Tag Archives: Veterans health care

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

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“MILITARY TIMES”

“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.”

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“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.”

https://www.militarytimes.com/news/pentagon-congress/2019/02/20/wave-of-elderly-veterans-creates-financial-worries-for-vas-nursing-home-services/

VA Software Shuffle To Delay National Rollout Of Patient Scheduling

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“FEDSCOOP”

“The Department of Veterans Affairs’ recent decision to fast-track new patient-scheduling software instead of a successfully piloted platform could mean it will be several more years before veterans facilities nationwide have modernized scheduling functionality. “

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“The Cerner-built system will replace the one at the center of the department’s 2014 scheduling scandal, in which several veterans died while waiting for care. That older system, known as VistA, remained in place everywhere except Columbus, where the $32 million pilot by health care software provider Epic and systems integrator Leidos showed great promise. Called the Medical Appointment Scheduling System (MASS), it improved wait times and increased the number of completed appointments after its implementation in 2017.

For a while, Leidos appeared to have the inside track on providing the nationwide replacement system. The VA had entered into a $623 million contract with the company in 2015 to roll out functionality in five years, but work was paused until the 2017 pilot. Leidos said after the pilot it was confident it could deliver nationwide functionality in two years and for less than $350 million.

A separate agreement with Cerner, though, essentially got in the way. Because VA is investing billions in a Cerner-based modernized EHR platform, it’s no surprise that it would choose to also adopt Cerner’s scheduling portal at some point for the seamlessness of the two platforms. But it was anticipated, until recently, that VA would continue developing MASS nationwide before turning to Cerner scheduling down the road.

“Given that Cerner was awarded a no-bid contract to replace VistA, we recognized VA would likely be required to use Cerner scheduling at some point in the future,” Meghan Roh, an Epic spokesperson, told FedScoop in an email. “We thank VA, our partners, and the team at the Columbus VA Ambulatory Care Center for their work on a wonderfully successful scheduling pilot.”

Now, with the progress of the Epic-based MASS abandoned, VA officials aren’t sure exactly when patient scheduling functionality will arrive at medical facilities across the nation. John Windom, executive director of VA’s Office of Electronic Health Record Modernization, told a Senate Appropriations subcommittee Tuesday the VA will look to deploy the Cerner scheduling solution at three select facilities in the Pacific Northwest after March 2020, when those locations reach initial operating capability (IOC) under the larger EHR modernization program. The VA will also likely look to launch the scheduling functionality at other facilities out of sequence with the EHR deployment.

“We have committed to deploying a Cerner scheduling module out of sequence post-IOC,” Windom said. “The intent is to leverage the learnings of IOC to deploy” the scheduling module.

But from there, things are unclear, because, according to Windom and his team, they plan to address the rollout based on the success of the first few sites.

“The timeline for that has yet to be fully flushed out because we have not developed fully our execution strategy, but we expect that to start shortly after we achieve IOC milestones in March of 2020,” he said. He also couldn’t give an estimate for how much the Cerner scheduling portal rollout might cost. And until then, veterans and care providers are stuck scheduling under VistA, the same program at the center of the 2014 crisis.

Lawmakers were disappointed to hear of VA’s decision to abandon the successful MASS for an uncertain start from scratch with Cerner.

“Almost five years after the scheduling problems at the VA came to light, the VA is telling Congress that veterans are going to have to wait another five years or more for nationwide deployment of a modern scheduling system — a system that the VA hasn’t tested and doesn’t know the capabilities of… I have to tell you I’m skeptical,” said Sen. Tammy Baldwin, D-Wisc. “Our veterans have waited too long, and we’ve spent over $30 million on a canceled scheduling pilot that showed tremendous progress and promise.”

Under VA’s plan, it will take a decade from the point of IOC for the Cerner EHR to be fully operational across the U.S. The concern is that the VA and Cerner will roll out scheduling functionality on a similar timeline.

