VETERANS AFFIARS SAYS SHORTER HOSPITAL STAYS BETTER FOR PATIENTS

FROM: U.S. DEPARTMENT OF VETERANS AFFAIRS
Shorter Hospital Stays Are Better for Patients, VA Finds

A shorter stay in the hospital can actually be more beneficial to you than a longer stay, according to a recent VA study that appeared in the December 18, 2012 issue of Annals of Internal Medicine.

"This study shows that a large health care system like VA can improve both quality and efficiency to provide better, more cost-effective care," said Dr. Peter Kaboli, a hospitalist at the Iowa City VA Health Care System and the study’s lead researcher. "Ultimately the focus should not be how long a patient is in the hospital, but ensuring they get the care they need as efficiently as possible and get them out of the hospital as soon as they are ready."

Kaboli and his research team came to this conclusion after examining the records of over four million Veterans hospitalized at 129 VA medical centers between 1997 and 2010.

"People come to the hospital for all kinds of medical conditions, so for our study we looked at everybody," the researcher said. "But we also zeroed in on some of the more common health issues like heart failure and pneumonia."

As the study progressed, an interesting pattern began to emerge: hospital stays at VA decreased by almost 30 percent over a period of about 14 years.

"We initially thought this might translate into higher readmission rates and death rates," Kaboli said. "It turned out to be just the opposite: readmission rates went down by 16 percent. Death rates went down by three percent."

"Creative research of this nature is a major factor leading to continuous improvement of the medical services we provide to our Nation’s Veterans."

— Dr. Joel Kupersmith, VA Chief Research & Development Officer

The take-away from all this? "The individual needs to be in the hospital for as long as it takes to address their medical issues, and no longer," Kaboli observed. "Everyone is different…one patient might be able to go home within 48 hours. Another patient might not be able to go home for five days."

Kaboli said VA’s success in lowering readmission rates while simultaneously reducing hospital stays points to an increased level of efficiency. He attributes this increased efficiency to three big factors.

"First, throughout VA we’ve been working hard on improving the coordination that occurs between the hospital and our outpatient services," he explained. "Successfully transitioning out of the hospital into outpatient care is so critical. The patient’s health and well-being depend on this transition being done correctly.

"Second," he continued, "we’re working hard on constantly improving the quality of the care we provide. For example, care at VA is now delivered by Patient Aligned Care Teams — a team of specialists who coordinate closely with one another regarding the patient’s case. The patient is a big part of this team."

The third big factor? Specialization.

"VA has adopted the use of hospitalists at over 80 percent of our medical centers," Kaboli said. "Hospitalists are physicians who specialize in the care of hospitalized patients. Care delivered by hospitalists has been shown to be more efficient and can result in higher quality health care."

Kaboli said quality health care occurs when everyone — the patient, the patient’s family, and hospital staff — are communicating with one another.

"In the end," he said, "it’s all about listening to the patient so we can determine what their needs are, what their goals are. The patient needs to be at the center of the whole process."

A CITY WORKS TO END VETERAN HOMELESSNESS

Photo:  U.S. Air Force.

FROM: U.S. DEPARTMENT OF DEFENSE

New Orleans Works to End Veteran Homelessness
By Claudette Roulo
American Forces Press Service

NEW ORLEANS, Jan. 18, 2013 – In 2009, the same year the Volunteers of America of Greater New Orleans Veteran’s Transitional Facility opened, President Barack Obama and the Veterans Affairs Department set a goal to end veteran homelessness by 2015.

Lisa Battaglia, wife of the senior enlisted advisor to the chairman of the Joint Chiefs of Staff, visited the facility here yesterday and spoke to American Forces Press Service after visiting with residents and staff.

"As a woman veteran myself, finding ways in getting our veterans off the streets remains a priority for my husband and me," she said.

The facility arose out of a need for ways to assist homeless veterans transition out of homelessness, said Melissa Haley, director of supportive services for veteran families for Volunteers of America.

Its existence is a sign that people in the greater New Orleans area, as in cities across the country, have taken the president’s call to action to heart, Battaglia said.

Around 400 veterans have come through the transition program since the facility opened, said Gerald Rooks, the program director. About 88 percent successfully completed it, meaning they are permanently off the streets, he said. "We try every day to increase that number," he added.

Veterans arrive at the facility in a number of ways, Rooks said. The staff seeks out veterans at places where the homeless gather, he said, but veterans can either self-refer or be referred by the VA.

Norman Adams, a Navy veteran residing at the facility, said he found the transitional facility through the staff’s outreach program.

"I retired from nursing after 45 years," Adams said. "I lived a pretty good life until it just went off the road."

After several months of homelessness -- during which he made his way to New Orleans -- outreach personnel told him about the transitional facility.

"This is where I belong right now. … I’m going to move on," he said, "but I want to be right when I move on."

The main facility has space to house up to 40 male veterans, while two other locations can house a total of 16 men. Currently, residents range in age from 34 to 68, Rooks said.

"We’re starting to see younger vets," he added, noting that four homeless veterans in their 20’s have sought assistance from the program in the past 12 months.

Rooks said he’s also seen an increase in female veterans with children seeking assistance through the facility’s non-resident programs. He added that there are only 5 beds in all of New Orleans available to female veterans, and they don’t accept children.

The term "homeless veteran" should be an oxymoron, Haley said.

"When you’re a veteran, you have a home," she said. "This is America, this is your community." Her goal, she said, is to ensure veterans are homeless for as short a period of time as possible.

The organization works closely with the city of New Orleans and the New Orleans regional Veterans Affairs office to find funding, educational opportunities, employment and housing for veterans, Rooks said.

