information about mental health coverage, visit the TRICARE website.
TRICARE Prime to start Urgent Care Pilot Program in May
For years the Department of Defense has bitterly complained that TRICARE Prime beneficiaries go to the expensive emergency room for care that is much more appropriate for a (much cheaper) Urgent Care practice. However, they continued to require TRICARE Prime beneficiaries to get a prior authorization to go to urgent care while no prior authorization was needed for emergency room care.
Finally they may have found a solution. A new Urgent Care Pilot Program will allow TRICARE Prime beneficiaries two visits to a network or TRICARE authorized provider without a referral or prior authorization. The program starts on May 23rd and will run for 2 years.
Active Duty Family Members (ADFMs) and retirees and their families who are enrolled in TRICARE Prime or TRICARE Prime Remote, along with TRICARE Young Adult-Prime will be qualified to use the program. (As well as a few active duty service members who are enrolled in TRICARE Prime Remote and stationed overseas but traveling stateside)
There are no Point of Service (POS) deductibles or cost shares for these two urgent care visits, but network copayments still apply. Once a beneficiary receives urgent care, he or she must notify their Primary Care Manager (PCM) about that care within 24 hours or the first business day after the urgent care visit.
Always remember if you need advice on what to do you can call the Nurse Advice Line 1-800-TRICARE (1-800-874-2273), option 1 24 hours a day 7 days a week. (They can give you a pre authorization on the Nurse Advise Line and then it won’t count as one of your 2 visits.)
The Testimony at Two Bill Hearings
On Wednesday, April 13, A presentation was made on pending legislation before the House Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs. If enacted into law, these bills will provide special compensation to veterans who lost the use of their reproductive organs, authorize a COLA increase for 2017, improve burial benefits and protect surviving spouses from repaying the VA for certain overpayments. View this hearing. On Thursday, April 14, testimony was presented before the House Veterans’ Affairs Subcommittee on Economic Opportunity. This bill hearing focused on legislation that will provide additional educational benefits to veterans in STEM programs, expand GI Bill usage for certain pre-apprenticeship programs, and make permanent the Vets Success on Campus program, along with other meaningful legislation. View this hearing.
House Holds Hearing on IT
On Thursday, April 14, the House Veterans’ Affairs Subcommittee on Oversight and Investigation held a hearing to examine the VA’s work to improve and implement needed improvements to its IT to support the Choice Program. The committee heard directly from the VA Under Secretary for Health, Dr. David Shulkin, and Assistant Secretary for Information and Technology, LaVerne Council, on issues surrounding the VA’s IT scheduling and community care provider claims processing system, as well as the new system that will support the consolidation of community care networks. View this hearing.
Military Construction and VA Bill Advanced by Congress
Thursday, the Senate Appropriations Committee held a markup to discuss and advance the fiscal year 2017 MilConVA appropriations bill that sets funding levels for VA and DOD’s military construction accounts. The bill would provide $74.9 billion for the VA’s discretionary accounts. The bill also includes two provisions that are important.. It would expand VA fertility treatment options for veterans who have lost their ability to start a family due to their military service. The bill would also prohibit the VA from interfering with the medications of veterans participating in state-approved medical marijuana programs. The Senate bill’s VA discretionary appropriations are $1.4 billion above the House’s MilConVA bill’s, which was also reported out of its respective committee this week. Both bills await consideration by their respective congressional chambers. Stay tuned to the Action Corps Weekly for updates on this important legislation.
The VA's Commission on Care to Hold Public Meeting
The VA announced that its Commission on Care will host a meeting open to the public on April 18 and 19, 2016. The commission was established by the Veterans Access, Choice and Accountability Act of 2014 and is responsible for recommending ways to better deliver health care to veterans for the next 20 years. The meeting will be held in Washington, D.C., and those who cannot attend in person can register to dial into the meeting. For more information on the meeting and how to attend by phone,click here.
Puerto Rican Regiment Receives Congressional Gold Medal
A Puerto Rican Army regiment, the 65th Infantry Regiment known as the “Borinqueneers,” was honored with the Congressional Gold Medal during a ceremony inside the U.S. Capitol on Wednesday. The supported recognition comes more than 50 years after the unit was disbanded, and the effort was largely due to the leadership of Congressional Gold Medal Alliance chairman Frank Medina
Veterans in Public Office
An American Enterprise Institute article released on Tuesday provides a detailed breakdown of veterans serving in federal and state elected offices. Nationally, veterans made up 72 percent of the U.S. House of Representatives and 78 percent of the U.S. Senate in 1971. Today, those percentages are 18 and 20 percent, respectively, which still doubles veterans’ representation in Congress despite being only 9 percent of the general population. Veteran status averages about 14 percent in the state legislatures, with the top five being New Hampshire (23 percent), Nevada and Alabama (22), and North Dakota and Tennessee (21), and the bottom five being Utah (5), California and Minnesota (6), and Massachusetts and Illinois (7). The article includes a political party breakdown, but does not go further into detail regarding names or congressional districts. Read more.
