Category Archives: veterans

Veterans Administration Has $1 Billion Unexpected Funding Shortfall

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VA Budget Shortfall httpdelmarvapublicradio.net

Image: delmarvapublicradio.net

“THE ARIZONA REPUBLIC”

“Under repeated questioning, VA Secretary David Shulkin acknowledged the department may need emergency funds.

The Department of Veterans Affairs was scolded by both parties over its budget Wednesday as lawmakers scurried to find a fix to an unexpected shortfall of more than $1 billion that would threaten medical care for thousands of veterans in the coming months.

“We would like to work with you,” Shulkin told a Senate appropriations panel. “We need to do this quickly.”

At the hearing, lawmakers pressed Shulkin about the department’s financial management after it significantly underestimated costs for its Choice program, which offers veterans federally paid medical care outside the VA. Several questioned Shulkin’s claim that the VA can fill the budget gap simply by shifting funds — without an emergency infusion of new money — without hurting veterans’ care.

“The department’s stewardship of funds is the real issue at hand,” said Sen. Jerry Moran, R-Kan., chair of the Appropriations panel overseeing the VA. He faulted VA for a “precarious situation” requiring a congressional bailout.

Shulkin cited unexpectedly high demand for Choice and defended President Donald Trump’s 2018 budget request as adequate, but allowed that more money may be needed.

“On financial projections, we have to do better,” he said. “We do not want to see veterans impacted at all by our inability to manage budgets.”

Shulkin made the surprise revelation last week, urgently asking Congress for help. He said VA needed legal authority to shift money from other VA programs.

His disclosure came just weeks after lawmakers were still being assured that Choice was under budget, with $1.1 billion estimated to be left over on Aug. 7. Shulkin now says that money will dry up by mid-August. He cited excessive use of Choice beyond its original intent of using private doctors only when veterans must wait more than 30 days for a VA appointment or drive more than 40 miles to a facility.

Skeptical senators on Wednesday signaled they may need to move forward on a financial bailout.

In a letter Wednesday to the VA, Moran joined three other GOP senators, including John McCain, in demanding more detailed information from VA on what fix is needed.

“Unless Congress appropriates emergency funding to continue the Veterans Choice Program, hundreds of thousands of veterans who now rely on the Choice Card will be sent back to a VA that cannot effectively manage or coordinate their care,” the senators said. “We cannot send our veterans back to the pre-scandal days in which veterans were subjected to unacceptable wait-times.”

VA is already instructing its medical centers to limit the number of veterans sent to private doctors. Some veterans were being sent to Defense Department hospitals, VA facilities located farther away, or other alternative locations “when care is not offered in VA.” It also was asking field offices to hold off on spending for certain medical equipment to help cover costs.

Congressional Democrats on VA oversight committees have also sharply criticized the proposed 2018 budget. Shulkin, for instance, says he intends to tap other parts of the VA budget to cover the shortfall, including $620 million in carryover money that had been designated for use in the next fiscal year beginning Oct. 1.

The budget proposal also seeks to cover rising costs of Choice in part by reducing disability benefits for thousands of veterans once they reach retirement age, drawing an outcry from major veterans’ organizations who said veterans heavily rely on the payments.

Shulkin has since backed off the plan to reduce disability benefits but has not indicated what other areas may be cut.

Sen. Patty Murray, D-Wash., told Shulkin that it sure sounded like VA needed money.

“You’re defending this budget, but your job is to defend veterans,” she said. “It seems to me if the administration makes the request, it will be better served.”

The VA’s faulty budget estimates were a primary reason that Congress passed legislation in March to extend the Choice program beyond its Aug. 7 expiration date until the money ran out, which VA said would happen early next year. At the bill-signing ceremony with veterans’ groups, Trump said the legislation would ensure veterans will continue to be able to see “the doctor of their choice.”

The department is now more closely restricting use of Choice to its 30-day, 40-mile requirements.

The unexpectedly high Choice costs are also raising questions about the amount of money needed in future years as VA seeks to expand the program.