Programs for residents include life skills classes like resume writing and money management, peer and group counseling and assistance with obtaining benefits from the VA, he said.

"I get to help fallen heroes get back on their feet," he said.

"We are committed to working with people who hire veterans," Haley said, "because we know that [veterans] have transferrable skill sets."

"I’d hate to see what it would be like if the program wasn’t here for others," said Wayne Duvall, an Army veteran residing at the transitional facility. "I’m prepared to make that transition … and get out."

"When I first came here, it was just a hideout … I’d just get lost in the background," said Adams. But the staff helped him get on track, he said, and he has reconnected with his family and found a place to volunteer his time.

"Those who have served this nation as veterans should never find themselves on the streets, living without care and without hope," VA Secretary Eric K. Shinseki said when he announced an initiative in 2011 highlighting local services for homeless veterans, their families and those at risk of becoming homeless.

THE RIGHT STUFF: FROM HEROS TO JOB CREATORS

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS

Heroes on the Homefront: New Report Highlights Veterans as Job Creatorsby Marie Johns
 
I’m excited to announce the release of a report by the Interagency Task Force on Veterans Small Business Development called "Heroes on the Homefront: Supporting Veteran Success as Small Business Owners." This is the second report of its kind where task force members from seven agencies have come together to collaborate on small business issues that are unique to Veteran business owners.

The U.S. Small Business Administration (SBA) believes that two of America’s greatest assets are the service of our returning veterans and the economic dynamism of our small businesses. It is no secret that entrepreneurs and small businesses are the engines of American innovation and economic prosperity. For example, our nation’s 28 million small firms employ 60 million Americans, or half of the private sector workforce, and they are responsible for creating 2 out of 3 net new private sector jobs across the country. And, these numbers are even better when looking at Veteran Owned Small Businesses:
U.S. military veterans own 2.4 million businesses, or nearly 1 in 10 of all businesses nationwide. 8.3 percent of veteran business owners have service-connected disabilities.
Veteran-owned businesses generate $1.2 trillion in receipts and employ nearly 5.8 million people.
In the private sector workforce, veterans are at least 45 percent more likely than those with no active-duty military experience to be self-employed.
The focus of this year’s report, the Task Force’s second, is to provide updates on the 18 recommendations that were made in last year’s report. The recommendations are organized around three priority areas for engaging the Federal government: (1) Increase Opportunities for Growth; (2) Improve and Expand Counseling and Training Services; and (3) Reduce Barriers to Growth and Improve Coordination and Efficiencies.

We are pleased to report great progress has been made since the Task Force’s initial review. In FY 2012, the Task Force, along with the interagency Veterans Employment Initiative, developed and piloted a re-designed military transition program, entitled Transition GPS, that includes an entrepreneurship training program called "Operation Boots to Business: from Service to Startup." This program is expected to be rolled out nationally in the coming year. The Task Force has also worked to streamline programs and cut paperwork for veteran small businesses through support for initiatives such as BusinessUSA and QuickApp for surety bonds and it has continued the efforts begun last year to make the process of winning Federal government contracts simpler and easier for service-disabled veterans and veteran-owned small business.

We know that our nation’s veterans helped reshape the American economy following World War II. They helped to build one of the longest periods of economic growth in our country’s history. And we know they can do it again if they are simply given the right tools and the right opportunities.

That’s why the SBA and the entire Obama Administration is committed to ensuring that these amazing men and women have the access and opportunity they need to fully realize their potential as entrepreneurs and small business owners.

These men have women have served our country so well. And as they begin this next chapter in their lives, we are prepared to be with them every step of the way.

Marie Johns is Deputy Administrator of the U.S. Small Business Administration. She is responsible for management and oversight of the agency, and leads the agency’s efforts to reach underserved communities.

U.S. SECRETARY OF DEFENSE PANETTA MAKES COMMENTS ON SYRIA AND SEQUESTRATION

Defense Secretary Leon E. Panetta poses for photos with the U.S. Naval Academy Midshipmen cheerleaders and band during a pep rally held in the halls of the Pentagon, Dec. 6, 2012. DOD photo by U.S. Navy Petty Officer 1st Class Chad J. McNeeley

FROM: U.S. DEPARTMENT OF DEFENSE

Panetta Discusses Syria Situation, Sequestration
By Terri Moon Cronk
American Forces Press Service
WASHINGTON, Dec. 6, 2012 - Defense Secretary Leon E. Panetta today repeated the U.S. government's growing concern that Syrian forces loyal to President Bashar Assad may be preparing to use chemical weapons on their own people.

Without getting into specific intelligence, Panetta told reporters at a news conference at the Department of Veterans Affairs there is no question that "as the opposition advances, in particular in Damascus, that the [Assad] regime might very well consider the use of chemical weapons." He added that what the U.S. knows "raises series concerns that this is being considered."

Panetta's comments came three days after President Barack Obama warned the Assad regime that there would be consequences for such a move, and that Assad himself would be held accountable.

Today, Panetta expanded on that warning.

"The president has made very clear that the Assad regime ought not to make the mistake of thinking that somehow it can use chemical weapons on its own people and get away with that. The whole world is watching," the defense secretary said.

Panetta said he would not comment on the consequences if Assad were to use weapons of mass destruction.

"But I think it's fair enough to say that the use of those weapons would cross a red line for us," he added.

The warnings to the Assad regime come as reports suggest opposition forces are closing in on Damascus and that the nearly two-year-old civil war is increasingly threatening Assad's inner circle.

On another matter, Panetta was asked today about the impact of sequestration on defense programs, should it occur.