The Defense POW/MIA Accounting Agency has announced one burial update and the identification of remains of four sailors who had been unaccounted for since Dec. 7, 1941, when the battleship USS Oklahoma suffered multiple torpedo hits as it was moored off Ford Island in Pearl Harbor, Hawaii. The attack capsized the ship, resulting in 429 casualties. Thirty-five sailors would be subsequently recovered and identified; the rest would eventually be buried as unknowns in the National Memorial Cemetery of the Pacific, better known as the Punchbowl. Being returned home for burial with full military honors on a date and location yet to be determined are Ensign Joseph P. Hittorff Jr., 25, of Westmont, N.J.; Chief Storekeeper Herbert J. Hoard; Fire Controlman 1st Class Paul A. Nash, 26, of Indiana; and Machinist’s Mate 1st Class Alfred F. Wells.
Army Cpl. Dudley L. Evans, 24, will be buried with full military honors on April 23 in his hometown of Greenville, Miss. He was assigned to Company G, 2nd Battalion, 23rd Infantry Regiment, 2nd Infantry Division, engaged in a battle in the vicinity of Chipyong-ni, South Korea. It would be later learned he died in captivity after being taken prisoner on Feb. 15, 1951.
TRICARE’S Nurse Advice Line: the Right Choice for Active Adults
Do you know that more than half of all adults 65 and older have three or more chronic medical problems, such as heart disease, diabetes, cancer, or arthritis? Older adults can have multiple health problems and not know whether they need to see a doctor or can administer self-care. Have you considered TRICARE’s Nurse Advice Line (NAL)?
If you are suffering from a rash, a sinus infection, or perhaps you just have a common cold; there is help! When you call the NAL, a registered nurse will help you assess if you can handle your health concern with self-care or if you need to see a medical professional.
Since its launch, the NAL has been able to increase patient safety and further ensure a positive patient experience. Military Health System (MHS) Patient Centered Medical Home (PCHM) team members can access live NAL information so they are aware of their patients’ situation and can provide follow-up, if needed.
The NAL is a great medical assessment tool that provides access to care, especially after hours and when traveling, which is great for retirees on the move. When you don’t know what kind of care you need, the NAL helps you access the right type of care at the right time. The NAL can also help you find a doctor and schedule next-day appointments at military hospitals and clinics when available.
The NAL is an easy option for beneficiaries to get information on their medical problems quickly and at any time. To access the NAL dial 1-800-TRICARE (874-2273) and select option 1. Get more information about the Nurse Advice Line on the TRICARE website.
Report Reveals Depth of 2014 Wait List Scandal
According to an analysis of more than 70 federal reports that were recently released, USA Today reported last week that employees at 40 VA medical facilities in 19 states and Puerto Rico “regularly 'zeroed out' veteran wait times... in some cases, investigators found manipulation had been going on for as long as a decade. In others, it had been just a few years.”
VA facility leaders often told investigators that they had fixed the problems in the wake of the Phoenix scandal, but investigators found in some cases that nothing had changed at all in regard to scheduling practices. The manipulation masked growing demand as new waves of veterans returned from wars in Iraq and Afghanistan and as Vietnam veterans aged and needed more health care.
The reports, totaling 70 in all, were the VA Inspector General's response to the scandal. They were launched to figure out the scope and depth of the problem at more than 100 VA facilities.
Apparently supervisors instructed schedulers to manipulate wait times in Arkansas, California, Delaware, Illinois, New York, Texas and Vermont, giving the false impression facilities there were meeting VA performance measures for shorter wait times.
According to USA Today, approximately half of the 70 reports are from investigations completed more than a year ago, and the VA says it already initiated discipline against 29 people. Three of those 29 have already left the agency.
VA says that it has responded to the scandal by retraining thousands of schedulers and is updating software to make it easier for them to book appointments properly. A pilot program at 10 facilities allows veterans to book their own appointments, and the VA expects to roll that out nationwide.
However, there are VA whistle-blowers who are saying right now that schedulers still are manipulating wait times. Shea Wilkes, co-director of a group of more than 40 whistle-blowers from VA medical facilities in more than a dozen states, said the group continues to hear about it from employees across the country who are scared to come forward.
