VA SUBMITS PLAN TO MOVE FORWARD ON DENVER REPLACEMENT MEDICAL CENTER

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS
VA moving Forward on Denver Replacement Facility, Transformational Plan
Plans submitted to Congress

 WASHINGTON – The Department of Veterans Affairs (VA) today submitted a plan to Congress to move forward on the Denver Replacement Medical Center.
"The delays and cost overruns that have plagued the Denver Replacement Medical Center campus are inexcusable," Secretary Robert A. McDonald wrote in his letter to Congress. "I respectfully request that Congress take action to allow us to move forward so that construction on the Denver Replacement Medical Center in Aurora does not shut down later this month."  The full text of the letter is included in the link below.

VA is committed to completing the construction of the Denver replacement hospital to serve the 390,000 Veterans and their families of the Colorado area.
In addition to detailed construction and funding plans for the Denver facility, VA also released updates outlining  progress made in areas such as accountability, access, homelessness and other priorities, as well as the MyVA Transformational Plan.

"VA is changing. It will take time to fully implement these changes, but we at VA are committed to work with Congress on this and many other challenges and opportunities as we transform VA into the Veteran-centric, customer service-oriented organization Veterans have earned and deserve," McDonald wrote.

MEDICAL EXPERT GROUP TO ADVISE VA ON HEALTH CARE

FROM:  U.S. VETERANS ADMINISTRATION
Group of Respected Medical Experts to Advise VA on Health Care for 9 Million Veterans
April 24, 2015, 03:30:00 PM
 Group of Respected Medical Experts to Advise VA on Health Care for 9 Million Veterans
Special Medical Advisory Group Led by Dr. Jonathan Perlin of Hospital Corporation of America

WASHINGTON – The Department of Veterans Affairs (VA) today announced a new 11-member Special Medical Advisory Group (SMAG) composed of leading medical experts to assist the Department in delivering health care to the 9 million Veterans enrolled in the Veterans Health Administration.

The SMAG is a reconstituted federally-chartered committee that advises the Secretary of Veterans Affairs, through the Under Secretary for Health, on matters related to health care delivery, research, education, training of health care staff and planning on shared care issues facing VA and the Department of Defense.
“We want the best of the best to work on behalf of our nation’s Veterans,” said VA Secretary Robert A. McDonald. “We are honored these respected leaders from the private, non-profit and government sectors have agreed to join in our mission improve how we provide the quality health care our nation’s Veterans need and deserve.”

The appointment of the new members of the SMAG comes at a time when VA is experiencing increased demand for its health care services. Nationally, VA completed more than 51 million appointments between May 1, 2014, and March 31, 2015. This represents an increase of 2.4 million more completed appointments than during the same time period in 2013-2014. In March 2015, VA completed 97 percent of appointments within 30 days of the Veteran’s preferred date.

Serving as SMAG Committee Chair is Dr. Jonathan Perlin, who previously served as VA Under Secretary for Health from 2004-2006. Dr. Perlin is currently Chief Medical Officer and President of Clinical Services for the Nashville, Tennessee-based Hospital Corporation of America (HCA).  In this capacity, Dr. Perlin provides leadership for clinical services and improving performance for HCA’s 166 hospitals and more than 800 outpatient centers and physician practices. Recognized perennially as one of the most influential physician executives in the United States by Modern Healthcare, Dr. Perlin is a recipient of numerous awards.

Other Committee members:

Karen S. Guice, MD, M.P.P.

Dr. Guice serves as Principal Deputy Assistant Secretary of Defense for Health Affairs and Principal Deputy Director, TRICARE Management Activity. In these two roles, Dr. Guice assists in the development of strategies and priorities to achieve the health mission of the Military Health System (MHS), and participates fully in formulating, developing, overseeing and advocating the policies of the Secretary of Defense. The Office of Health Affairs is responsible for providing a cost effective, quality health benefit to 9.6 million active duty uniformed Service Members, retirees, survivors and their families. The MHS has a $50 billion annual budget and consists of a worldwide network of 59 military hospitals, 360 health clinics, private-sector health business partners, and the Uniformed Services University.