“You’re going to have to find a way to do that much more rapidly,” said Sen. John Boozman, R-Ark., adding that a “10-year reprogramming of that is simply unacceptable.”

James Byrne, acting VA deputy secretary, said it will be “well before 10 years that the scheduling solution will be across the United States.” He said the “separate” but concurrent effort to roll out the scheduling system at facilities not in line with the EHR deployment, that should cut down the time.

“I’m not going to say it’s going to be in four or five years, but that is probably more likely than” 10 years, said Byrne, who is also VA’s general counsel.

“We intend to get scheduling out to our veterans as soon as we possibly can,” Windom said.”

Military Units To Reunite In New VA Pilot To Prevent Suicide

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Military Units Reunite

Photo: Staff Sgt. Gabriela Garcia/Marine Corps

“MILITARY TIMES”

“The Veterans Health Administration this week announced a new pilot program with the advocacy group The Independence Fund which will reunite troops who experienced some of the toughest combat conditions in Iraq and Afghanistan. 

[The program is] for group therapy sessions, with the hopes of using those common bonds to better work through individual post-military struggles.”


“Mental health professionals in the past have touted the benefits of veterans meeting with peers for counseling sessions to discuss trauma and prevent suicide.

Now, Veterans Affairs officials are readying to take that idea one step further: Bringing whole military units back together for treatment.

“I had one guy tell me, ‘I literally went to hell with these men, so I can go on a yoga retreat or whatever you want if you think it will help them,’” said Sarah Verardo, chief executive officer of The Independence Fund. “They still want to support each other. And building on that trust is key to getting some of these veterans the help they need.”

The effort comes at a time when progress on preventing veterans suicide nationwide has remained stalled. About 20 veterans a day take their own lives, a figure that has held steady in recent years.

Most of those veterans have little or no contact with official VA programs, making outreach a key component of VA’s suicide prevention programs. Dr. Keita Franklin, executive director of the department’s suicide prevention efforts, said in a statement that programs like the new pilot dubbed Operation Resilience can help reach those who need it.

The first retreat will take place in April with members of Bravo Company, 2-508 Parachute Infantry Regiment, 82nd Airborne Division — the unit where Verardo’s husband, Mike, was serving when he was severely wounded by a roadside bomb in Afghanistan eight years ago.

Since his return, the couple has attended numerous funerals of his fellow soldiers. Some were combat deaths. Several others were suicides after the unit returned home.

“It got to the point where the only time they saw each other was funerals,” she said. “We needed to change these guys’ perspective on what it means to return home.”

Details of the first event are still being worked out, but Independence Fund officials have already heard from more than a dozen more units who want to participate in future retreats. The program will focus on groups who saw heavy casualties overseas or a significant number of suicides after they returned home.

Defense Department officials are working with VA to identify unit members and issue invites. VHA officials will handle mental health counseling presentations and interventions, and use the event as an opportunity to look for ways to better connect with all veterans.

A second event is already being planned for early summer, with another hard-hit unit. Verardo hopes to expand the program in years to come.

“These are men and women who went to war together, survived Iraq and Afghanistan,” she said. “We need to help them survive at home.”

More information on the program will be available on the Independence Fund site.

Veterans who are experiencing distress may contact the Veteran Crisis Line at 1-800-273-8255 and select option 1 for a VA staffer. Veterans, troops or their families members can also text 838255 or visit VeteransCrisisLine.net for support assistance.”

https://www.militarytimes.com/news/2018/12/11/new-va-pilot-will-reunite-military-units-for-mental-health-support/

New Veterans Administration (VA) Consolidated Home Page

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New VA Web Site

“FEDSCOOP”

“Veterans in search of information about benefits now have a brand new homepage — VA.gov.

The site now “consolidates information and places it in one easy to navigate location.Veterans can use their existing MyHealtheVet, DS Login, or ID.me account to sign in. “


“We are so excited for the new VA.gov,” Marcy Jacobs, Executive Director of the VA Digital Service, told FedScoop in an emailed statement. “It marks an important step toward providing the modern digital experience Veterans deserve, and our team will continue to improve and streamline VA’s digital tools and content. Thank you to all of our partners across VA and our contracting teams who helped bring this across the finish line in time for Veterans Day.”