This is not new information to many of the people who have been following this issue since 2014 – in fact, there were reports about wait-time manipulation strategies at the individual facility level going back to 2010, if not as early as 2005.
We believe that much of the recent rise in wait times to access VA healthcare is due to the fact that the actual wait times are now being entered into the system, showing the true gap between demand for VA healthcare and the actual supply that exists nationwide. For more on how Congress is responding to this problem, read the statement that Senate Veterans' Affairs Committee Chairman Johnny Isakson (R-GA) released last week:
Thursday, April 7, 2016
'We in Congress must now put veterans first… Anything less is failing those who served us’
WASHINGTON – U.S. Senator Johnny Isakson, R-Ga., chairman of the Senate Committee on Veterans’ Affairs, today issued the following statement regarding the bipartisan, comprehensive legislative package he is drafting in the Senate to reform the Department of Veterans Affairs (VA):
“As chairman of the Senate Committee on Veterans’ Affairs, comprehensive reform of the VA has always been and remains my highest priority. I have been working for weeks to craft bipartisan legislation that I believe can pass the Senate that would require significant improvements in the way the VA treats our veterans and holds its employees accountable.
“While we are still finalizing the details of the legislation, it will include strong provisions to:
- Hold all VA employees accountable for mismanagement and misconduct;
- Provide caregiving benefits to veterans of all generations;
- Address the crisis of opioid over-prescription among veterans;
- Expand availability of orthotic and prosthetic care for veterans;
- Help reduce the VA’s appeals backlog; and
- Implement strict rules to ensure community physicians providing care to our veterans receive prompter payment for that care.
“I am sincerely appreciative of the bipartisan, bicameral collaboration that has helped pave the way for this sweeping reform legislation. I look forward to working with my Senate colleagues and with the House to pass these significant and meaningful reforms for our nation’s veterans.
“We in Congress must now put veterans first and get a bill to the president’s desk. Anything less than that is failing those who served us.”
A New Study for TRICARE Beneficiaries is Helping Smokers Kick the Habit
Have you tried everything to quit smoking? TRICARE beneficiaries now have a new resource to help them called the The Freedom Smoking Quitline. If qualified, participants will have a 2 ½ times better chance at quitting smoking.
The Freedom Smoking Quitline is a National Institutes of Health-funded research study, co-sponsored by the 59th Medical Wing and University of Tennessee Health Science Center. The study is enrolling TRICARE beneficiaries that are motivated to quit smoking. If qualified, participants will receive four proactive, telephone-based smoking cessation counseling sessions along with eight weeks of free nicotine replacement therapy (NRT) sent directly to their homes. After 3 months, participants will receive a follow-up call to ensure they are still smoke free. However, if they experienced a relapse and started up again, participants are offered a second chance to try again.
Dr. Gerald Wayne Talcott, Ph.D., Col USAF (Ret) is a co-investigator for The Freedom Quitline. He served as an Air Force psychologist for 28 years and has 30 years of experience in tobacco cessation treatment. Dr. Talcott states that relapses for people trying to quit smoking are all too common, and that’s why participants are offered a second chance with The Freedom Quitline. Further, when participants enroll in this study, they are not only receiving a premium smoking cessation program at no cost, but they are also helping researchers gather critical data to improve these programs for our military community. Talcott says “Quitting smoking is one of the hardest things that anyone ever tries to do in their lifetime and studies show that it might be even more difficult for our military community”. He also emphasized that what makes The Freedom Quitline more effective than most alternatives, is that the counselors have not only extensive training in smoking cessation, but 90% are military veterans themselves.
Results from an Air Force study evaluating a smoking Quitline conducted by the University of Tennessee Health Science Center showed participants were 2 ½ times more likely to quit compared to those who called a standard Quitline.
It’s easy to find out if you qualify. Call 1-844-I-AM-FREE (1-844-426-3733) or go online to learn more at www.freedomquitline.org.
Army to Integrate Active Force With Reserve/Guard Units
The Army is going to begin testing mixing active duty units with Guard and Reserve units, according to an article from Federal News Radio.com. After working side by side
in Iraq and Afghanistan the Army has decided it wants to try the same thing during peace time.
It will follow the model that has been used for years by the Air Force to maintain and fly aircraft at some bases. The Air Force has recently announced it will expand its program.
This summer a dozen Army units will be integrated, some with active duty units as the host, while others with Guard or Reserve units as the host. The idea is to have the troops become familiar with one another and have the same training before they meet on a battlefield somewhere and have to figure things out there.