Joy Ilem, Deputy National Legislative Director, DAV

Ms. Ilem, a U.S. Army service-connected disabled Veteran, was named Deputy National Legislative Director of the of the 1.2 million-member Disabled American Veterans (DAV), in June 2009. In this capacity, Ms. Ilem directs the advancement of DAV’s public policy objectives.

Thomas Lee, MD

Dr. Lee serves as Chief Medical Officer for Press Ganey, which advises and consults with healthcare businesses to help identify the best practices for the organization and the patient. Dr. Lee joined Press Ganey in 2013, bringing more than three decades of experience in health care performance improvement as a practicing physician, a leader in provider organizations, researcher and health policy expert. As Chief Medical Officer, Dr. Lee is responsible for developing clinical and operational strategies to help providers across the nation measure and improve the patient experience, with an overarching goal of reducing the suffering of patients as they undergo care and improving the value of that care. In addition to his role with Press Ganey, Dr. Lee is an internist and cardiologist, and continues to practice primary care at Brigham and Women’s Hospital in Boston.
Ralph Snyderman, MD

Dr. Snyderman is former president and CEO of the Duke University Health System and director of Duke’s Center for Research on Personalized Health Care. He currently serves as Chancellor Emeritus for the Duke University Department of Medicine. He is former Chair of the Association of American Medical Colleges (AAMC).  

Jennifer Daley, MD

Dr. Daley is a Senior Adviser for the consulting firm, Cambridge Management Group. She is nationally recognized for her expertise in operational improvement, patient safety, quality and service excellence. Dr. Daley is a past recipient of a U.S. Naval Academy-Harvard Business Review Ethical Leadership Award in July 2007.

James Henry Martin, MD

Dr. Martin has been practicing emergency medicine and primary care medicine in the Chicago area since 1978 and is currently on the medical staffs of Captain James A. Lovell Federal Health Care Center, North Chicago; and Metro South Medical Center, Blue Island, IL. He has extensive clinical research experience in the area of nasal insulin studies. Dr. Martin is currently developing a nasal mupirocin spray foam to eradicate nasal MRSA, and a nasal foam medication formulation. He has had 14 US patents issued and over 40 foreign patents issued, including a patent in 2014 covering the formulation above.

Melvin Shipp, OD, MPH, DrPH    
  
Dr. Shipp serves as Dean Emeritus, College of Optometry for The Ohio State University. He has served as a consultant, panelist and reviewer for several federal institutions –notably, the Food and Drug Administration, the Health Resources and Services Administration and in several capacities with the National Eye Institute (NEI) of the National Institutes of Health. Dr. Shipp also has assumed leadership and membership roles within a variety of non-federal, national health-related organizations. He is a Fellow of the American Academy of Optometry, and a Diplomate and former Chair of the Public Health and Environmental Optometry Section. Dr. Shipp is only the second optometrist to receive the DrPH degree; he is the first to do so through the highly competitive Pew Health Policy Doctoral Fellowship Program at the University of Michigan.
James Weinstein, DO, MD

Dr. Weinstein serves as Chief Executive Officer and President of Dartmouth Hitchcock, a nonprofit academic health system that serves a patient population of 1.2 million in New England. Anchored by Dartmouth-Hitchcock Medical Center in Lebanon, NH, the system includes the Norris Cotton Cancer Center; the Children's Hospital at Dartmouth-Hitchcock; affiliate hospitals in New London, NH, and Windsor, VT; and 24 Dartmouth-Hitchcock clinics that provide ambulatory services across New Hampshire and Vermont. Under Dr. Weinstein’s leadership, Dartmouth-Hitchcock is working to create a “sustainable health system” for patients, providers, payers and communities. Dr. Weinstein also is a member of the Institute of Medicine (IOM) of the National Academy of Sciences. He serves on the IOM Committee on advising the Social Security Administration on Disability. Most recently, Dr. Weinstein was one of four members appointed to the IOM Board on Population Health and Public Health Practice.