A bit of history: The web ecosystem for information on veterans benefits has for some time been fractured and complex, with hundreds of different sites dedicated to different pieces of the puzzle. VA.gov, the centerpiece, has historically focused on the agency itself — a place for announcements from the Secretary, mission statements and media information. This is generally not what a veteran needs most.

This reality is what led to the launch of Vets.gov in 2015 — a central portal for housing assistance information, health benefits, a new Appeals Status tool and much more. Vets.gov was, in may ways, a success. The site was recently getting as many as 1.8 million users per month, and in October, Jacobs won a Service to America Medal for her work on the project.

Now, Vets.gov and all its tools have a new home on VA.gov — the agency’s primary web address.

The site now “consolidates information and places it in one easy to navigate location,” Secretary Robert Wilkie said in an introduction video.

“I’ve said it many times and I’ll say it again: my main priority as Secretary is simple — to give our customers the best possible experience the minute they encounter VA,” Wilkie said. “Today, we’re doing just that with the new VA.gov — the new online front door of your Department of Veterans Affairs.”

The word “customer” here speaks volumes about how the VA is trying to reformat and recast itself. Vets.gov and VA.gov were both created using user-centered design, but it’s not just about development methods. “It has to be that everyone here has that customer experience mindset,” DSVA lead Jacobs told FedScoop in a recent interview.

“We’re a customer experience organization,” she added.”

https://www.fedscoop.com/va-digital-service-unveils-new-va-gov-time-veterans-day/

 

 

Minnesota Veterans Home Hastings and The State’s Growing, Progressive Program for Veterans Care

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Panoramic Photo Tour – MN Vets Home Hastings – Use “Open Index Feature”

Editors Note:  I enjoyed participating in the following podcast featuring the veterans community in which I have resided for the last 11 years.  With 3 more homes on the horizon in Bemidji, Monticello and Preston, adding to the existing 5 vets homes in  the state, Minnesota is at the forefront of health care for its military veterans.  

Ken Larson 


“Minnesota Military Radio”

“This week we meet with the Minnesota Department of Veterans Affairs and learn about the Minnesota Veterans Homes, discuss Military and Absentee Voting with Secretary of State Steve Simon, find out about the upcoming Nearly Naked Ruck March and get an update from our County Veteran Service Officer. Guests include:

Podcast link: (Turn On Your Computer Sound) Minnesota Military Radio

https://rosecoveredglasses.blogspot.com/2018/10/minnesota-veterans-home-hastings-and.html

U.S. Veterans Hospitals Quality Ratings FY 2018

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VA Ratings

U.S. DEPARTMENT OF VETERANS AFFAIRS”

“The Veterans Health Administration uses a comprehensive performance improvement tool called Strategic Analytics for Improvement and Learning (SAIL). SAIL is developed for the VA to drive internal system-wide improvement.

Many of the metrics on SAIL are not publicly reported by non-VA hospitals and health systems.  Therefore, it is not appropriate to directly compare evaluation findings derived from SAIL with results from public and private sector hospitals. “


“The metrics are organized into 9 Quality domains and one Efficiency and Capacity domain.  The Quality domains are combined to represent overall Quality.  Each VA medical center is assessed for overall Quality from two perspectives: (1) Relative Performance compared to other VA medical centers using a Star rating system from 1 to 5 and (2) Improvement compared to its own performance from the past year.  Both relative performance and size of improvement are used to guide improve efforts.

In 2018 66% (96 out of 146) of VA Medical Centers Reported on SAIL Showed Improvement Compared to Their Baseline One Year Earlier.

The table below displays relative performance in star rating in the third column and size of improvement in arrows in the fourth column that indicate whether medical center performance has improved, stayed the same or declined over the past year.