According to the article, “In the first pilot, Task Force 1-28, an active duty infantry battalion at Fort Benning, Georgia, will be folded into the 48th Infantry Brigade Combat Team, part of the Georgia National Guard. Both will fall under the command of the 3rd Infantry Division, an active duty division based at Fort Stewart, Georgia.
“Following the test with the Georgia units, the Army plans to try the Associated Units notion in 11 other locations. In each of the pilot locations, the Army tries to pair active duty forces with National Guard and reserve units that are physically nearby.
“For example, in Hawaii, the Army Reserve’s 442 Infantry Regiment will be paired up with the active component’s 3rd Brigade Combat Team at Schofield Barracks. In the northeast, the Vermont Army National Guard’s 86th brigade combat team will be associated with the 10th Mountain Division at Fort Drum, New York.”
While the Army has tried similar things before that did not meet with success, the hope is that they have learned from past mistakes, as well as what the Air Force has done.
FOR IMMEDIATE RELEASE April 12, 2016
VA Announces Future Site of the VA National Archives
VA will have a home for the Department’s history in Dayton, O.H. WASHINGTON – The Department of Veterans Affairs today announced that the Dayton VA Medical Center has been officially selected as the site for the National Department of Veterans Affairs Archives. Secretary Robert A. McDonald made the announcement this morning speaking to a group of Dayton-area leaders. “I believe that history is incredibly important to VA. We’re all about keeping the promises of the past to the Veterans of the present and the future,” said Secretary McDonald. “With the necessary capital improvements, I can announce today that the Dayton Headquarters and Club House buildings will serve as a fitting home for VA’s National Archives and we look forward to working with community leaders to make the archive a reality and to improve the lives of Veterans. “ Dayton has a long history of service to our nation’s Veterans and is home to one of the original United States Veterans’ facilities. The Ohio community has been caring for our nation’s Veterans since the Civil War era when it housed a branch of the A National Home for Disabled Volunteer Soldiers, a predecessor to the Department of Veterans Affairs. The Department of Veterans Affairs and its predecessor agencies have generated archival records and artifacts from the time before the Revolutionary War. Many of these historic materials are stored at the Washington-area facilities of the National Archives and Records Administration along with records from other federal agencies. VA is one of the largest federal agencies and it owns more historic buildings than any other civilian federal agency. Many of its historical documents, photographs, artifacts, and other materials are spread across the country in its 150 facilities under conditions that do not meet federal curation standards. The VA Archive at Dayton will enable VA to organize and protect its important heritage and eventually share VA’s rich history with the public.
VA Provides New Care to Migraine Sufferers
VA is now offering a new form of preventative care to patients suffering from migraine headaches. Cefaly is a new technology that uses electrodes to stimulate nerve cells which stop pain receptors from causing migraines. The device was approved by the FDA in 2014 and is suggested to be worn daily for a minimum of 20 minutes. Most patients report their migraines either completely end or at least drastically improve after consistent use of Cefaly. “It’s reduced the amount of meds I’m taking,” one patient said. “When you’ve had a headache for 14 days, you’re willing to try anything to get relief, and this thing works. If you’re having issues with headaches, it’s worth a try. It’s a comfort, having it here, knowing I can use it whenever I need it.” To read more, click here:
Army in State of High Risk
In testimony before the Senate Armed Services Committee, Army Chief of Staff Gen. Mark Milley said Thursday that his service is in a state of “high risk,” which could spell disaster in terms of being able to respond when, where, and in sufficient strength to a major world crisis. He said another problem is the gap is closing in the U.S. military’s ability to outrange and outgun other major militaries. His current assessment doesn’t include what might happen if mandatory sequestration is restarted again next year, which would force the Army to drop from its planned 450,000 active-duty strength to 420,000. Eliminating sequestration has been a top legislative priority ever since it was created by the Budget Control Act of 2011, not only because it slashes almost $1 trillion from Defense Department funding, but because the world has become far more dangerous and unpredictable since then. Five years ago the Islamic State didn’t exist, Russia wasn’t in Crimea, China wasn’t creating islands out of rocks, and North Korea and Iran weren’t pushing the limits of international patience as much as they are now. The we want all members and veterans advocates to use this federal election cycle to force Congress to eliminate that which it created. Watch video of the hearing at: http://www.armed-services.senate.gov/hearings/16-04-07-posture-of-the-department-of-the-army.