"There is no question that if sequestration happens, it will impact those who are coming home [from the wars in Iraq and Afghanistan]," he said. "It's going to impact on what we're going to be able to provide them."

Panetta compared the automatic budget cuts triggered by sequestration to a "meat-axe approach."

If implemented, sequestration would "have a serious impact in terms of those [service members] coming home, the programs that serve them, the support system that we have not only for them, but for their families," he added.

"It's for that reason, obviously, that our continuing hope is that the leadership in this country comes together and finds an agreement that avoids this deficit cliff that we're hanging on," Panetta said.

NEARLY A QUARTER OF VETERANS RECEIVING VA CARE HAVE DIABETES



Credit:  U.S. Department Of Veterans Affairs

FROM: U.S. DEPARTMENT OF VETERANS AFFAIRS

American Diabetes Month — Time to Take Action

Nearly one in four Veterans receiving care from VA has diabetes.
This is partly attributable to the older average age of Veterans compared to the general US population. Veterans should know all the risk factors listed in the box on the right.

The Centers for Disease Control and Prevention estimate that nearly 26 million people, or about 8 percent of the US population, have diabetes.

That includes about 11 million persons 65 and older, or about 27 percent of seniors.

In the United States, about one-in-four persons with diabetes are not aware that they have the condition.

While exact numbers are not available, it is likely that the number is lower for Veterans receiving regular VA primary care.

However, many Veterans of all ages are at risk for diabetes because of the high rate of obesity and those who are overweight, estimated at over 70 percent of Veterans receiving VA care.

Weight Loss and Physical Activity

An individual does not have to achieve drastic weight loss. Losing about five percent of one’s weight will help.

In recent studies, a weight loss and exercise program was more effective than medication in both younger and older individuals. The medication was not effective in persons older than 60.

The VA’s MOVE! Weight Management Program is available to all Veterans who are overweight or obese and for whom weight management is appropriate. It supports Veterans in developing plans that work for them to lose or maintain weight through balanced diet, physical activity, and behavior change approaches.

For the MOVE! program to be tailored to the individual’s needs, the Veteran can complete a 23 item questionnaire. More information is available at www.move.VA.gov.

Diabetes and Agent Orange

Diabetes mellitus type 2 is one of the diseases VA presumes is associated with exposure to herbicides, such as Agent Orange. Veterans who were exposed to Agent Orange do not have to prove a connection between their type 2 diabetes mellitus and military service to be eligible for VA benefits. Healthy eating habits and exercise can help prevent this chronic disease.

Visit the Agent Orange home page to learn more about Agent Orange and VA benefits.

VA APPROVES $28 MILLION IN GRANTS FOR HOMELESS VETS

New York Mayor Michael Bloomberg, center, and retired Army Gen. David H. Petraeus, director of the CIA, salute a crowd during the Veterans Day Parade in New York, Nov. 11, 2011. U.S. Army photo by Staff Sgt. Teddy Wade

　
FROM: U.S. DEPARTMENT OF VETERANS AFFAIRS
VA Approves $28 Million in Grants for Homeless Veterans
From a Department of Veterans Affairs News

WASHINGTON, Sept. 19, 2012 - The Department of Veterans Affairs today announced it has approved $28.4 million in grants to fund 38 projects in 25 states and the District of Columbia that will provide transitional housing to homeless veterans.

Among these 38 projects, 31 will provide temporary housing to homeless veterans with the goal that they will retain the residence as their own.

"As we drive toward our goal to end homelessness among veterans by 2015, VA continues to find innovative ways to permanently house veterans who were formerly homeless," said Veterans Affairs Secretary Eric K. Shinseki. "Under President [Barack] Obama's leadership, we have made incredible strides in creating programs to aid these brave men and women who have served our Nation so well."

Thirty-one of the grants were awarded through VA's Homeless Providers Grant and Per Diem Program's "Transition in Place" model. The program allows veterans the opportunity to take over payment of a lease instead of moving out after using VA services—substance use counseling, mental health services, job training and more. Other VA programs require veterans living in transitional housing to move out after 24 months.

GPD helps close gaps in available housing for the nation's most vulnerable homeless veterans, including women with children, Native American tribal populations, and veterans with substance use and mental health issues.

Those receiving funding have undergone a rigorous review by teams of experts rating each application under objective criteria to ensure that those funded have the ability to provide the services described and a solid plan to get these Veterans into housing with a high probability of obtaining residential stability and independent living.

"Securing permanent housing is a vital step in the journey of our homeless Veterans," said Dr. Susan Angell, executive director for VA's Veterans Homeless Initiative. "This is the last piece of the puzzle, and it is crucial for them in continuing to lead independent lives."

Community-based programs funded by GPD provide homeless veterans with support services and housing. GPD grants are offered annually as funding is available by VA's National Homeless Program.

Lisa Pape, national director of homeless programs for the Veterans Health Administration which oversees GPD said VHA's focus is creating and strengthening community services around the country so that homeless Veterans get the support they need.

"Our focus is creating a team of community support -- pairing a variety of services, such as mental health support, employment assistance and job training with the essential component of housing," Pape said. "Whether it is aid in overcoming substance use or finding a job, a community helping hand is exactly what these veterans need to lead a better quality of life."

On a single night in 2011, a national count of homeless veterans totaled 67,495, which is 12 percent lower than 76,000 in 2010. As part of the government's five-year plan to eliminate veteran homelessness by 2015, VA has committed almost $1 billion to strengthen programs that prevent and treat the many issues that can lead to veteran homelessness.