VISN Medical Center Relative Performance
Star Rating (1 to 5)
Improvement From
Baseline Scores 2017
2 Albany 3  ↑↑
22 Albuquerque 2  ↑
16 Alexandria 2
4 Altoona 4
17 Amarillo 4 ↑↑
20 Anchorage 3
10 Ann Arbor 3
6 Asheville 5 ↑↑
7 Atlanta  1
7 Augusta  2
5 Baltimore 3
2 Bath 5
10 Battle Creek 2 ↑↑
8 Bay Pines 3
5 Beckley 2
1 Bedford 5
17 Big Spring 1 ↑↑
7 Birmingham 4
20 Boise 3
1 Boston 4
2 Bronx 4
2 Brooklyn 3
2 Buffalo 4 ↑↑
4 Butler 5
2 Canandaigua 4 ↑↑
23 Central Iowa 4
7 Charleston 4
19 Cheyenne 2
12 Chicago 3
10 Chillicothe 4
10 Cincinnati 5
5 Clarksburg 4 ↑↑
10 Cleveland 5
4 Coatesville 5
15 Columbia MO 3
7 Columbia SC 2
10 Columbus 4
1 Connecticut 5
17 Dallas 2 ↑ 
12 Danville 3
10 Dayton 3
19 Denver 2
10 Detroit 3
7 Dublin 3 ↑↑
6 Durham 3
2 East Orange 2
17 El Paso 1 ↑↑
4 Erie 5
23 Fargo 4
16 Fayetteville AR 3
6 Fayetteville NC 2
23 Fort Meade 3
10 Fort Wayne 2
21 Fresno 2
8 Gainesville 3
19 Grand Junction 4
16 Gulf Coast HCS 2
6 Hampton 2
17 Harlingen 2 ↑↑ 
12 Hines 3
21 Honolulu 2
23 Hot Springs 5 ↑↑
16 Houston 3
2 Hudson Valley 3
5 Huntington 4 ↑↑
10 Indianapolis 3 ↑ 
23 Iowa City 3
12 Iron Mountain 5
16 Jackson 2 ↑↑
15 Kansas City 2
8 Lake City 2
21 Las Vegas 2 ↑↑
15 Leavenworth 4
4 Lebanon 5
9 Lexington 4
16 Little Rock 3 ↑↑
22 Loma Linda 1
22 Long Beach 2
22 Los Angeles 3
9 Louisville 3
12 Madison 5
1 Manchester 3
15 Marion IL 2
5 Martinsburg 2
9 Memphis 1
8 Miami 3
12 Milwaukee 3
23 Minneapolis 4
19 Montana 2
7 Montgomery 1
9 Mountain Home 4
9 Murfreesboro 2
19 Muskogee 2
9 Nashville 2
16 New Orleans 3
2 New York 4
12 North Chicago 4
1 Northampton 5 ↑↑
2 Northport 3
19 Oklahoma City 2
23 Omaha 4
8 Orlando 3
21 Palo Alto 2
5 Perry Point 3 ↑↑ 
4 Philadelphia 3
22 Phoenix 1
4 Pittsburgh 4
15 Poplar Bluff 3
20 Portland 3 ↑↑ 
22 Prescott 2
1 Providence 3
20 Puget Sound 2 ↑ 
21 Reno 3
6 Richmond 4
20 Roseburg 2
21 Sacramento 3 ↑↑
10 Saginaw 5 ↑↑
6 Salem 5
6 Salisbury 3
19 Salt Lake City 3
17 San Antonio 3 ↑↑
22 San Diego 3
21 San Francisco 3 ↑ 
8 San Juan 2
19 Sheridan 4 ↑↑
16 Shreveport 3
23 Sioux Falls 4
20 Spokane 3 ↑↑ 
23 St Cloud 5
15 St Louis 3
2 Syracuse 3
8 Tampa 4
17 Temple 3
1 Togus 5 ↑↑
12 Tomah 3
15 Topeka 3
22 Tucson 1
7 Tuscaloosa 3 ↑ 
20 Walla Walla 2 ↑↑
5 Washington 1
8 West Palm 3 ↑↑
20 White City 3 ↑↑ 
1 White River 3 ↑ 
15 Wichita 4
4 Wilkes Barre 3
4 Wilmington 3 ↑↑