USAF Authorizes Gold Star Lapel Button Wear
The Air Force is now allowing airmen to wear the Gold Star lapel button or the Next of Kin of Deceased Personnel lapel button on their dress coats, mess dress and service dress uniforms. Soldiers have been able to wear the pins on their dress uniforms since 2014. No decision has yet been reached for the Navy, Marine Corps or Coast Guard. Under federal law enacted in 1947, members of the armed forces who are issued the Gold Star pin include widows and widowers, parents, stepparents, children, siblings, and half- or step-siblings of those who died in combat. The Gold Star pin applies to conflicts from World War I forward. Those not eligible for the Gold Star pin could receive the Next of Kin pin, which applies to relatives who lost loved ones on active duty or were assigned to a Reserve or Guard unit on drill status. Learn more about both at: https://www.gpo.gov/fdsys/pkg/CFR-2006-title32-vol3/pdf/CFR-2006-title32-vol3-sec578-63.pdf.
The Defense POW/MIA Accounting Agency announced the identification of remains of two Marines lost fighting in World War II, and burial updates of two World War II pilots and three Korean War soldiers. Returned home are:
-- Marine Corps Pfc. John F. Price, who was lost fighting on Tarawa on Nov. 20, 1943, will be buried with full military honors on a date and location to be determined. He was assigned to Company F, 2nd Battalion, 8th Marine Regiment, 2nd Marine Division.
-- Marine Corps Pfc. Anthony Brozyna, of Hartford, Conn., who was lost fighting on Tarawa on Nov. 20, 1943, will be buried with full military honors on a date and location to be determined. He was assigned to Company G, 2nd Battalion, 8th Marine Regiment, 2nd Marine Division.
-- Army Cpl. Robert P. Graham, 20, of San Francisco, is being buried today with full military honors in Colma, Calif. In February 1951, Graham was assigned to Company A, 13th Engineer Combat Battalion, 7th Infantry Division, which was engaged in a battle near Hoengsong, South Korea. His unit was ordered to withdraw south while under heavy attack. He was reported missing on Feb. 13, 1951. Learn more at: http://www.dpaa.mil/NewsStories/NewsReleases/tabid/10159/Article/711220/soldier-missing-from-korean-war-accounted-for-graham.aspx.
-- Army Air Forces Flight Officer Dewey L. Gossett, 23, of Spartanburg, S.C., will be buried with full military honors on April 11 in Wellford, S.C. On Sept. 27, 1943, Gossett was piloting an A-36A Apache in a flight of four searching for targets of opportunity when they encountered bad weather. Only three aircraft returned to base. He was assigned to the 527th Fighter Squadron, 86th Fighter Group, 12th Air Force. Learn more at:http://www.dpaa.mil/NewsStories/NewsReleases/tabid/10159/Article/714241/airman-missing-from-world-war-ii-accounted-for-gossett.aspx.
-- Army Pfc. Aubrey D. Vaughn, 20, will be buried with full military honors on April 12 in his hometown of Union, S.C. On April 23, 1951, Vaughn was assigned to Company C, 1st Battalion, 5th Infantry Regiment, 5th Regimental Combat Team, when his company's position was overrun by Chinese forces in North Korea. Vaughn was reported missing in action after the battle. Learn more at: http://www.dpaa.mil/NewsStories/NewsReleases/tabid/10159/Article/713796/soldier-missing-from-korean-war-accounted-for-vaughn.aspx.
-- Army Air Forces Capt. Arthur E. Halfpapp, 23, of Steelton, Pa., will be buried April 14 with full military honors in Annville, Pa. On April 24, 1945, Halfpapp was piloting a P-47 Thunderbolt that crashed during an armed reconnaissance mission southeast of Alberone, Italy. He was assigned to the 87th Fighter Squadron, 79th Fighter Group. Read more at: http://www.dpaa.mil/NewsStories/NewsReleases/tabid/10159/Article/715567/airman-missing-from-world-war-ii-accounted-for-halfpapp.aspx.
-- Army Cpl. Dennis D. Buckley, 24, of Detroit, will be buried April 14 with full military honors in Rittman, Ohio. On Feb. 5, 1951, Buckley was assigned to A Battery, 15th Field Artillery Battalion, 2nd Infantry Division, which was fighting in the central corridor of South Korea. Buckley would be reported missing on Feb. 13 after the Chinese counterattacked. Read more at: http://www.dpaa.mil/NewsStories/NewsReleases/tabid/10159/Article/715592/soldier-missing-from-korean-war-accounted-for-buckley.aspx.