The award of grants follows closely with a notice VA published asking interested organizations to submit a nonbinding letter of intent to the Supportive Services for Veteran Families Program to apply for initial and renewal supportive services grants by Sept. 28, 2012. The SSVF Program in the first 10 months of operation has assisted more than 28,000 veterans and their families to prevent or rapidly end homelessness.

VA INSTALLS NEW ENVIRONMENTAL MANAGEMENT SYSTEM AT CENTRAL OFFICE

FROM: U.S. DEPARTMENT OF VETERANS AFFAIRS

System Will Provide $3.5 Million in Savings

WASHINGTON – The Department of Veterans Affairs recently completed the installation of a sophisticated Environmental Management System (EMS) at its central office, which will provide an estimated $3.5 million in savings over the next five years.
　
"At VA, we strive to be a leader in promoting energy conservation and reducing our environmental footprint," said Secretary of Veterans Affairs Eric K. Shinseki. "It is part of fulfilling our financial responsibilities, and it’s the right thing to do."
　
In 2009, the White House issued executive orders to set sustainability goals for federal agencies to improve their environmental, energy and economic performance. In support, VA established an initiative for using emerging technologies to understand energy demands and help manage complex energy data for day-to-day and strategic goals.
　
"EMS provides us an opportunity to reduce our energy use, save taxpayer money, and create a model for energy management across disparate facilities in the Federal government," said Assistant Secretary for the Office of Information and Technology Roger Baker. "Information technology can play a valuable role in adapting performance data to simple, actionable visualizations for short-term and long-term change in energy management."
　
The EMS installation at VA’s central office is illustrative of a larger initiative to enhance energy management across the National Capital Region. The system collects and reports 3,000 energy data points every 10 seconds, including main electrical and water services, lighting, plug loads, air conditioning, cooling towers, motors and chillers. The system analyzes these data in real-time to identify usage patterns, and allow for credible forecasting of potential cost-savings scenarios.
　
"In a fiscally-constrained environment, the need to closely monitor energy consumption is not only a good idea, it’s a business imperative," said Assistant Secretary for the Office of Human Resources and Administration (HRA) John U. Sepúlveda. "The initiative has afforded VA central office the opportunity to be the forerunners in process improvements as we identify areas to cut waste and reduce energy consumption. Great strides have already been made in this area, but more can be done."
　
EMS is a partnership between two offices within the VA - Information and Technology and HRA - and the General Services Administration (GSA).
　
The VA EMS is easily adaptable for use by other government agencies, especially those with large building portfolios such as GSA and the Department of Defense. In particular, VA’s 94-year-old central office location is a case study on how information technology and building facilities can work together to reduce energy consumption and maintenance cost in older government buildings.

STUDY FINDS PROSTRATE SURGERY MAY NOT INCREASE LONGEVITY



FROM: U.S. DEPARTMENT OF VETERANS AFFAIRS
Men Treated Surgically Have No Greater Lifespan in 15-Year Follow-UpWASHINGTON -- A major federal study led by the Department of Veterans Affairs found no difference in survival between men with early-stage prostate cancer who had their prostate surgically removed and those who were simply watched by their doctors, with treatment only as needed to address symptoms if they occurred.

"The study results have significant implications for a great number of Veterans in our care," said Secretary of Veterans Affairs Eric K. Shinseki. "This study is a prime example of how VA’s research program is advancing medical knowledge in areas that are top priorities for Veterans."

The findings appeared in the July 19 issue of the New England Journal of Medicine.

"Our data show that observation provides equivalent length of life, with no difference in death from prostate cancer, and avoids the harms of early surgical treatment," said lead author Dr. Timothy Wilt. Wilt is with the Center for Chronic Disease Outcomes Research at the Minneapolis VA Medical Center, and the University of Minnesota.

The randomized trial involved 731 men and took place at 44 VA sites and eight academic medical centers nationwide. Eligible trial participants voluntarily agreed beforehand that to take part in the study they would be randomly assigned to one treatment or the other.

Known as the Prostate Cancer Intervention Versus Observation Trial, or PIVOT, the study was conducted and funded by VA’s Cooperative Studies Program, with additional funding from the National Cancer Institute and the Agency for Healthcare Research and Quality.

The first trial group had a radical prostatectomy—surgical removal of the walnut-sized prostate. Surgery is generally performed in the belief it can lower the risk of prostate cancer spreading and causing death. Evidence had been lacking as to the treatment’s effectiveness, especially for men whose cancer was initially detected only on the basis of a blood test—the prostate specific antigen (PSA) test. In most cases, these tumors are not large enough to be felt during a doctor’s exam and do not cause any symptoms.

The second trial group was the "observation group." In this approach, physicians generally do not provide immediate surgical or radiation therapy. Rather, they carefully follow men and provide treatments aimed at relieving symptoms, such as painful or difficult urination, if and when the cancer progresses and causes bothersome health problems.

The trial followed patients between eight and 15 years.

When Wilt and colleagues analyzed the results, they found no difference in death rates between the two groups, either from any cause whatsoever or specifically from prostate cancer.

In terms of quality of life for men in the study, the surgery group experienced nearly double the rate of erectile dysfunction—81 percent versus 44 percent—and roughly three times the rate of urinary incontinence—17 percent versus 6 percent. Bowel dysfunction was similar between the groups, 12 percent versus 11 percent.

Dr. Robert A. Petzel, Under Secretary for Health, said the trial "provides crucial information that will help physicians and patients make informed decisions on how best to treat prostate cancer, which affects so many Veterans who rely on VA health care."

Dr. Joel Kupersmith, VA’s Chief Research and Development Officer, added: "This trial, the largest ever comparing these two treatments, provides definitive evidence on a subject that affects millions of Veterans and all men above a certain age."