Earlier this month, Shulkin described the outlines of an overhaul, dubbed Veterans CARE, which would replace Choice and its 30-day, 40-mile restrictions to give veterans even wider access to private doctors. He is asking Congress to approve that plan by this fall.”

http://www.azcentral.com/story/news/nation/2017/06/22/veterans-affairs-facing-1-billion-shortfall-because-unexpected-choice-program-costs/418787001/

 

Generals and Admirals Need Checks and Balances Too

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ASSOCIATION OF UNITED STATES ARMY”  By Lt. Col. Joe Doty, USA Retired and Maj. Gen. Rich Long, USA Retired

“Without question, most past and present top officers are some of the finest, most competent, values-based and selfless officers our nation can produce.

But they, like us all, are human, flawed, and we all need a healthy dose of oversight and accountability.

Some generals have made the news lately for behaviors that violate the professional ethic. Although this trend seems new or current, it isn’t. Thomas E. Ricks, a well-published author on defense matters, wrote “General Failure” in the November 2012 issue of The Atlantic and in the same year published a book, The Generals: American Military Command from World War II to Today, on the same topic. His critique focused on a perceived lack of accountability in our armed forces at the general-officer level.

In June 2008, Lt. Col. Robert Bateman wrote “Cause for Relief: Why Presidents No Longer Fire Generals” in Armed Forces Journal. And in May 2007, then-Lt. Col. Paul Yingling wrote his (in)famous “A Failure in Generalship,” also in Armed Forces Journal. Our national security advisor, Lt. Gen. H.R. McMaster, in 1997 wrote Dereliction of Duty: Lyndon Johnson, Robert McNamara, the Joint Chiefs of Staff, and the Lies that Led to Vietnam. The book talks about failures at our highest officer and political levels up to and during the Vietnam War.

Generals are human beings and as such we need to be honest and frank about human behavior and human frailty. Nobody is perfect. So it seems to be an appropriate question: How is the system working in terms of oversight and accountability for general officers?

Recently we’ve had an admiral caught up in the “Fat Leonard” scandal; a former aide to the secretary of defense, Maj. Gen. Ronald Lewis, was relieved of his duties due to transgressions; and Maj. Gen. David Haight was forced to retire due to questionable professional behavior. At some point, we must ask ourselves whether there is a more effective system of checks and balances that can mitigate some of these issues. Lastly, and perhaps most egregiously, there is the case of former Brig. Gen. Jeffrey Sinclair, who pleaded guilty to adultery, maltreatment of a subordinate, engaging in improper relations and several other charges. Who was providing oversight of him or holding him accountable for his actions?

Don Snider, an expert in the study of the Army profession, notes that professions like the military are self-policing. Other unique aspects of professions (such as law and medicine) include that they:

  • Provide a necessary service to the country.
  • Have a shared ethic.
  • Have a unique expert knowledge.
  • Develop their own members.

Our military takes each of these aspects of being a profession seriously. As the most senior representatives of a self-policing profession, our general officers should be the standard-bearers and set the example for the rest of the force—and for the country—in their personal and professional lives.

They should also know how to self-police. Assuming there is real self-policing of generals, either by someone or a group, would it be helpful to make the policing process more transparent? Would making public the specific (and anonymous) examples of how generals are holding themselves accountable be an appropriate service to the nation?

At the risk of oversimplifying this self-policing and oversight challenge, is a general’s immediate supervisor responsible for policing and holding accountable his or her subordinate? Is the four-star responsible for the three-star? Is the two-star responsible for the one-star? Here, it is important to note that the concept of chain of command is ingrained in the DNA of every service member. It is part of the professional ethic. And the construct of chain of command has a built-in concept and understanding of responsibility and accountability, which does not cease once someone is promoted to general rank.

DoD inspectors general certainly play a role in oversight and accountability, but it’s a role initiated after an allegation has been made. IG investigators are not involved in the day-to-day business of general officers. How do we get more proactive and ahead of the allegations?

At the top levels, trust is sacrosanct. Theoretically, our promotion and selection system has selected those who need little or no oversight. However, the promotion and selection system is only as good as people can make it, and there will be bad apples. It can be argued that officers at this level need more or closer oversight due to their strategic responsibilities and the potential for national or international embarrassment. The Gen. David Petraeus affair could serve as an example.

Mathematically and statistically, it is safe to assume there are bad apples among general officers. The military’s selection and promotion system is run by human beings, so it must have flaws and make mistakes. Is it realistic to think every general never does anything wrong? This violates common and reasoned sense. There are just over 300 generals in the active Army and about 650 in the Total Army. The fact that only one or two get in trouble each year is pretty good and perhaps surprising, but because of the sacred nature of their duties, even one-tenth of a percent is too high. Again, the need for oversight and accountability.