FOR IMMEDIATE RELEASE April 8, 2016
Top VA Health Care Official Announces Initiatives and Progress Made to Improve Access to Care New Initiatives Chart Roadmap to Access-to-Care Improvements
WASHINGTON – The Department of Veterans Affairs’ (VA) top health care official today announced progress and new steps VA is taking to improve Veterans access to health care. Dr. David J. Shulkin, Under Secretary for Health, announced the measures during a briefing to a group of more than 100 journalists attending the Association of Health Care Journalists’ conference April 8 in Cleveland, Ohio. “We are working to rebuild the trust of the American public and more importantly the trust of the Veterans whom we are proud to serve,” said Dr. Shulkin. “We are taking action and are seeing the results. We are serious about our work to improve access to health care for our nation’s Veterans. We want them to know that this is a new VA.” During the briefing, Dr Shulkin discussed a new initiative, MyVA Access. MyVA Access represents a major shift for VA by putting Veterans more in control of how they receive their health care. It is a top priority for VA’s Veterans Health Administration (VHA). MyVA Access is a declaration from VHA employees to the Veterans they care for; it is a call to action and the reaffirmation of the core mission to provide quality care to Veterans, and to offer that care as soon as possible to Veterans how and where they desire to receive that care. The initiative ensures that the entire VA health care system is engaged in the transformation of VA into a Veteran-centered service organization, incorporating aspirational goals such as same day access to mental health and primary care services for Veterans when it is medically necessary. At present, 34 VA facilities offer same-day appointments, and as a practicing physician, Dr. Shulkin currently sees Veterans needing same-day appointments at the VA Medical Center in Manhattan. VA is hoping to be able to offer same day appointments when it is medically necessary at all of its medical centers by the end of 2016. In addition, Dr. Shulkin introduced a new smart phone app called the Veteran Appointment Request App. This app allows Veterans to view, schedule and cancel primary care and mental health appointments as well as track the status of the appointment request and review upcoming appointments. It is currently available in 10 locations and has received positive feedback from the vast majority of Veterans using the app. VA expects to make the app available to all Veterans by early 2017. Other efforts underway include a website enhancement that will allow Veterans to check wait times in real time where ever they live – this includes new and existing patients and a new, easy-to-use scheduling software program. The new program is being piloted in 10 sites and is expected to reduce scheduling errors and enhance VA’s ability to measure and track supply, demand and usage. MyVA Access is part of MyVA, introduced in 2014 by VA Secretary Robert McDonald following one of the most challenging times in the history of VA. MyVA is centered around the needs of Veterans by putting them first in everything VA does. Since that time, VA has made significant progress in addition to the new initiatives announced by Dr. Shulkin. Among the health care progress made: Nationally, VA completed more than 57.36 million appointments from March 1, 2015 through February 29, 2016. This represents an increase of 1.6 million more appointments than were completed during the same time period in 2014/2015. VHA and Choice contractors created over 3 million authorizations for Veterans to receive care in the private sector from February 1, 2015 through January 31, 2016. This represents a 12 percent increase in authorizations when compared to the same period in 2014/2015. From FY 2014 to FY 2015, Community Care appointments increased approximately 20 percent from 17.7 million in FY 2014 to 21.3 million in FY 2015. VA completed 96.46 percent of appointments in February 2016 within 30 days of clinically indicated or Veteran’s preferred date. In FY 2015, VA activated 2.2 million square feet of space for clinical, mental health, long-term care, and associated support facilities to care for Veterans. VA held two Access Stand Downs, focusing on patients with the most urgent health care needs first. During a nationwide Access Stand Down that took place on February 27, the one-day event resulted in VA reviewing the records of more than 80,000 Veterans to get those waiting for urgent care off wait lists; 93 percent of Veterans waiting for urgent care were contacted, with many receiving earlier appointments. VA increased its total clinical work (direct patient care) by 10 percent over the last two years as measured by private sector standards (relative value units). This increase translates to roughly 20 million additional provider hours of care for our Veterans. VA is also working to increase clinical staff, add space and locations in areas where demand is increasing and extending clinic hours into nights and weekends, all of which have helped increase access to care even as demand for services increases. VA is addressing critical components necessary for the delivery of a seamless community care experience by consolidating all purchased care programs into one Veterans Choice Program (New VCP). The New VCP will clarify eligibility requirements, strengthen VA’s high-performing network, streamline clinical and administrative processes, and implement a care coordination model across the continuum of care. VHA offers an extensive community provider network of over 257,000 providers through the PC3/Choice Programs and more are joining VHA offers an extensive community provider network of over 257,000 providers through the PC3/Choice Programs and more are joining each month. VA Telehealth services are critical to expanding access to VA care in more than 45 clinical areas. In FY2015, 12 percent of all Veterans enrolled for VA care received Telehealth based care. This includes 2.14 million telehealth visits, touching 677,000 Veterans.