While PIVOT found no difference in overall mortality or prostate cancer deaths between the two groups for men who had cancers with a PSA value of 10 or less, the authors say there may be a survival benefit to surgery for men with PSA scores above 10, or other clinical results indicating more aggressive, higher-risk tumors.

Only about one in five men in PIVOT had tumors classified as high-risk. Wilt said this proportion is representative of U.S. men with an early-stage prostate cancer diagnosis based on PSA testing and follow-up biopsy. Prostate cancer is usually slow-growing, and most men with PSA-detected prostate cancer do not die from the disease or develop health problems related to it, even if it is not treated with surgery or radiation.

For more information on the Cooperative Studies Program and VA research overall, visit www.research.va.gov.

VETERAN UNEMPLOYMENT RATE AT 9.5 PERCENT

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS 
Post-9/11 Veteran Unemployment Rate Continues to Fall; At 9.5 Percent
July 6, 2012 by Brandon Friedman
On Friday, the Bureau of Labor Statistics released Veteran unemployment data for the month of June. The unemployment rate for one closely watched group, Iraq and Afghanistan-era Veterans (or Gulf War II-era Veterans), fell more than three full percentage points to 9.5 percent. The steadier 12-month moving average also fell to 10.7 percent—the lowest figure we’ve seen since 2010.

While much remains to be done, since January 2012, post-9/11 Veterans have experienced the lowest unemployment rate in any combined six-month period since 2008—with the rate reaching single digits in four of the last six months. Additionally, the trend over the past 30 months—since January 2010—remains downward for America’s most recent Veterans.

Month-to-month unemployment rate figures for this demographic are fairly volatile, but the long-term trend has shown a consistent decline over this two and a half-year period—a strong sign of recovery following the worst economic disaster since The Great Depression.

Because chunks of data are often better indicators of real movement, another way to view the trend is by looking at the moving (or rolling) average. The chart below captures 12-month averages for the periods ending each month since December 2010. This chart looks a bit different, but the trend is similar: modest, but markedly downward. This is significant because the moving 12-month average is far more conservative than the month-to-month data. When we see downward movement in the moving average, we can be confident that the unemployment rate among post-9/11 Veterans is, indeed, falling. 

All that said, while we’re heartened that the unemployment rate among younger Veterans has fallen over the long term, it is still too high as long as thousands of returning Veterans still can’t find meaningful work.

That’s why VA is collaborating with the White House and the Chamber of Commerce on hiring fairs across the country through the “Hiring Our Heroes” Program. It’s also why we’re urging Veterans to prepare themselves for the job market by taking advantage of programs like the Post-9/11 GI Bill and the Veterans Retraining and Assistance Program (VRAP).

If anything, today’s positive figure reminds us that there’s still much work to be done. VA, in conjunction with the White House, remains committed to ensuring that the unemployment rate for all Veterans continues its downward path.

UNEMPLOYMENT AMONG POST-9/11 VETS

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS
The Latest on Unemployment Among Post-9/11 Veterans
June 1, 2012 by Brandon Friedman 
On Friday, the Bureau of Labor Statistics released Veteran unemployment data for the month of May. The unemployment rate for one closely watched group, Iraq and Afghanistan-era Veterans (or Gulf War II-era Veterans), rose to 12.7 percent from 9.2 percent the previous month.

Tracking Veteran unemployment is notoriously difficult and we often see significant swings from one month to the next—making long-term analysis critically important. In the case of post-9/11 Veterans, the long-term unemployment trend remains stable and downward—a sign of recovery following the worst economic crisis since The Great Depression.

                                  Chart From:  U.S. Veterans Administration

One way to visualize this is by looking at the trend line of monthly unemployment rates for the past 29 months (since January 2010). Even with intermittent spikes, the overall trend continues to move steadily downward.

                                    Chart From:  U.S. Veterans Administration

However, because chunks of data are often better indicators, another way to view the trend is by looking at the moving (or rolling) average. The chart below captures 12-month averages for the periods ending in each of the previous 18 months. That chart looks a bit different, but the trend is similar: modest, but downward.

As you can see, while we’d like to have a sharper decline, it is absolutely inaccurate to assert that the unemployment rate for post-9/11 Veterans is “way up” or “skyrocketing” based solely on one month’s report.

That said, we’ve clearly got our work cut out for us. There is much to do in the way of lowering unemployment among all Veterans, and that’s why the President on Friday announced three more Veteran hiring programs. The White House has also called for the creation of a Veterans Job Corps.

In addition to these efforts, VA is continuing to hold events like our upcoming Veteran Hiring Fair in Detroit. It’s free and will offer jobs nationwide. We’ve also recently opened applications for the Veterans Retraining and Assistance Program (VRAP)—for eligible Veterans age 35 – 60.

The bottom line is that unemployment is still too high as long as thousands of returning Veterans still can’t find meaningful work. For that reason, VA, in conjunction with the White House and our private sector partners, will work tirelessly until we get where we need to be.

CITIES WORK TO FIGHT VETERAN HOMELESSNESS

FROM:  U.S. VETERANS ADMINISTRATION
Communities Get Fit to Fight Veteran Homelessness
May 29, 2012 by Pete Dougherty
Can boot camps get communities in shape to fight Veteran homelessness? Several cities are about to find out.

This month, San Diego, Orlando, and Houston hosted Rapid Results Housing Boot Camps to build grass-roots responses to the problem of Veteran homelessness.