Deborah Trautman, PhD, RN

Ms. Trautman is Chief Executive Officer for the American Association of Colleges of Nursing (AACN), a role she assumed in 2014. At AACN, she oversees strategic initiatives, signature programming and advocacy efforts led by the organization known as the national voice for baccalaureate and graduate nursing education. She has authored and coauthored publications on health policy, intimate partner violence, pain management, clinical competency, change management, cardiopulmonary bypass, the use of music in the emergency department and consolidating emergency services.

Bruce Siegel, MD, MPH, President and CEO, America’s Essential Hospitals
Since joining America’s Essential Hospitals (formerly the National Association of Public Hospitals and Health Systems) in 2010, Dr. Siegel has used his extensive background in health care management, policy, and public health to achieve the association’s strategic vision of its members as integrated delivery systems and leaders in access and quality. He served previously as Center for Health Care Quality director and health policy professor at The George Washington University Milken Institute School of Public Health. Before that, Dr. Siegel was president and CEO of two association member systems: Tampa General Healthcare and the New York City Health and Hospitals Corporation. He also served as New Jersey’s commissioner of health. Among many accomplishments, Dr. Siegel has led groundbreaking work on quality and equity for the Robert Wood Johnson Foundation, as well as projects for the Commonwealth Fund, the California Endowment, and the Agency for Healthcare Research and Quality. He also chairs the National Advisory Council for Healthcare Research and Quality. Modern Healthcare has named Dr. Siegel one of the “100 Most Influential People in Healthcare” and one of the “50 Most Influential Physician Executives” for the past four years.

The announcement of the Special Medical Advisory Group follows the introduction of the Veterans Health Administration’s “Blueprint for Excellence,” which lays out strategies for transformation to improve the performance of VA health care now —making it more Veteran-centric by putting Veterans in control of their VA experience.

 The SMAG Committee is scheduled to conduct its first meeting on May 13, 2015.

AN END TO BED SORES? VA SAYS DEVICE BEING TESTED

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS
Groundbreaking Device Being Tested By VA May Put End to Pressure Ulcers
March 19, 2015, 10:23:00 AM
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Groundbreaking Device Being Tested By VA May Put End to Pressure Ulcers
 Helps detect the earliest signs of ulcer formation

Pressure ulcers (commonly known as bed sores) are one of the most troublesome and painful complications for patients during a long hospital stay, but a joint project between the Department of Veterans Affairs (VA) Center for Innovation and General Electric (GE) Global Research may one day make pressure ulcers a thing of the past.

A multi-disciplinary team of scientists have combined an array of sensing and analytical tools, including motion analysis, thermal profiling, image classification/segmentation, 3-D object reconstruction and vapor detection into a single medical sensing handheld probe to assess and monitor the progression of bed sores or pressure ulcers.

The device is currently in pilot testing at the Augusta, Georgia, VA Medical Center Spinal Cord Injury Unit. The probe integrates multiple sensing capabilities with analytics and user support features to more acutely measure pressure ulcer formation and/or to determine if an ulcer is healing.

“The collaboration with GE is another example of the innovative work VA is doing with our private sector colleagues to advance the science of health care for our Veterans,” said Dr. Carolyn Clancy, VA’s Interim Under Secretary for Health. “We are pleased to work with GE to pilot a technology that holds the promise of revolutionizing the protocol for preventing and treating painful bed sores. We know that if patients are not turned on a regular basis, they can develop bed sores during their hospital stay as pressure builds up on their skin. By combining physical inspection with the technology capable of allowing real-time monitoring, we may be able to prevent ulcers from forming or advancing. This innovation is about providing the best care to our Veterans and collaborations like this one with GE helps us do just that.”

Individuals with spinal cord injuries with loss of sensation and mobility are particularly at risk for developing pressure ulcers. In U.S. hospitals alone, an estimated 2.5 million patients per year develop pressure ulcers, which require treatment.

“Pressure ulcers are a very pervasive, but also very preventable condition for hospital patients,” said Ting Yu, GE’s Principal Investigator on the pressure ulcer prevention and care program. “The device can help detect the earliest signs of ulcer formation. It also provides a more objective and comprehensive assessment of the wound to understand its progression. We’re now testing this device with VA in a clinical setting to see if it provides the kind of information that will help hospitals reduce and one day eliminate pressure ulcers from developing with patients.”