FOR IMMEDIATE RELEASE April 7, 2016 100th VA Grant-
Funded Veterans Cemetery Dedicated Grants Partnership Improves Veteran Access to Burial Benefits
WASHINGTON – The Department of Veterans Affairs (VA) announced the opening of the 100th VA grant funded Veterans cemetery. An $8.9 million grant from the VA funded the new Arizona Veterans’ Memorial Cemetery in Marana, Arizona. The cemetery is the 100th Veterans cemetery funded with a VA grant awarded to a State or Tribal organization. “This significant milestone underscores the importance of our partnerships with State and Tribal organizations to increase Veterans access to benefits, said Secretary of Veterans Affairs Robert A. McDonald. “This grant helps VA fulfill its goal of providing at least 95 percent of Veterans and spouses with access to an open national, state or tribal cemetery within 75 miles of their home,” McDonald said VA’s Veterans Cemetery Grants Program complements VA’s 134 National Cemeteries across the country. Since 1980, the Veterans Cemetery Grants Program has awarded grants totaling more than $665 million to establish, expand, and improve 100 Veterans cemeteries in 47 states and territories including tribal trust lands, Guam, and Saipan. These VA-funded Veterans cemeteries provided more than 35,000 burials in 2015. The new cemetery opened on March 14, 2016 and was dedicated on March 26, 2016 with a public ceremony with remarks by George D. Eisenbach Jr., Director, Veterans Cemetery Grants program. The cemetery, on approximately 20 acres, includes 1,802 pre-placed crypts, 1,638 cremains gravesites and 1,920 columbarium niches and will help serve the needs of approximately 105,000 Arizona Veterans and their families. Veterans with a discharge issued under conditions other than dishonorable who have completed a period of active duty service as required by law, their spouses and eligible dependent children may be buried in the Arizona Veterans’ Memorial Cemetery at Marana. The closest VA national cemetery to the new Arizona cemetery is VA’s National Memorial Cemetery of Arizona in Phoenix, approximately 91 miles away. The nearest VA grant-funded state Veterans cemetery is Southern Arizona Veterans’ Memorial Cemetery in Sierra Vista, which is located at a distance of about 107 miles from the new site. For more information on VA’s Veterans Cemetery Grants Program, visit: www.cem.va.gov/cem/grants. For more information on Arizona's Veterans Memorial at Marana, visit: https://dvs.az.gov/arizona-veterans-memorial-cemetery-marana
VA and DoD Commemorate 50th Anniversary of the Vietnam War Below is a press release outlining the hundreds of events that occurred last week commemorating the Vietnam War. There will be many more in the future.
Exemplifies a MyVA priority to Improve the Veteran Experience While Thanking
Vietnam Veterans and Their Families
The Department of Veterans Affairs (VA) conducted hundreds of events in VA facilities across the nation last Tuesday, Mar. 29, to recognize, honor and thank U.S. Vietnam Veterans and their families for their service and sacrifices as part of the national Vietnam War Commemoration.
VA Secretary Robert McDonald hosted a wreath-laying ceremony at the Vietnam Veterans Memorial – “The Wall” to initiate VA’s contribution to the Commemoration. He was joined by Defense Secretary Ashton Carter. “We are proud to partner with the Department of Defense in this endeavor. Secretary Carter’s Vietnam War Commemoration staff has greatly assisted us in planning this humble tribute to our Vietnam Veterans and their families.”
VA, along with more than 9,000 organizations across the country, has joined with the Department of Defense as a Commemorative Partner to help Americans honor our nation’s Vietnam Veterans.
Authorized by Congress, established under the Secretary of Defense, and launched by the President in May 2012, the Vietnam War Commemoration recognizes all men and women who served on active duty in the U.S. Armed Forces from November 1, 1955 to May 15, 1975. Nine million Americans, approximately 7 million living today, served during that period, and the Commemoration makes no distinction between Veterans who served in-country, in-theater, or were stationed elsewhere during those 20 years. All answered the call of duty.
“This Commemoration has special significance for those of us at VA because of our honored mission to serve those who have “borne the battle,” said McDonald. “It’s also an opportunity to remember our VA colleagues who served in this generation of Veterans, to extend our heartfelt appreciation to them and to their families who shared the burden of their loved one’s service.”