The two-day boot camp sessions taught those already helping homeless Veterans in their communities new and more efficient ways to house Veterans. They developed plans to address the unique nature of Veteran homelessness in their cities and developed strategies for cutting through red tape to obtain the resources that Veterans need.

Communities were encouraged to set ambitious, 100-day goals to expedite the delivery of housing to all homeless Veterans. Tactics to meet the goals may include reducing the number of days needed to process shelter applications or improving housing-related service delivery in other ways.

National and local experts—including representatives from VA—are working together to provide communities with the tools, funding, and resources needed to meet the goals. Boot camp participants, in turn, closely track their own progress in meeting the targets.
Based on similar housing placement events co-created by 100,000 Homes, the Institute for Healthcare Improvement, and the United Way of Greater Los Angeles the boot camp sessions apply business management strategies to speed the process of housing Veterans. According to 100,000 Homes, participants at the previous events used the techniques to reduce the number of days spent processing Veteran applications for housing by up to 40 percent.

Duplication of these results in Rapid Results Housing Boot Camp communities and other localities will help edge VA closer to its goal of ending Veteran homelessness by 2015. In 2011, on a given night, more than 67,495 Veterans were homeless in the United States.

Experts from VA, HUD, U.S. Interagency Council for Homelessness, public housing authorities, Continuums of Care, and Veteran-serving nonprofits attended the boot camps to offer technical assistance. A centerpiece of the training is building each community’s capacity to win a share of $75 million in federal Veteran housing assistance available through the 2012 HUD-VASH program.

Boot Camps occurred in:
Orlando, Fla., serving Alachua County and Gainesville; New Orleans and Kenner, La.; and the state of Georgia
Houston, Texas serving Houston, San Antonio, and Harris County, Texas; Texas Valley Coastal VAMC; and Detroit
San Diego, California serving San Diego; San Francisco; and Tucson, Arizona
If you are a Veteran who is homeless or at risk of becoming homeless contact VA’s National Call Center for Homeless Veterans at 1-877-4AID-VET (1-877-424-3838) to speak to a trained VA responder, or visit us online.
Pete Dougherty is the Acting Executive Director of VA’s Homeless Veterans Initiative Office.

ST. JUDE MEDICAL INC. PAYS $3.65 MILLION TO SETTLE CLAIMS OF OVERCHARGES

FROM:  U.S. DEPARTMENT OF JUSTICE
Thursday, May 31, 2012
Minnesota-based St. Jude Medical Pays U.S. $3.65 Million to Settle Claims That It Overcharged for Implantable Cardiac Devices St. Jude Medical Inc. has agreed to pay the United States $3.65 million to resolve civil allegations under the False Claims Act that the company inflated the cost of replacement pacemakers and defibrillators purchased by the Departments of Defense and Veterans Affairs, the Justice Department announced today. St. Paul, Minn.-based St. Jude Medical develops, manufactures and distributes cardiovascular and implantable neurostimulation medical devices.
         
The settlement resolves allegations that St. Jude actively marketed its pacemakers and defibrillators by touting the generous credits available should a device need to be replaced while covered under warranty.   At the same time, St. Jude allegedly knew that it failed to grant appropriate credits to the purchasers of devices in a large number of cases where a product was replaced while still under warranty.   As a result, the United States contended that St. Jude submitted invoices to Department of Veterans Affairs hospitals and Department of Defense military treatment facilities that overstated the cost for replacement pacemakers or defibrillators.

“As medical device use becomes more prevalent, it is essential that device manufactures provide federal health care programs with the warranty discounts they are entitled to receive,” said Stuart F. Delery, Acting Assistant Attorney General for the Justice Department’s Civil Division.   “If medical device manufacturers are actively concealing warranty credits from the government, the department will use all the tools at its disposal to hold them accountable.”

“Like any other customer, the government is entitled to get what it paid for,” said Carmen M. Ortiz, U.S. Attorney for the District of Massachusetts.   “Where a vendor warrants that its products will last a certain amount of time and then does not honor warranty claims when the products fail early, actions like this are appropriate.”
The civil settlement resolves allegations initially brought by two whistleblowers in federal court in the District of Massachusetts under the qui tam, or whistleblower, provisions of the False Claims Act, which allow for private citizens to bring civil actions on behalf of the United States and share in any recovery.   As part of today’s resolution, the whistleblowers will receive $730,000 from the settlement amount.

 “The Department of Veterans Affairs, Office of Inspector General continues with its partners at the U.S. Attorney’s Office and other federal investigative agencies to combat fraud, waste, and abuse within the health care industry,” said Jeffrey G. Hughes, Special Agent in Charge, Department of Veterans Affairs, Office of Inspector General.  “This civil settlement will return funds to VA to benefit our nation’s veterans.”

“The Defense Criminal Investigative Service is committed to working with the U.S. Department of Justice and the U.S. Department of Veterans Affairs, Office of Inspector General, to ensure that taxpayer dollars are properly spent and that the health care needs of our military members and their families are met,” said Edward Bradley, Special Agent-in-Charge, Defense Criminal Investigative Service, Northeast Field Office.   “Today’s settlement demonstrates the importance of this collaborative effort to hold companies accountable when they fail to honor warranty discounts to which the U.S. Department of Defense is entitled.”

The settlement was the result of an investigation by the U.S. Attorney’s Office for the District of Massachusetts, the Justice Department’s Civil Division, and the Offices of Inspector General at the U.S. Department of Defense and Veterans Affairs.   The claims settled by this agreement are allegations only, and there has been no determination of liability.