STUDY FINDS 15.7% OF OEF/OIF DEPLOYED VETERANS SCREENED POSITIVE FOR PTSD

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS
PTSD in Iraq and Afghanistan Veterans

PTSD is a significant public health problem in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) deployed and non-deployed Veterans and should not be considered an outcome solely related to deployment.
A study finds that 15.7% of OEF/OIF deployed Veterans screened positive for PTSD compared to 10.9% of non-deployed Veterans. Overall 13.5% of study participants screened positive for PTSD.

Researchers determined if Veterans screened positive for PTSD by looking at survey answers to the PTSD Checklist Civilian Version (PCL-C). The PCL-C is a screening instrument routinely used in VA.

PTSD Among Recent Veterans – Who Screens Positive?

The National Health Study for a New Generation of U.S. Veterans is a health survey of 60,000 Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans, and non-deployed Veterans who served during the same time period. Researchers sent Veterans a survey which included questions that help VA health care providers screen Veterans for post-traumatic stress disorder (PTSD). This is the first study to report positive screens for PTSD in OEF/OIF-era Veterans who were not deployed and those who do not use VA health care.

Overall screening positive for PTSD: deployed Veterans, 15.7%; non-deployed Veterans, 10.9%. The overall percentage of study participants screening positive for PTSD was 13.5%

Screened positive by VA health care user status: deployed VA health care users, 24.7%; non-deployed VA health care users, 17.5%; deployed VA health care non-users, 9.8%; non-deployed VA health care non-users, 7.9%.
Screened positive by service branch: deployed Army Veterans, 18.6%; non-deployed Army Veterans, 13.8%; deployed Air Force Veterans, 6.6%; non-deployed Air Force Veterans, 6.2%; deployed Navy Veterans, 12.3%; non-deployed Navy Veterans, 10.1%; deployed Marine Corps Veterans, 20.6%; non-deployed Marine Corps Veterans, 10.5%.

Screened positive by unit component: deployed active duty, 18.5%; non-deployed active duty, 13.2%; deployed National Guard, 14.5%; non-deployed National Guard, 7.5%; deployed Reserves, 11.9%; non-deployed Reserves, 7.2%.
Screened positive by gender: deployed males, 16.2%; non-deployed males, 10.5%; deployed females, 12.5%; non-deployed females, 12.3%. Deployed males were 1.39 times more likely to screen positive for PTSD than deployed females. Among females, prevalence of a positive screen for PTSD was nearly equal among deployed and non-deployed Veterans.

Screened positive by race/ethnicity: deployed Hispanics, 19.7%; non-deployed Hispanics, 13.7%; deployed White non-Hispanic, 14.1%; non-deployed White non-Hispanic, 9.2%; deployed African American non-Hispanic, 21.9%; non-deployed African American non-Hispanic, 15.7%; deployed non-Hispanics other race, 16.2%; non-deployed non-Hispanics other race, 15.7%; deployed missing race/ethnicity, 23.5%; non-deployed missing race/ethnicity, 10.1%.

PTSD is a significant public health problem among OEF/OIF deployed and non-deployed Veterans and is not solely related to deployment.

These data are from the National Health Study for a New Generation of U.S. Veterans.

Findings from the New Generation Study

The findings are from the National Health Study for a New Generation of U.S. Veterans, a long-term study on the health of 30,000 OEF/OIF Veterans and 30,000 Veterans from the same era who were not deployed.

This is the first study to report positive screens for PTSD in OEF/OIF-era Veterans who were not deployed and those who do not use VA health care. Read the study abstract.

Health concerns?

Talk to your health care provider if you are concerned about PTSD. Effective treatments for PTSD exist.

Not enrolled in the VA health care system? Find out if you qualify. OEF, OIF, and Operation New Dawn combat Veterans are eligible for VA health care for five years after leaving the military. There are other ways to qualify too, including by having a service-connected disability.

Sources

Bliese PD, Wright KM, Adler AB, Cabrera O, Castro CA, Hoge CW.  Validating the primary care posttraumatic stress disorder screen and the posttraumatic stress disorder checklist with soldiers returning from combat. J Consult Clin Psychol 2008; 76: 272-281.