More than 329 VA medical centers, regional benefit offices and national cemeteries also hosted events, many in partnership with local Veteran service organizations and volunteers.
By presidential proclamation issued on May 25, 2012, the Commemoration extends from its inaugural event on Memorial Day 2012 through Veterans Day 2025.
Commemorative Partners – local, state and national organizations, businesses, corporations and governmental agencies – have committed to publicly thank and honor Vietnam Veterans and their families on behalf of the nation and have pledged to host a minimum of two events annually.
To learn more about the Vietnam War Commemoration, go to: www.vietnamwar50th.com
New Report Says that Bad Paper Discharges Are At All-Time High in Military
A report released on March 30 by Swords to Plowshares and National Veterans Legal Services Program, and covered by both Task and Purpose (taskandpurpose.com) and the New York Times has found that 125,000 veterans who served since 2001 have been excluded from basic VA services because of so-called “bad paper,” or other-than-honorable, discharges.
Bad paper discharges occur when a service member leaves the military under conditions that are less than honorable: other-than-honorable, bad conduct, and dishonorable discharges.
Approximately 33,000 of the 125,000 other-than-honorable discharges since 9/11 deployed to Iraq and Afghanistan. Many other servicemembers with less-than-honorable discharges are victims of military sexual trauma.
Overall, that 125,000 number amounts to 6.5% of all post-9/11 service members. In contrast, the report found that only 2.8% of Vietnam-era veterans and 1.7% of World War II-era veterans were excluded from VA benefits due to bad paper discharges. Further, the report suggests this may be in violation of the 1944 GI Bill of Rights.
In the GI Bill of Rights, officially called the Servicemen’s Readjustment Act of 1944, Congress deemed that other-than-honorable discharges can only bar a veteran from basic VA services if the individual’s misconduct led to a dishonorable discharge after a court-martial due to serious crimes.
Many other veteran service organizations have noted, two of the VA's main purposes are ending veteran homelessness and stopping veteran suicide. Veterans with bad paper are at higher risk for both homelessness and suicide, but are purposefully excluded from services that are specifically designed to help them.
The report cites the VA’s regulations as the problem because they do not match the eligibility standards set up by Congress, as noted above.
Apparently this policy of denying veterans' benefits to those with other-than-honorable discharges is not consistently applied. Taskandpurpose.com reported that in 2013, VA regional offices denied eligibility to 90% of veterans with bad paper discharges. While the Boston regional office denied 69% of veterans with bad paper discharges, the Indianapolis regional office denied 100%.
In an interview with taskandpurpose.com, Deputy Secretary of the VA Sloan Gibson said:
“Under long-standing law and regulations, VA considers whether individuals with less than honorable discharges are eligible for VA benefits on a case-by-case basis, taking into account the reason for the discharge. I believe the report provides us as a department an opportunity to do a thorough review, take a fresh look this issue and make changes to help veterans.”
However, even when the department does investigate the character of discharges to determine if a veteran should be blocked from receiving benefits, the report found that it takes too long to complete, averaging three years or more.
Travelling with TRICARE
Below is a DoD Press Release telling you how to access care with TRICARE when you travel. It has lots of useful information.
Getting Care When Traveling
Are you on Spring Break or preparing for vacation? Either way, you should know how to get medical or dental care when you need it.
Your rules for getting care depend on your TRICARE plan and travel destination. If you’re using Prime, get your routine care from a primary care manager (PCM) before you go. If you have an emergency, go to the nearest Emergency RoomThe hospital department that provides emergency services to patients who need immediate medical attention.. However, if you decide you need urgent care, you must have a referral from your PCM.
Standard and Extra beneficiaries can visit any TRICARE-Authorized ProviderAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. for care, whether stateside or overseas. Keep in mind, if you’re overseas, you may need to pay up front and file a claim with the overseas claims processor for reimbursement.
If you need dental care and are enrolled in the TRICARE Dental Program, you can visit any licensed dentist for treatment. You can search for a participating dentist both stateside and overseas. TRICARE Retiree Dental Program enrollees can search for a stateside dentist or call Delta Dental’s international dentist referral service collect at 1-312-356-5971. Call 1-215-942-8226 for dental emergencies.
Don’t forget about your prescriptions. TRICARE beneficiaries have several options for filling prescriptions; military hospitals or clinics, network pharmacies, non-network pharmacies and home delivery.
If you’re traveling stateside and you don’t know what to do for care, call the TRICARE Nurse Advice Line at 1-800-TRICARE, Option 1. You can get information about all of your TRICARE benefits on the TRICARE website.