MEMORIAL DAY, A DAY OF REFLECTION

Photo:  Annapolis National Cemetery.  Credit:  U.S. Department of Defense.
FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS
Memorial Day – When America Remembers
Reflecting on the Sacrifice of America’s Fallen Warriors
Memorial Day is a time for somber remembrance of the loved ones who died in the service of their nation.

Memorial Day is the Federal holiday celebrated the last Monday of each May to honor the men and women who died while serving in the military.

Unlike Veterans Day, which is held each November 11 to honor all Veterans, Memorial Day represents a time for the nation to pause, remember and honor the service of deceased Veterans and military members who died on active duty.

Memorial Day is a time when people visit cemeteries and memorials. Many cemeteries will host ceremonies of remembrance, which are usually coordinated on the local level by officials at those cemeteries.
                                                                            Photo:  Corinth National Cemetery.  Credit:  Wikimedia.
The holiday was originally called Decoration Day, when the tradition of decorating the graves of Union and Confederate Veterans began. It still brings loved ones to the graves of the deceased, often with flowers.

“I call on all Americans to come together to honor the men and women who gave their lives so that we may live free, and to strive for a just and lasting peace in our world.”
— President Barack Obama

More than 100,000 people are expected to attend activities at VA’s national cemeteries with color guards, readings, bands, and choir performances. Events will honor about one million men and women who died in the military during wartime, including about 655,000 battle deaths.

National cemetery staff and volunteers typically place American flags on each grave.
At Arlington National Cemetery in Virginia, soldiers from the 3rd U.S. Infantry Regiment based at Fort Myer, Va. — the famed “Old Guard” — traditionally decorate each grave with a small American flag.

Remembering Fallen Warriors
On Memorial Day at 3 p.m., local time around the nation, Americans will pause for the annual Moment of Remembrance to pause and reflect on the sacrifice of America’s fallen warriors and the freedoms that unite Americans.

The Department of Veterans Affairs maintains approximately three million gravesites at its 131 national cemeteries and has the potential to provide six million graves on more than 19,000 acres in 39 states and Puerto Rico, as well as 33 soldier’s lots and monument sites.

NATIONAL NURSES WEEK

FROM:  U.S. VETERANS AFFAIRS
Photo:  Florence Nightingale
National Nurses Week is celebrated every year beginning May 6th and ending on May 12, Florence Nightingale’s birthday.

VA Nursing is a dynamic, diverse group of honored, respected, and compassionate professionals. VA is the leader in the creation of an organizational culture where excellence in nursing is valued as essential for quality health care to those who served America.

The VA nursing team is composed of Registered Nurses (RNs), Licensed Practical/Vocational Nurses (LPNs/LVNs), and nursing assistants.

VA Nursing provides the largest clinical training and cooperative education opportunities in association with undergraduate and graduate programs at numerous colleges and universities.

In the 1990s, VA provided clinical experiences to one out of every four professional nursing students in the country. VA nurses are highly valued members and leaders of the health care team, contributing their knowledge and expertise to the care of patients.

In addition to clinical care, VA Nursing is also a significant part of advancing research in VA and keeping up with the latest technological innovations. Nurse researchers help to promote inclusion of evidence into practice to provide quality care for Veterans.

STUDY TO DETERMINE IF HYPERTENSION AND RESPIRATORY DISEASES RELATED TO VIETNAM WAR HERBICIDE AGENT ORANGE

FROM: U .S. DEPARTMENT OF VETERANS AFFAIRS
The Army Chemical Corps Vietnam-Era Veterans Health Study is designed to learn if high blood pressure (hypertension) and some chronic respiratory diseases are related to herbicide exposure during the Vietnam War.

Background
This study follows a request by Secretary of Veterans Affairs Eric K. Shinseki for VA to conduct research on the association between herbicide exposure and high blood pressure (hypertension), as a basis for understanding if hypertension is related to military service in Vietnam.  VA is also interested in learning more about the relationship between herbicide exposure and chronic obstructive pulmonary disease (COPD).
This study is a follow-up of a similar study conducted between 1999-2000. We have examined the health status of individuals who served in the Army Chemical Corps since the 1990s.

Goals
Researchers have two questions:
Is the risk of high blood pressure (hypertension) related to Agent Orange exposure during service in Vietnam?
Is the risk of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema, related to Agent Orange exposure during service in Vietnam?

Participants
Researchers are asking approximately 4,000 Veterans who served in the U.S. Army Chemical Corps sometime during the Vietnam era (1965-1973) to participate in this study.  Army Chemical Corps personnel were responsible for the maintenance and distribution or application of chemicals for military operations. Army Chemical Corps personnel who served in Vietnam during the Vietnam War constitute the largest group of Army Vietnam Veterans who were thought to have had the greatest potential exposure to herbicides.

We have already selected participants from earlier Army Chemical Corps study rosters, and researchers cannot accept volunteers for this study. Each Veteran selected for this study represents other Veterans with similar characteristics.

Methods
We are conducting telephone interviews, reviewing medical records, and measuring the blood pressure and lung function of these Veterans.

Investigators
Han Kang, Dr.P.H.
Aaron Schneiderman, Ph.D., M.P.H., R.N.
Yasmin Cypel, Ph.D.
Amii Kress, M.P.H.
Stephanie Eber, M.P.H.