In terms of the human dimension and understanding of this topic, there are basic psychological processes at work. One can be called the Bathsheba Syndrome or “the dark side of success,” which suggests absolute power corrupts absolutely or that enormous success can be an antecedent to ethical failure. There are numerous historical examples of this: Tiger Woods and Richard Nixon come to mind. As such, it can easily be argued that because of their success, top officers need more oversight and accountability.

Expectancy theory is taught in most basic psychology courses and suggests people behave in ways they are expected to behave. Officers who attain the rank of general are the best of the best and are expected to be that way—almost flawless—and in some cases, may think they are flawless (as their evaluation reports state) and therefore think they can get away with anything. Unhinged or unbalanced ambition and/or unhealthy narcissism are recipes for disaster.

There is a difference between an officer who knows they should be and deserve to be a general, and one who may be a bit surprised and humbled to obtain the rank. This difference may be cognitively and emotionally subtle at the individual level, but can be profound in how it plays out. Again, an argument for more structured oversight and accountability.

It is the nature of life in the military to cover for each other. Loyalty to and taking care of your buddies and comrades in arms is part of the professional ethic. These bonds are emotional and powerful, as they must be due to the nature of the profession. But to what extreme? When are the times when this loyalty does not and should not apply?

The answer is: when one’s actions are unethical, against the law or will hurt the effectiveness of the organization. Importantly, a subordinate’s loyalty to a general-level officer is often exponentially magnified due to the rank, position power, referent power and expert power of the general. Hence, loyalty at this level may be impervious to and blind to wrongdoing. Asking or expecting a subordinate to call out a possible transgression by a superior officer can, unfortunately, be a career-ender for the subordinate. Is it realistic to think people in and around Sinclair over the course of his career never suspected anything nefarious was going on?

A recommended solution to this challenge is for DoD to require colonels selected as executive officers for generals to attend the IG course and have as part of their duties a formal responsibility of reporting and answering outside the chain of command and to certify, under oath, that they are not aware of malfeasance or issues that must be addressed. Other duties could include:

  • Challenging the general’s assumptions and thinking.
  • Attempting to find blind spots in the general’s personality and thinking.
  • Asking lots of “why” questions.
  • Providing candid and blunt feedback and assessments.

We also recommend that DoD increase its education and developmental opportunities in terms of helping officers increase their emotional intelligence, specifically in terms of self-awareness and self-management. Emotional intelligence is a leadership skill that can be taught, learned and increased over time. Individuals with high levels of emotional intelligence are less vulnerable to self-delusion, burnout, and personal and professional indiscretions.

Our purpose here is not to poke anyone in the eye or throw stones. Our focus is on organizational improvement and learning. “

GENERALS NEED CHECKS AND BALANCES TOO

 

 

U.S. President Blocks Veterans Group of 500,000 Members on Twitter

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Blocked Vets

“THE HILL”

“Veterans group has been critical of his time in office on Twitter.

“The Commander in Chief can block @VoteVets, the voice of 500k military veterans and families, but we will NOT be silenced,” VoteVets.org wrote on Twitter, including a screenshot that shows Trump had blocked the organization’s account.

The group has in the past criticized the president over his budget proposal, Republican attempts to repeal and replace ObamaCare and the president’s executive order temporarily barring individuals from certain predominantly Muslim nations from entering the United States

In one television advertisement aired during MSNBC’s “Morning Joe” in early February, VoteVets spoke directly to Trump, telling him to start acting like “a legitimate president.”

“Look, you lost the popular vote … You’re having trouble drawing a crowd …  And your approval rating keeps sinking …” a veteran of the war in Afghanistan says in the ad.

“But kicking thousands of my fellow veterans off their health insurance by killing the Affordable Care Act, and banning Muslims won’t help …  And that’s not the America I sacrificed for … . You want to be a legitimate president, sir? Then act like one.”