*Note: Improvement From Baseline: ↑↑ – Large Improvement; ↑ – Small Improvement; →: Trivial Change; ↓: Large Decline”

https://www.va.gov/QUALITYOFCARE/measure-up/End_of_Year_Hospital_Star_Rating_FY2018.asp

“MILITARY TIMES”

” Veterans Affairs officials claimed improvements at 66 percent of their medical centers across the country last fiscal year, with 18 earning the highest level of excellence in the department’s internal ratings system.

But nine others remain on the VA’s list of underperforming facilities after getting the lowest possible rating. They include the embattled Washington VA Medical Center, which sits just a few miles from the White House and has seen a series of leadership shake-ups in recent years.

The VA ratings — made public in 2016 after a USA Today report on the internal scorecards — grade each of the locations on metrics like patient mortality, patient length of stay, reported accidents and patient satisfaction. Officials have said the system is used to collect best practices from high-performing facilities to use in underperforming ones.

In a statement, VA Secretary Robert Wilkie touted improvements across the 146 medical centers.

“With closer monitoring and increased medical center leadership and support, we have seen solid improvements at most of our facilities,” he said. “Even our highest performing facilities are getting better, and that is driving up our quality standards across the country.”

The number of one-star facilities dropped by six from the start of fiscal 2018 to the end. Of the nine medical centers still at that level, four were cited for significant improvements: El Paso and Big Spring in Texas, Memphis in Tennessee, and Loma Linda in California.

The five others — Washington, Phoenix and Tucson in Arizona, Montgomery in Alabama, and Atlanta in Georgia — saw no overall change.

Earlier this year, VA placed 12 medical centers on a high-risk list for “aggressive” management intervention. Of those, eight were removed from the program after showing sufficient improvement by the end of last month.

Wilkie said while he is pleased with the results thus far “there’s no doubt that there’s still plenty of work to do.”

 

https://www.militarytimes.com/news/2018/10/04/here-are-the-best-and-worst-va-medical-centers/

 

Who’s Really Accountable For Interoperability Between DOD And The VA On E-health Records System?

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VA Maze

“FEDSCOOP”

“The departments of Defense and Veterans Affairs both have billion-dollar modernizations in progress for their electronic health record systems. And they’ve each identified who is accountable for the success of those programs.

But the more important question might be: Who is ultimately accountable for seeing that the EHR systems, when fully developed, work together seamlessly as members of the military retire and becomes veterans?”


“House lawmakers pressed this point this week during the first hearing held by the Veterans Affairs’ Subcommittee on Technology Modernization. They examined the role of the DOD/VA Interagency Program Office (IPO), stood up in 2008 for the exact purpose of ensuring seamless transfer of records. So far, though, that office has no real authority over the interoperability of the two programs —VA’s EHR Modernization and DOD’s MHS GENESIS, both of which are based on Cerner’s commercial EHR platform.

Lauren Thompson, the head of the office, told lawmakers that despite the intention of the 2008 National Defense Authorization Act to make the IPO the single point of accountability for the interoperability of the two departments’ EHRs, “at this point in time, we make recommendations. We do not have the decision-making authority.” IPO is based within DOD.

According to the law, said Carol Harris, director of IT management issues for the Government Accountability Office, “the IPO is supposed to be the single point of accountability. So that would include responsibility, authority and decision-making responsibilities. I think that [the office’s current operation, as described by Thompson], is in conflict with the expectation set out by law.”

