Tag Archives: VA

Veterans Administration COVID-19 Control Program And Regular Stats On Hospital Virus Occurrences



“Novel Coronavirus Disease (COVID-19)

See here for the latest Centers for Disease Control and Prevention Coronavirus information.

What is VA doing?

VA has implemented an aggressive public health response to protect and care for Veterans, their families, health care providers, and staff in the face of this emerging health risk. We are working directly with the CDC and other federal partners to monitor the outbreak of the virus.

On March 27, VA shared its COVID-19 response plan. This best-practice guide is a valuable tool, which may be useful nationwide for the medical community.

VA has administered over 13,216 COVID-19 tests nationwide, while taking aggressive steps to prevent COVID-19 transmission.

These measures include outreach to Veterans and staff, clinical screening at VA health care facilities, and protective procedures for patients admitted to community living centers and spinal cord injury units.

What should Veterans do?

Any Veteran with symptoms such as fever, cough or shortness of breath should immediately contact their local VA facility. VA urges Veterans to call before visiting – you can find contact information for your closest VA facility.

Alternatively, Veterans can sign into My HealtheVet to send a secure message to VA or use telehealth options to explain their condition and receive a prompt diagnosis.

Upon arriving at VA, all patients will be screened for flu-like symptoms before they enter in order to protect other patients and staff. A VA health care professional will assist you with next steps once this screening process is complete.

At this time, VA is urging all visitors who do not feel well to please postpone their visits to VA facilities.

How to protect yourself

Currently, there is no vaccine to prevent the COVID-19 infection and no medication to treat it. CDC believes symptoms appear 2 to 14 days after exposure. Avoid exposure and avoid exposing others to an infection with these simple steps.

  • Learn to use VA Video Connect through the VA mobile app store or by contacting your VA care team, before any urgent problems arise.
  • Wash your hands often with soap and water for at least 20 seconds. An easy way to mark the time is to hum the “Happy Birthday” song from beginning to end twice while scrubbing.
  • Use an alcohol-based hand sanitizer that contains at least 60% alcohol.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick or becoming sick.
  • Cover your cough or sneeze with a tissue (not your hands) and throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.
  • Getting a flu shot is recommended.

VA COVID-19 Cases

Nationally, as of March 30, 2020, VA is tracking the following Veteran patients with a positive COVID-19 diagnosis. This is a rapidly evolving situation and VA will provide updated information as it becomes available and verified.”


Increased Veteran Banking Options Under VA/AMBA Partnership

Image: https://www.blogs.va.gov/VAntage/70643/announcing-veterans-benefits-banking-program/


Some veterans may have better access to banking now, through a partnership between the Department of Veterans Affairs and the Association of Military Banks of America.

It’s especially beneficial for those who haven’t been able to open bank accounts in the past, which hampers their ability to get their VA benefit funds by direct deposit.


“The VA delivers about $118 billion each year in benefits and services for veterans and their families. About 250,000 veterans and beneficiaries receive their benefits through a pre-paid debit card or paper check, and may not have a bank account.

An added plus is that these banks are already familiar with the financial needs and challenges of service members, and can also support veterans with financial education and resources tailored to their needs, said Paul Lawrence, under secretary for benefits for the VA. Some of the participating banks have branches on bases, but they also have a large number of branches outside the gate, which will be accessible to veterans, said Andia Dinesen, vice president of communications and operations for AMBA.

There are currently seven banks participating in the Veterans Benefits Banking Program: Armed Forces Bank; Bank of America; First Arkansas Bank and Trust; Fort Hood National Bank; FSNB; Regions; and Wells Fargo. Dinesen said other banks and credit unions are welcome to join the effort, too.”

For more information, visit https://www.benefits.va.gov/benefits/banking.asp.


VA Developing Cyber Careers Program Filling Gaps In Workforce

Image: Purdue University Global


The Cyber Workforce Management (CWM) plans to identify work roles across every single position within VA and its IT office and establish qualification requirements for each role that all of government can use..”


“The Department of Veterans Affairs is developing a cybersecurity career program to fill gaps in the NICE Cybersecurity Workforce Framework.

VA’s Office of Information Security stood up a Cyber Workforce Management (CWM) program across the broader Office of Information and Technology (OIT), which determined existing NICE Framework roles didn’t meet all of VA’s mission needs. The NICE framework, developed by the National Initiative for Cybersecurity Education, prescribes knowledge, skills, abilities and tasks (KSATs) to work roles like a cyber defense analyst.