VoteVets is a progressive veterans group founded in 2006 that focuses on providing voices to veterans on issues ranging from foreign police to LGBTQ rights.”

http://thehill.com/homenews/administration/337560-trump-blocks-veterans-group-on-twitter

 

VA Will Shift Medical Records To DOD’s “In-Process” Electronic Medical Records System

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Veterans Gaming the System

Image:  Military Times

Total Investment To Date Now Projected at Nearly $10 Billion

“MILITARY TIMES”

VA has already spent more than $1 billion in recent years in attempts to make its legacy health record systems work better with military systems.

The military’s health record system is still being put in place across that department, more than three years after the acquisition process began. The initial contract topped $4.6 billion, but has risen in cost in recent years.

Shulkin did not announce a potential price tag for the move to a commercial electronic health records system, but said that a price tag of less than $4 billion would likely be “unrealistic.”


“Veterans Affairs administrators on Monday announced plans to shift veterans’ electronic medical records to the same system used by the Defense Department, potentially ending a decades-old problematic rift in sharing information between the two bureaucracies.

VA Secretary David Shulkin announced the decision Monday as a game-changing move, one that will pull his department into the commercial medical record sector and — he hopes — create an easier to navigate system for troops leaving the ranks.

“VA and DoD have worked together for many years to advance (electronic health records) interoperability between their many separate applications, at the cost of several hundred millions of dollars, in an attempt to create a consistent and accurate view of individual medical record information,” Shulkin said.

“While we have established interoperability between VA and DOD for key aspects of the health record … the bottom line is we still don’t have the ability to trade information seamlessly for our veteran patients. Without (improvements), VA and DoD will continue to face significant challenges if the departments remain on two different systems.”

White House officials — including President Donald Trump himself — hailed the announcement as a major step forward in making government services easier for troops and veterans.
Developing implementation plans and potential costs is expected to take three to six months.

But he did say VA leaders will skip standard contract competition processes to more quickly move ahead with Millennium software owned by Missouri-based Cerner Corp., the basis of the Pentagon’s MHS GENESIS records system.

“For the reasons of the health and protection of our veterans, I have decided that we can’t wait years, as DOD did in its EHR acquisition process, to get our next generation EHR in place,” Shulkin said.

Shulkin for months has promised to “get VA out of the software business,” indicating that the department would shift to a customized commercial-sector option for updating the health records.

The VA announcement came within minutes of Trump’s controversial proposal to privatize the nation’s air traffic control system. The president has repeatedly pledged to make government systems work more like a business, and in some cases hand over public responsibilities to the private sector.

Shulkin has worked to assure veterans groups that his efforts to rely on the private sector for expertise and some services will not mean a broader dismantling of VA, but instead will produce a more efficient and responsive agency.

He promised a system that will not only be interoperable with DOD records but also easily transferable to private-sector hospitals and physicians, as VA officials work to expand outside partnerships.

Shulkin is expected to testify before Congress on the fiscal 2018 budget request in coming weeks. As they have in past hearings, lawmakers are expected to request more information on the EHR changes then. ”

http://www.militarytimes.com/articles/va-share-dod-electronic-medical-records-decision

 

 

Female Veteran Business Leaders Share Tips for Success

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Female Veteran Business Leaders

Photo Credit: Master Sgt. Jenifer Calhoun/Air Force

“MILITARY TIMES” By Leo Shane III

“Highlights of last month’s Women Veterans Leadership Summit organized by The Mission Continues was a panel from prominent business leaders on how to navigate the transition from military life to civilian careers.

Below are excerpts from that event, designed to focus on ways women leaving the service can use their experience to succeed in workplaces very different than their military posts:

** Know your mission

Amy Gravitt, executive vice president at HBO Programming, is a Navy veteran who served on board the USS Constellation in Persian Gulf:

“It was quite a change going from the Navy to the entertainment industry. I took an unpaid internship with a production company. So I went from being a lieutenant and having a ton of responsibility and having people who worked for me to being the low man on the totem pole, by far.

“What got me my start in the industry and got me to where I am now is that I was the best intern. I went into this industry that was a mess and had no systems in place, and I started organizing it like my division on the ship …

“The company I worked for was George Clooney and Steven Soderberg’s company, and there were a lot of eager film students there who wanted to talk to them about films and ideas. And I knew they did not want to hear my ideas. They weren’t interested in me pitching them movies.

“So, I did the job that made their lives easier, and I was recognized for that.”