The departments and the IPO are trying to sort out the interoperability governance now that VA and DOD each has a massive EHR in development. Though they both are developing instances of the same Cerner platform so that interoperability will be easier to achieve, there are still myriad technical and functional decisions that must align so that the data ultimately matches as it flows from one system to the next. VA, DOD and the IPO are in the process of developing new governance bodies and a new structure with the hope that things can be dealt with at the lowest level possible.

“Clinicians talking to clinicians, technicians talking to technicians,” said John Windom, VA’s acting chief health information officer and program executive officer for the new Office of Electronic Health Record Modernization. When disagreements happen, the issues are elevated to new governance boards, but the goal is to avoid that, he said.

Windom explained that the governance process is “evolving,” and it will take time to get there. “The as-is state of the enterprise with the VA is different than the as-is state of the enterprise within DOD. … Now we’re understanding the gaps between how we sought to implement and how DOD is implementing. And so those gaps have to be reconciled, and they have to be reconciled through governance.”

But even with that model, lawmakers were unhappy because there is no single person or organization accountable. “There’s really no one there to break the ties or resolve the differences,” Rep. Scott Peters, D-Calif., said, pushing for action from the president or Congress to spark the change. “The only person both agencies report to now is the president of the United States.”

Rep. Mike Coffman, R-Colo., said perhaps there’s a place for the IPO in the process, but either the DOD or VA should be given the ultimate decision-making authority.

Harris agreed that a “single executive-level entity that is the point of accountability” with decision-making authority and that binds both departments at the deputy secretary level or higher is “essential.”

She doesn’t have much faith in the IPO, though, at least in its current form — and really for no fault of its own.

“They never had to clout to mediate and resolve issues between DOD and VA,” Harris said. “The IPO was never set up to succeed there because neither of the departments were willing to relinquish control.”

Harris called the IPO’s ability to drive the necessary interoperability “lackluster” in the past decade. “In the past situations, what we’ve seen historically is that when everyone is responsible, no one is responsible. I think that’s what has led us to where we are today,” she said. “Accountability has been so diffused so that when the wheels fall off the bus, you can’t point to a single entity who’s responsible. And that’s a problem.”

https://www.fedscoop.com/dod-va-ehr-interoperability-hearing/

Veterans Administration Says One In 10 Department Jobs Is Unfilled

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Unfilled VA Jobs

“MILITARY TIMES”

“More than 45,000 department posts are currently unfilled, with about 40,000 in the Veterans Health Administration alone, according to new data released by the department last week.

The rate was even higher among VA staff offices, with more than 2,500 vacancies, nearly 17 percent of the budgeted management posts.”


“More than one in 10 Veterans Affairs jobs is currently unfilled, a vacancy rate being downplayed by department officials but likely to raise serious worries among lawmakers who have already voiced concerns about a lack of medical professionals for veterans programs.

The figures were touted as another step toward transparency in federal government by VA officials, but were mandated to be made public by Congress in the recently passed VA Mission Act. The data was released just before 5 p.m. on the Friday before the extended Labor Day holiday weekend.

VA officials also called the information release positive news for their department, since it shows their employee turnover rates “compare favorably with other large cabinet-level agencies.”

But the number of vacancies — roughly 11 percent of the department’s workforce — is almost 10,000 higher than total open positions reported by VA officials.

For months, Democratic lawmakers have said the rising number of vacancies threatens to undermine VA care and services, and have criticized department leaders for not doing enough to fill the roles.

They have also pressed Republican colleagues to require VA fill many of those open positions before expanding care options outside the VA system, arguing that not properly staffing hospitals and clinics undermines the department’s ability to handle veterans’ medical needs.

In a statement, VA said their health systems’ “workforce challenges” mirror that of the larger American health care industry.

“There is a national shortage of healthcare professionals, especially for physicians and nurses,” officials said. “VHA remains fully engaged in a fiercely competitive clinical recruitment market.”