“There are gaps in the framework. Medical is not in there, med cyber — jack of all trades, master of medical devices,” Stephanie Keith, CWM program manager, said during a panel discussion at the 2020 Health IT Summit. “But where are the cybersecurity aspects of that? At VA we’re looking at how we develop what that work role looks like.”

“I’m not about unique requirements for an agency,” Keith said. “I’m about federal national standards.”

CWM is also standing up a cyber training academy pilot to teach employees baseline skills associated with the work roles. Baseline skills for, say, a cyber defense analyst should be the same at every agency so they’re portable, Keith said.

Training for new work roles covering positions like healthcare technology managers and informaticists should happen at the device level, not the network level, she added.

VA employees further removed from technical positions still require cyber training as well in areas like early detection and zero trust, said Paul Cunningham, chief information security officer at VA.

“We’re never going to get medical teams to be primarily cybersecurity. It’s not their mission; we shouldn’t expect it,” Cunningham said. “But we should make it very easy for them to help us as first-line defenders recognize when things are not operating correctly.”

Vets Housing Vouchers In The Thousands Go Unused

A program with a proven track record to help homeless veterans is being under-utilized and Congress wants to know why. (Getty Images)


VA Homeless Program Office acknowledged 14,000 vouchers went unused last year, even though an estimated 38,000 veterans are still considered homeless.

The department has about 650 case management positions currently vacant.  Federal hiring rules coupled with the slow pace of federal contracting rules have made filling the positions and processing more vouchers difficult.


“Lawmakers want to know why thousands of housing vouchers for destitute veterans are going unused each year despite almost 38,000 potential recipients still living on the street.

The answer, Veterans Affairs officials testified on Tuesday, is a combination of hiring problems within the federal agency and rising rent costs in areas of the country with some of the largest homeless veterans populations.

Outside advocates warned that without solutions to those problems, the national goal of ending homelessness among veterans will remain stalled.

“Every veteran deserves safe and permanent housing,” said Kathryn Monet, CEO of the National Coalition for Homeless Veterans. “We’ve got to pair investments in affordable housing with housing-first initiatives in order to see true success.”

At issue are the Housing and Urban Development/Veterans Affairs Supportive Housing program, launched in 2008. Over the last 11 years, in coordination with community groups, the program has provided direct housing payments to veterans in an effort to provide a stable living situation, allowing them to more effectively deal with other health and employment issues.

Outside advocates have lauded the vouchers as a key tool in driving down homeless numbers among veterans. The total number of veterans without stable housing nationwide has dropped by half over the last decade, with most of the decrease coming between 2010 and 2016.

As of last fall, more than 90,000 HUD-VASH vouchers were in use.

But Keith Harris, national director of clinical operations in the VA Homeless Program Office, acknowledged at a House Veterans’ Affairs Committee hearing Tuesday that about 14,000 vouchers went unused last year, even though an estimated 38,000 veterans are still considered homeless.

Part of that problem is a result of paperwork issues. The department has about 650 case management positions currently vacant (about 16 percent of the federal workforce handling the vouchers). He said if the positions were filled, “HUD-VASH could house over 6,000 additional veterans.”

But Harris said the slow pace of federal hiring rules coupled with the slow pace of federal contracting rules have made filling the positions and processing more vouchers difficult.

In addition, Housing and Urban Development officials acknowledged that in some regions across the country, federal calculations for the voucher amounts have not kept pace with local housing costs.

That issue, lawmakers said, needs a faster fix from VA and HUD bureaucrats.

“All over the country, in places like California and Florida, these vouchers aren’t enough,” said Rep. Gus Bilirakis, R-Fla. “Part of the reason these vouchers aren’t being used is they aren’t helpful.”

Federal officials promised they are working on both issues, although affordable housing issues will take wider efforts from local communities and real estate firms.

VA and HUD leaders also looking at expanding eligibility criteria for voucher recipients, to give more veterans access to the financial support.

The hearing was held one day after House lawmakers overwhelmingly approved a measure to extend the homelessness vouchers to veterans with other-than-honorable discharges, who are excluded from a host of current VA health and transition benefits.

Harris said the department supports the idea, and estimates as many as 6,000 of the nearly 38,000 homeless veterans spread across the country today could have an other-than-honorable discharge.