** Appreciate your service

Paula Boggs, founder of Boggs Media, served as an Army attorney and later when on to roles in the U.S. Attorney’s office and various technology firms.

“By the time I got to Dell, there were very few people who had military experience. I was like a unicorn. But because of that, there was heightened awareness of who the military was and what they were doing. And this was pre-9/11.

“A lot of tech companies are heavily male. So I was a unicorn in the sense of being a veteran, and a unicorn in the sense of being a woman. All the greater in figuring out how to capitalize on those two things in a setting like that…

“As a team building exercise, we were doing war games, playing Army … There was a moment when Michael Dell, founder of the company, just stopped and said, ‘Guys, Paula really did this!’ And you’d see this awe, this transformative moment. ‘She did something we can only play at.’

“Never underestimate how special being a veteran is, particularly in this post 9/11 environment … There’s this moment now in the country where veterans are not understood, but there is an elevated awareness of who you are and the specialness of the service you have given.”

** Embrace the civilian workplace

Nana Adae, executive director at JP Morgan Private Bank, spent seven years in the Navy specializing in communications and signals, including assignments in Japan, Greece and Spain.

“One of the things that I stress is that people just need to know you, because if it’s all about whether or not people like you, that’s a very superficial way of thinking about how you’re going to be judged.

“And unfortunately as women, I think a lot of times we put our head down. We just want to work. We don’t want to have any of the noise about who we really are or what’s going on with us because that might complicate things.

“But truthfully, in the work environment, the more successful people are the people who are known.”

** Don’t exaggerate your skills or limitations

Gravitt: “You’ll make a million mistakes along the way … so don’t be too eager to move up quickly. Make sure you’re ready to ride without the training wheels before you take them off.”

“When you make a mistake, apologize once and move on. Nobody else is going to obsess about your mistake, so you shouldn’t. Just figure out what you can learn from it.

“It doesn’t mean you have terrible instincts. It doesn’t mean that you’re bad at your job. It just means that you made a mistake. People do it all the time.”

** Keep looking for mentors

Boggs: “One of the most powerful mentors for me was my last assignment. I worked in the White House on the Iran-Contra investigation. My boss was a civilian, middle-aged white guy. I was a 20-something black female.

“On the surface, not like me at all. But saw something in me that reminded him of himself, and became my champion for the first 15 years of my career.”

“Years later, someone wrote an article where I called him the most significant mentor of my career. He called me and said, ‘Paula, I never considered myself your mentor. You were just my friend.’ But he was that to me.”

“Mentors can be everywhere … keep an active peripheral vision, because you just never know.”

http://www.militarytimes.com/articles/mission-continues-business-advice-women-veterans

Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at lshane@militarytimes.com.

Military Veterans Take to Twitter to Fight Discrimination

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(Photo Credit: Douglas E. Curran/AFP)

“MILITARY TIMES”

“A group of veterans are fighting anti-immigration messages one tweet at a time.

Vets Fight Hate has partnered with Southern Poverty Law Center with the goal of reminding people that they are all much more than just their looks or ancestry.

Their Twitter account  @VetsFightHate targets users who post hateful messages and possess a large number of followers. They reply to these hateful messages with personalized messages of their own — messages of immigrants who have served in the U.S. military.

“Veterans are one of the most respected and honored groups of Americans, and they have an important voice in fighting back against those spreading hatred,” SPLC spokeswoman Wendy Via told the Huffington Post.

The organization’s very first post introduces us to Roy who tells his story: “I joined the US Army at 17 to defend America. I’m from Germany, but I was willing to fight for this country because it accepted me. Immigrants are what make America great.”

Another veteran named Lawrence responded to a hateful message that said “immigrants are a disease to this country.”

“I’m an immigrant; I’m a citizen; and I’m a veteran. I served in the U.S. Air Force and fought for you, your family, and people I don’t even know. I risked my life for a free and inclusive country. This country was built by immigrants. Respect us. This is our home too,” Lawrence replied.

Approximately 11 percent of all U.S. veterans come from an immigrant background, whether they immigrated themselves, or their parents did. That’s the equivalent to nearly two million veterans, according to  migrationpolicy.org.”

http://www.militarytimes.com/articles/military-veterans-take-to-twitter-to-fight-discrimination-with-vetsfighthate

Military’s Health Records Maze

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VA Records Maze

“MILITARY TIMES”

“More than $1 billion has been invested in medical record interoperability in recent years but with mixed results.