The department also issued a pre-emptive rebuttal to critics of the staffing issues, calling them in line with other large health care systems and that “the best indicators of adequate staffing levels include veteran access to care and health care outcomes, not vacancies.”

t his confirmation hearing in July, VA Secretary Robert Wilkie said he was not in favor of a “blunderbuss approach to filling the vacancies” because that could lead to a host of unqualified candidates undertaking sensitive department posts.

In a statement on Friday, Wilkie said that his department is “always looking for new ways to recruit high-quality talent, and will continue to do everything we can to provide the best quality care for our nation’s veterans.”

Lawmakers have also been critical of leadership gaps at the department. President Donald Trump has been unable to nominate a new head of VA health services since becoming president in January 2017, and numerous other top jobs have turned over in the last 20 months.”

https://www.militarytimes.com/veterans/2018/09/04/one-in-10-va-jobs-is-unfilled-leaving-gaps-in-veterans-services/

 

 

Federal and State Governments Crack Down on Bogus Veteran Charities

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Veterans Fraud Web Sites

Image:  Federal Trade Commission

“MILITARY.COM”

“The Federal Trade Commission, along with law enforcement officials and regulators from offices in every state, DC, American Samoa, Guam and Puerto Rico, announced more than 100 actions and a consumer education initiative in “Operation Donate with Honor”.

The action was a crackdown on fraudulent charities that con consumers by falsely promising their donations will help veterans and service members.”


“You may have seen them standing outside convenience stores, those guys dressed in camo that vaguely resembles a uniform. They have signs saying claiming they are charities that help veterans. Are they legit?

Well, not all of them are.

Americans are grateful for the sacrifices made by those who serve in the U.S. armed forces,” said FTC Chairman Joe Simons. “Sadly, some con artists prey on that gratitude, using lies and deception to line their own pockets. In the process, they harm not only well-meaning donors, but also the many legitimate charities that actually do great work on behalf of veterans and service members.”

TWO CHARITIES FACE FEDERAL CHARGES

Help the Vets

Neil G. “Paul” Paulson, Sr. and Help the Vets, Inc., (HTV) will be banned from soliciting charitable contributions under settlements with the FTC and the states of Florida, California, Maryland, Minnesota, Ohio and Oregon, for falsely promising donors their contributions would help wounded and disabled veterans.

The defendants were charged with violating federal and state laws related to their actions. According to the FTC’s complaint, HTV did not help disabled veterans, and 95 percent of every donation was spent on fundraising, administrative expenses, and Paulson’s salary and benefits.

Operating under names such as American Disabled Veterans Foundation, Military Families of America, Veterans Emergency Blood Bank, Vets Fighting Breast Cancer, and Veterans Fighting Breast Cancer, HTV falsely claimed to fund medical care, a suicide prevention program, retreats for veterans recuperating from stress, and veterans fighting breast cancer.

In addition to the ban on soliciting charitable contributions, the proposed settlement order bans Paulson from charity management and oversight of charitable assets. To ensure that donors to HTV are not victimized again, HTV and Paulson must destroy all donor lists and notify their fundraisers to do so.

The order imposes a judgment of $20.4 million, which represents consumers’ donations from 2014 through 2017, when HTV stopped operating. The judgment will be partially suspended when the defendants have paid a charitable contribution to one or more legitimate veterans charities recommended by the states and approved by the court.  Paulson must pay $1.75 million – more than double what he was paid by HTV – and HTV must pay all of its remaining funds, $72,000.

Veterans of America

The FTC charged Travis Deloy Peterson with using fake veterans’ charities and illegal robocalls to get people to donate cars, boats and other things of value, which he then sold for his own benefit.

The scheme used various names, including Veterans of America, Vehicles for Veterans LLC, Saving Our Soldiers, Donate Your Car, Donate That Car LLC, Act of Valor, and Medal of Honor. Peterson allegedly made millions of robocalls asking people to donate automobiles, watercraft, real estate, and timeshares, falsely claiming that donations would go to veterans charities and were tax deductible.

In fact, none of the names used in the robocalls is a real charity with tax exempt status. Peterson is charged with violating the FTC Act and the FTC’s Telemarketing Sales Rule.