The annual point-in-time count for federal homelessness estimates is scheduled for next week, although results from that work won’t be made public until this fall. While veterans homelessness dropped by half over the last decade, the rate among the entire U.S. homeless population decreased by only about 11 percent.

Both lawmakers and VA officials cited that statistic as evidence that their veteran-focused programs are effective. The next step, they said, is making sure they are more efficient and more fully used.

“We have a responsibility to abolish chronic homelessness for veterans, and strengthening the HUD-VASH program is an important first step,” said Rep. Mike Levin, D-Calif.”


VA And DOJ Join Forces To Crack Down On Health Care Fraud

Image: “Stars and Stripes


The Departments of Veterans Affairs and Justice are teaming up to combat healthcare fraud as the VA expands a Medicare-like program that allows veterans to seek care at private facilities in the community at taxpayer expense.”


“The VA’s Office of Inspector General is joining forces with the Justice Department’s criminal division to form an interagency task force that will focus on that program, the government said in a statement Tuesday.

The new partnership “will aggressively target fraud in the VA’s expanding health care programs,” said Assistant Attorney General Brian A. Benczkowski of the DOJ’s criminal division.

Legislation passed last year allows veterans to receive care from approved providers from outside the VA’s more than 1,200 medical facilities. As with Medicare, the providers submit claims to the government for payment for their services.

In announcing the task force, the VA IG released a list of more than a dozen cases in which the office partnered with the Justice Department to bring charges or obtain guilty pleas in recent months, including one involving a former chief of pathology for the VA in Arkansas accused of involuntary manslaughter, another in which VA claims processors are accused of collecting overtime pay for hours not worked, and several cases involving fraudulent prescriptions.

Federal investigators from the FBI, IRS, Department of Health and Human Services IG and other agencies are investigating the cases and the DOJ criminal division’s fraud section is prosecuting them, the statement said.

“This Task Force sends a clear message to anyone considering committing health care fraud at VA — we will protect our veterans’ health care system at all costs,” VA IG Michael J. Missal said in the statement.

Modeled on DOJ’s Medicare Fraud Strike Force, the task force will include an attorney from the VA IG’s office assigned to the fraud section as a special prosecutor in its health care fraud unit.

A partnership between Justice, the U.S. Attorney’s Offices, the FBI and the Department of Health and Human Services IG formed in 2007, the Medicare fraud strike force has charged more than 4,200 defendants with defrauding the Medicare of a total of around $19 billion.

“This is one of those rare opportunities in government where we can be proactive and get ahead of the curve by partnering with the Fraud Section and leveraging its proven strategies for combating fraud,” said Missal, the VA IG.”


VA-Distributed Video Tablets Deliver Telehealth to Veterans



“The department’s tablet program is one part of VA’s extensive telehealth program. The VA’s use of technology to enhance care options for Veterans is supported by the VA MISSION Act.


“The U.S. Department of Veterans Affairs (VA) was recently recognized in studies by two independent peer-review journals — JAMIA Open and Psychiatric Services — for efforts to deliver trusted, easy access and high-quality online health care services to Veterans with complex health care needs or residing in remote areas.

“Telehealth technology remains a vital platform to provide high-quality health care to all Veterans, regardless of challenges they may face in accessing care,” said VA Secretary Robert Wilkie. “VA’s tablet program is a model that other networked health care systems across the country can mirror, and demonstrates the potential of telehealth capabilities in the years to come.”

According to the JAMIA Open study published Aug. 5, VA’s initiative to distribute video telehealth tablets to high-need patients appears to have successfully reached Veterans with social and clinical access barriers, including Veterans in rural areas and patients with mental health conditions.

The study published by Psychiatric Services, Aug. 5, validates that the initiative also appears to improve access and continuity of mental health services of Veterans with mental health conditions. Furthermore, researchers discovered that VA’s efforts are improving clinical efficiency by decreasing missed opportunities for care.”

Learn more about VA Telehealth Services.


Multi-Million Dollar Scam of VA Spina Bifida Program

Image: “Daily Beast/Getty


A phony home care businessman has pleaded guilty to paying more than $1 million in bribes to a Veterans Affairs employee, who allegedly set up an elaborate scheme to defraud the VA’s benefits program for children diagnosed with spina bifida of nearly $20 million, according to the U.S. Attorney’s office in Denver.