Veterans Affairs Secretary David Shulkin said he is open to adopting the new military electronic health record system for his department but stopped short of promising that will happen this summer.

“We’re exploring all options,” Shulkin told members of the House Appropriations Committee on Wednesday. “It’s a highly complex issue … if there was an easy solution here, it would have been made already.”

The comments came in response to criticism from lawmakers related to the ongoing health records saga, a point of tension for the departments for decades.

“We’ve been giving you all a lot of money, and it’s not fixed,” said Rep. Tom Rooney, R-Fla. “You could be the best VA secretary of all time if you solved this one problem.”

At issue is the seamless medical transition of active-duty troops and reservists to VA care. Veterans have long lamented missing records, repeated exams and frustrating inefficiencies with the dueling department systems.

Last year, defense and VA officials certified that their Joint Legacy Viewer now allows physicians in both departments to share and read those critical health records, eliminating many of those problems.

But the separate back-end systems still prevent VA doctors from editing or updating veterans’ old military records, and vice versa. Shulkin acknowledged that “it is not the complete interoperability we would hope for.”

Earlier this year, officials with the Military Health System announced plans to shift to the new GENESIS system for all personal military health records, allowing easier access for both patients and doctors.

Shulkin said he hopes to settle on a similar new system for VA this summer. He said a number of factors will go into that decision, including long-term viability of the new system, ease of transferability from old systems and interoperability with defense records.

But VA officials have long been resistant to simply adopting the same IT systems as the military because of specific agency needs. Lawmakers pushed Shulkin to break that trend, but he would not commit to any system at the hearing.

He did say that “VA needs to get out of the software development business” and will be looking for more private sector “off-the-shelf” options for health record systems, to minimize the workload of maintaining any future health records systems.

“It’s not an easy project in a single hospital, much less a whole system the size of VA,” he said.

Shulkin’ appearance before the committee was billed as a conversation about next year’s budget request, but so far only a few details of that plan have been released publicly. A full budget is expected to be released by White House officials later this month.

The department would see a 6 percent boost in programming funds under the “skinny budget” outlined by President Trump, one of only a few federal agencies looking at a funding boost under his plan.

Committee members told Shulkin to expect many more questions about the health records issue after the fiscal 2018 specifics are released”

http://www.militarytimes.com/articles/va-dod-health-records-2017-search

 

 

Helping Injured Veterans Recover Through Fly Fishing

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fly-fishing

(Photo Credit: Ziga – Own work, Public Domain)

“MILITARY TIMES”

“After Alaska, Montana has the highest number of veterans per capita, according to NBC Montana.

Looking to combat Montana’s status as the state with the highest rate of veteran suicides, Montana Vets Montana Waters is offering injured veterans an escape through fly fishing, NBC Montana reports.

Bernie Jacobs, the chairman of the organization, told NBC Montana that fly fishing can help veterans regain muscle strength while also serving as a life-saving escape from stress. “Those are therapeutic in a sense that it gives vets a place to go when they start feeling boxed in or their stress levels are building up,” he told NBC Montana. “Tying a fly or doing some fly casting is just and escape.”

As of March 1, the organization has 30 veterans scheduled for trips on Big Hole and Missouri Rivers with 28 more veterans on the waiting list. Although currently only located in the Helena area, the organization is hoping to expand to service all Montana veterans in major fishing areas.

“I’ve seen what it has done for veterans,” veteran Wade Ingraham told NBC Montana. Ingraham served in the military for 27 years, including six deployments. “Some of them pick up a rod and spend a day on the river and never do it again, but some of them I’ve seen it change their lives.”

For more information or to donate to Montana Vets Montana Waters, click here:”

http://www.militarytimes.com/articles/montana-non-profit-is-helping-injured-veterans-recover-through-fly-fishing

The Rewards of Mentoring – Helping Success Stories Like “Thunder Road”

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It was a pleasure to assist with the business plan for “Thunder Road” seven years ago.

Today it is a vital, growing organization, serving veterans, the disabled and a tri-state community out of Decorah, Iowa.

Photo:  Michelle McLain-Kruse at “Thunder Road”

Thunder Road

PLEASE ENJOY THE VIDEO BELOW

http://www.thunderrode.org/