At the FTC’s request, a federal court issued a temporary restraining order prohibiting Peterson from making unlawful robocalls or engaging in misrepresentations about charitable donations while the FTC’s enforcement action is proceeding.

STATE ENFORCEMENT ACTIONS

States also identified and charged several charities and fundraisers who sought donations online and via telemarketing, direct mail, door-to-door contacts, and at retail stores. These groups falsely promised to help homeless and disabled veterans, to provide veterans with employment counseling, mental health counseling or other assistance, and to send care packages to deployed servicemembers.

Some actions charged veterans charities with using deceptive prize promotion solicitations. Others targeted non-charities that falsely claimed that donations would be tax deductible. Some cases focused on veterans charities engaged in flagrant self-dealing to benefit individuals running the charity, and some alleged that fundraisers made misrepresentations on behalf of veterans charities or stole money solicited for a veterans charity.

NATIONWIDE EDUCATION CAMPAIGN

As a result of these actions, the FTC and its state partners are launching an education campaign to help consumers avoid charity scams and donate wisely.

The FTC has new educational materials, including a video on how to research charities, and two new infographics. Donors and business owners can find information to help them donate wisely and make their donations count at FTC.gov/Charity.”

https://www.military.com/paycheck-chronicles/2018/07/27/feds-crack-down-bogus-veteran-charities.html

 

The Next $10 Billion Chapter In The Veterans Administration Health Care Systems Development Saga

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VA New System

Editors’ Note:  The story herein on “FEDSCOOP” announces the latest trip on a decades- long road of efforts by the Veteran’s Administration to connect the  health care systems of the military with those of the VA and establish state of the art records keeping for veterans.  

This sole source, non-competitive, contract award to CERNER,  a commercial firm in lieu of in-house systems development  is a major change in approach from past efforts that have cost billions and led to shut downs and start overs. 

Having seen these types of government systems management challenges from the inside for over 4 decades I find myself sincerely doubting that both the scope and the price tag are final.   For historical perspective, please see: 

A VETERAN CONNECTS THE DOTS IN THE MILITARY AND VETERANS HEALTH CARE SYSTEMS MAZE   

Ken Larson

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“FEDSCOOP”

“The Department of Veterans Affairs announced Thursday that it has officially signed a contract with Cerner for a new electronic health record (EHR) system.

The inked contract is worth up to $10 billion over 10 years.

“With a contract of that size, you can understand why former Secretary [David] Shulkin and I took some extra time to do our due diligence and make sure the contract does what the President wanted,” acting Secretary Robert Wilkie said in a statement. “President Trump has made very clear to me that he wants this contract to do right by both Veterans and taxpayers, and I can say now without a doubt that it does.”

The new EHR will be “similar” to that used by the Department of Defense, which will allow patient data will be “seamlessly” shared between the two. This has been a major pain point with the Department’s current EHR, the Veterans Information Systems and Technology Architecture, or VistA.

Wilkie reiterated Shulkin’s comments, from March, that the VA will learn from some of the DOD’s challenges in deploying its new EHR, known as MHS Genesis, and will not fall prey to the same pitfalls, which have plagued early pilots of the system and led to a report calling it “neither operationally effective nor operationally suitable.”

“VA and DoD are collaborating closely to ensure lessons learned at DoD sites will be implemented in future deployments at DoD as well as VA,” Wilkie said. “We appreciate the DoD’s willingness to share its experiences implementing its electronic health record.”

“Signing this contract today is an enormous win for our nation’s Veterans,” Wilkie said. “It puts in place a modern IT system that will support the best possible health care for decades to come. That’s exactly what our nation’s heroes deserve.”

However big an announcement this may be, actual rollout of the new EHR will take time. At an event in January, former VA CIO Scott Blackburn told the crowd to expect another 10 years of VistA.”

https://www.fedscoop.com/va-ehr-cerner-10-billion-robert-wilkie/