“In his guilty plea, Roland Brown, 58, of Clearwater, Florida, admitted to being long-time friends with the employee and to working with him to set up a bogus home care company called Legacy Home Health, whose purpose was to submit false claims to the Department of Veterans Affairs.

The employee was not named in a news release, but Joseph Prince, who oversaw the spina bifida program from the Denver VA’s Office of Community Care, was fired last fall and later indicted in the alleged ripoff.

Brown admitted to paying $1,007,205 to Prince, and in return, Legacy Home Health received more than $3,039,000 in false claims, the U.S. Attorney’s office said.

The U.S. Attorney’s office said that Prince and Brown targeted the VA’s Spina Bifida Health Care Benefits Program, which pays for home care providers.

Prince allegedly told family members and friends of children living with spina bifida that they could be paid for home care services if they signed up with Brown’s company, even though they were not authorized to provide the care.

Legacy Home Health then submitted claims to the VA for $88 an hour for the home care, although the friends and family members were actually being paid $16 an hour, the U.S. Attorney’s office said. A tentative sentencing date was set for Brown in December.

The scheme with Legacy was only one of several scams on the VA allegedly pulled off by Prince, according to the federal indictment and affidavits field last year.

He allegedly set up seven companies, including one run by his wife, to submit bogus claims to the spina bifida program.

According to his indictment, companies set up by Prince took in $18.9 million of the $25.2 million that the VA paid for home health services between June 2017 and June 2018.

In addition to the U.S. Attorney’s office, the FBI, the IRS and the VA’s Office of Inspector General joined in the investigation leading to the indictment.”


Sole Source Contractor With Non-Competitive $16 Billion VA Records Integration Contract Calls It “Immense Challenge”


Image: FCW.com


“This won’t be easy,” the prime contractor said Tuesday of the $16 billion effort to overcome decades of failure and finally make veteran and military health records compatible with a few computer clicks.

We must deploy to 117 sites, train over 300,000 VA employees, collaborate with DoD, interoperate with the community, aggregate decades of clinical data and update technology,” he told a hearing of the House Veterans Subcommittee on Technology. “


“It carries risk, and we don’t take the challenges lightly” in implementing Electronic Health Record Modernization (EHRM) programs across the Departments of Veterans Affairs and Defense”, said Travis Dalton, president of government services for Cerner Corp. of Kansas City.

In addition, the new system will have to link with additional community health care providers expected to come onboard with the June 6 rollout of the VA Mission Act, which will expand private health care options for veterans, said Rep. Jim Banks, R-Indiana, the ranking member of the subcommittee.

“Interoperability with the community providers is still the elephant in the room,” he said.

About 30% of veterans currently get health care at taxpayer expense in the private sector, and they “rightfully expect their records to follow them,” Banks said. He said his main concern is that a “half-baked system” will be rushed into use.

Rep. Susie Lee, D-Nevada, chairwoman of the subcommittee, said that Cerner and partners Leidos and Booz Allen Hamilton are attempting to create “one seamless lifetime record for our service members as they transition from military to veteran status,” but “this effort also has the potential to fail.”

“The VA unfortunately does not have a great track record when it comes to implementing information technology,” she said, “and it threatens EHRM.”

Previous attempts to mesh VA and DoD records have either failed or been abandoned, most recently in 2013 when then-Defense Secretary Leon Panetta and then-VA Secretary Eric Shinseki dropped an integration plan after a four-year effort and the expenditure of about $1 billion.

“This won’t be easy, but it is achievable and we are making progress” in the overall effort to let “providers have access to records wherever they deliver care,” Dalton said.

Jon Scholl, president of the Leidos Health Group and a Navy veteran, said the example to follow is the MHS Genesis system, the new electronic health record for the Military Health System. “MHS Genesis is the solution,” he said at the hearing.

However, Lee said that “a suitable single management structure has yet to emerge” for EHRM since then-Acting VA Secretary Robert Wilkie awarded a $10 billion, 10-year contract to Cerner in May 2018. The cost estimate for the contract has since risen to $16 billion.

At a hearing last month of the House Defense Appropriations Subcommittee, Acting Defense Secretary Patrick Shanahan was challenged on the DoD’s efforts to work with the VA on EHRM.

“I don’t ever recall being as outraged about an issue than I am about the electronic health record program,” Rep. Kay Granger, R-Texas, told him.