URANIUM IN SHRAPNEL COULD POSE LONG TERM HEALTH RISK

FROM:  AMERICAN FORCES PRESS SERVICE
Dr. Jose Centeno, director of the Joint Pathology Center's Biophysical Toxicology and Depleted Uranium/Embedded Metal Fragment Laboratories, demonstrates the variety of shrapnel pieces removed from service members and veterans. DOD photo by Terri Moon Cronk
Laboratory Analyzes Shrapnel to Look for Uranium
By Terri Moon Cronk
JOINT BASE ANDREWS, Md., April 19, 2012 - Military doctors here are examining shrapnel taken from service members and veterans, looking for depleted uranium and other metals.
Biophysical Toxicology and Depleted Uranium/Embedded Metal Fragment Laboratories branch is analyzing the embedded fragments and providing second opinions at military and Veterans Affairs medical centers to treat those who had retained shrapnel.
"Our goal is to improve the care of wounded warriors," said Army Col. (Dr.) Thomas Baker, interim director of the Joint Pathology Center, the umbrella organization for the lab.

"We advise [doctors] how to follow up and what treatment is needed" to mitigate the potential effects of uranium and other metals, he said.
The lab analyzes all combat-associated metal fragments taken from DOD personnel that might pose a long-term health risk, such as depleted uranium, which can contribute to kidney damage over time, Baker explained. The lab also develops laboratory capabilities in metal toxicology to support the Defense Department, The Pathology Center and VA and Army programs that require exposure assessment to depleted uranium, embedded fragment analysis and analysis of certain metal alloys, officials said.

The only one of its kind in the United States, Baker said, the lab keeps a registry of the fragments for future re-evaluation. The register now includes 600 specimens.
The lab also has the only diagnostic equipment in the nation that can detect where the uranium originates in the body, noted Dr. Jose Centeno, the lab's director.

A wide range of materials are packed in improvised explosive devices, the doctors said.
The metal fragments and alloys the labs analyze comprise common metals and alloys of steel, aluminum, copper and brass. Depleted uranium is contained in some fragments, the doctors said, noting that shrapnel specimens are tested in triplicate for accuracy.
Concerns about tainted fragments began in 1993 following the Gulf War, when evidence arose of kidney damage from uranium, the doctors said.

For 18 years, 75 volunteers have participated in a study as part of the depleted uranium program, Baker said. All but one, an Iraq War veteran, served in the Gulf War, said Centeno, a physical chemist with a background in the toxicology of metals.
While many service members and veterans have retained fragments because of high risks removing them would pose, Baker said, some alloys such as depleted uranium are not safe to leave in the body. Because of that potential risk, DOD and VA have comprehensive programs to reach troops and veterans for testing, he added.

Baker said service members and veterans who carry shrapnel but haven't sought medical care should seek advice from a doctor or call the Baltimore VA Medical Center, which works with the laboratories here.

"Anybody with an embedded fragment who hasn't been followed up or hasn't seen a physician should [do so] ... and talk to them to discuss their risks," he said.

MENTAL HEALTH STAFF AT VA TO INCREASE BY 10 PERCENT

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS VANTAGE POINT
VA to Increase Mental Health Staff by Nearly 10 Percent
April 19, 2012 by Brandon Friedman
In an effort to decrease wait times for Veterans in need of mental health care, VA will soon increase its mental health staff by 1,900. This will represent nearly a 10 percent increase in mental health staff across the Department.
As you read the full announcement below, one thing to note is that this increase is not necessarily final. VA will continue to evaluate the needs of our Veterans on an ongoing basis and the Department will add staff as needed.

Secretary of Veterans Affairs Eric K. Shinseki today announced that the department would add approximately 1,600 mental health clinicians – to include nurses, psychiatrists, psychologists, and social workers as well as nearly 300 support staff to its existing workforce of 20,590 mental health staff as part of an ongoing review of mental health operations.

“As the tide of war recedes, we have the opportunity, and the responsibility, to anticipate the needs of returning Veterans,” said Secretary of Veterans Affairs Eric K. Shinseki. “History shows that the costs of war will continue to grow for a decade or more after the operational missions in Iraq and Afghanistan have ended. As more Veterans return home, we must ensure that all Veterans have access to quality mental health care.”

VA’s ongoing comprehensive review of mental health operations has indicated that some VA facilities require more mental health staff to serve the growing needs of Veterans. VA is moving quickly to address this top priority. Based on this model for team delivery of outpatient mental health services, plus growth needs for the Veterans Crisis Line and anticipated increase in Compensation and Pension/Integrated Disability Evaluation System exams, VA projected the additional need for 1,900 clinical and clerical mental health staff at this time. As these increases are implemented, VA will continue to assess staffing levels.
“Mental health services must be closely aligned with Veterans’ needs and fully integrated with health care facility operations,” said VA Under Secretary for Health Dr. Robert Petzel. “Improving access to mental health services will help support the current and future Veterans who depend on VA for these vital services.”

VA will allocate funds from the current budget to all 21 Veterans Integrated Service Networks (VISNs) across the country this month to begin recruitment immediately. Under the leadership of President Obama and Secretary Shinseki, VA has devoted more people, programs, and resources toward mental health services to serve the growing number of Veterans seeking mental health care from VA. Last year, VA provided specialty mental health services to 1.3 million Veterans. Since 2009, VA has increased the mental health care budget by 39 percent. Since 2007, VA has seen a 35 percent increase in the number of Veterans receiving mental health services, and a 41 percent increase in mental health staff.

VA has enhanced services by integrating mental health care into the primary care setting, developed an extensive suicide prevention program, and increased the number of Veterans Readjustment Counseling Centers (Vet Centers). VA’s Veteran Crisis Line has received more than 600,000 calls resulting in over 21,000 rescues of Veterans in immediate crisis.“The mental health of America’s Veterans not only touches those of us at VA and the Department of Defense, but also families, friends, co-workers, and people in our communities,” said Petzel. “We ask that you urge Veterans in your communities to reach out and connect with VA services.”