“Personally, I spend quite a bit of time on how do we merge together” with the VA on the records, Shanahan assured her.

He said pilot programs on making the records compatible are underway in Washington state at Joint Base Lewis-McChordNaval Base KitsapNaval Air Station Whidbey Island and Fairchild Air Force Base.

The “rollout and implementation” of the fix to the electronic health records has shown promise at those installations, Shanahan said, adding that the next step is to put the programs in place at California installations in the fall.”


Wave Of Elderly Veterans Creates Financial Worries For VA’s Nursing Home Services



“More than one million veterans will be eligible for taxpayer-funded nursing home services within the next five years, according to the latest estimates from federal administrators trying to balance the costs of institutional care with alternative options allowing those individuals to stay in their homes.”


“Already, the annual costs of nursing home care have risen to almost $6 billion, Veterans Affairs officials told lawmakers at a congressional hearing last week. By 2024, that number could top $10 billion, a significant portion of the department’s overall budget.

“As veterans age, approximately 80 percent will develop the need for some long-term services and support,” Dr. Teresa Boyd, assistant deputy undersecretary for health at the Veterans Health Administration, told lawmakers. “The aging of the veteran population has been more rapid and represents a greater proportion of the VA patient population than in other healthcare systems.”

By law, VA officials must provide nursing home care for veterans with service-connected disabilities rated 70 percent or more. The department currently maintains 156 state homes across all 50 states.

But a study by USA Today and the Boston Globe last fall found that about two-thirds of those facilities scored worse than private-sector nursing homes in a series of quality indicators last year.

And VA officials acknowledge that many veterans are seeking options to remain at their own homes or with family caregivers rather than enter the institutions, a shift in cultural preferences in recent years.

“There’s an urgent need to accelerate the increase and the availability of the services since most veterans prefer to receive care at home,” Boyd said. “And VA can improve quality at a lower cost.”

Dr. Scotte Hartonft, acting director of VA’s Office of Geriatrics & Extended Care, said programs like adult day care, home-based primary care and tele-health options have been extended significantly in recent years. He called those programs a win for both veterans and the department.

“It provides (veterans a) choice, but it also is much less expensive than nursing home care,” he said.

Two years ago, VA officials launched the Choose Home Initiative to promote and expand more home care initiatives. Hartonft said five VA medical centers are running pilot programs related to that goal, with an eye towards expansion in coming years.

Lawmakers said that work is critical, not only for today’s elderly veterans population but for the long-term issues facing the Iraq and Afghanistan war generation.

“Looking forward to 2035, the veterans of Afghanistan and Iraq will be middle aged, they’ll have health issues much like the Vietnam veterans experience today,” said Rep. Sanford Bishop, D-Ga. “They have the co-morbidities of post-traumatic stress, traumatic brain injury, palliative traumas. How is VA going to address this?”

More information on VA long-term and geriatric care is available at the VA web site.”


VA Requests Contractor Participation In Veterans Appeals Modernization Project



“The agency recently posted a request for information on FedBizOpps, seeking contractor help with project management, training, help desk support and more.

The project has a 12 month period of performance, with three additional 12 month option periods. Interested entities have until Jan. 14 to respond to the RFI. “


“The Department of Veterans Affairs is seeking additional contractor support as it continues to develop Caseflow, a suite of modern appeals processing tools.

The VA appeals modernization project, aimed at streamlining a complicated and difficult system, began back in 2014. In 2015, the VA Digital Service (DSVA) team started looking into retiring the legacy Veterans Appeals Control and Locator System (VACOLS, developed in 1979) in favor of a new suite of digital solutions called Caseflow. This work has been ongoing — for example, DSVA and the VA launched Caseflow’s first tool, Caseflow Certification, in April 2016.

It is now time, however, for development and implementation to kick into high gear. According to the VA, no Caseflow products are “fully finished” at the moment, but all need to be in a state of minimum viability by the time the Veterans Appeals Improvement and Modernization Act of 2017 goes into effect Feb. 14, 2019. Per the Caseflow GitHub page, there are four products currently in a “mature state” and four others “in heavy development.”

This is where the VA’s call for help comes in.

Caseflow, as is typical of U.S. Digital Service projects, is being developed according to user-centered and agile methodology, so the VA is looking for a contractor that will stick with these same working principles. In response to the RFI, potential vendors are asked to submit a case study that demonstrates that vendor’s ability to fulfill the VA’s needs.”