DOD PHOTOS OF TRYOUTS FOR 2014 WARRIOR GAME

FROM:  U.S. DEFENSE DEPARTMENT 

The Navy holds volleyball tryouts during the 2014 Wounded Warrior Team Navy Trials on Norfolk Naval Base in Norfolk, Va., June 4, 2014. DOD photo by EJ Hersom.

Retired Navy Petty Officer 3rd Class Justin Schmidt rides a recumbent bicycle during the 2014 Wounded Warrior Team Navy Trials in Norfolk, Va., June 5, 2014. About 70 seriously wounded, ill and injured sailors and Coast Guardsmen from across the country are competing for a place on Team Navy 2014. About 40 athletes will be selected for the Navy's team and advance to the 2014 Warrior Games, an annual competition among each branch of the U.S. Armed Forces. DOD photo by EJ Hersom.

Retired Navy Petty Officer 3rd Class Brian Canich shoots a basketball over Carlos Spence, a member of a local adaptive sports basketball team, at an exhibition game during the 2014 Wounded Warrior Team Navy Trials in Norfolk, Va., June 4, 2014. DOD photo by EJ Hersom.

VA SECRETARY SHINSEKI ACCEPTS RESIGNATION OF UNDERSECRETARY FOR HEALTH

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS 

Statement from Secretary of Veterans Affairs Eric K. Shinseki

May 16, 2014

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WASHINGTON – Secretary of Veterans Affairs Eric K. Shinseki made the following statement:

“Today, I accepted the resignation of Dr. Robert Petzel, Under Secretary for Health in the Department of Veterans Affairs.

"As we know from the Veteran community, most Veterans are satisfied with the quality of their VA health care, but we must do more to improve timely access to that care.

"I am committed to strengthening Veterans’ trust and confidence in their VA healthcare system.

"I thank Dr. Petzel for his four decades of service to Veterans.”

DEFENSE SECRETARY HAGEL SAYS U.S. IS DOMINANT FORCE IN THE WORLD

FROM:  U.S. DEFENSE DEPARTMENT 
Hagel: The United States Remains an Unrivaled Power
By Terri Moon Cronk
American Forces Press Service

WASHINGTON, May 11, 2014 – While some around the world believe the United States is a weakening superpower, Defense Secretary Chuck Hagel today defended America as the world’s dominant force.

“I have seen some of [that perception], yes,” Hagel said, during an interview on the ABC program “This Week with George Stephanopoulos”. “But we are still the dominant power. No one’s in our universe, whether you apply a metric or measurement of an economic power or military power.”

But that doesn’t mean the United States can solve every problem alone, he said.
“No nation can do that. I do think there’s a sense out there by some that somehow America has powers eroding, or we’re not going to use our power, or we’re too timid about our power. I think we have been wise on how we use our power.”
“I don’t think you can run foreign policy or lead a nation and be president of the United States based on what other people think of you,” he added.

Hagel was asked about several issues in the news, including the kidnapping of more than 200 schoolgirls by the Boko Haram terrorist group in Nigeria, the situation in Ukraine and problems at the Veterans Affairs Department, in addition to cyber security threats, and questions regarding transgender people serving in the military.

The United States has sent a team of experts from the FBI, the intelligence community and the military to Nigeria to help authorities in the West African nation find the girls, kidnapped in the remote northeast last month.
“It’s a vast country, so this is not going to be an easy task, but we’re going to bear every asset we could possibly use to help the Nigerian government.” However, he said the United States has no plans to put American troops on the ground.
On the crisis in Ukraine, Hagel said even though Russian President Vladimir Putin said last week that Moscow was withdrawing tens of thousands of its troops from along the border with Ukraine, Russian forces appear to be still there.
“Russia continues to isolate itself for a short-term gain,” he said. “The Russians may feel they’re somehow winning, but the world is not just about short term,” Hagel noted.

Regarding the growing threat of cyber attacks, Hagel said the United States is paying full attention to cyber security threats, but added it’s difficult to be confident.

“You can’t be,” he said. “The fact is, [cyber security issues] are as dangerous a threat as the world is dealing with, especially the United States. It’s quiet, it’s insidious, it’s deadly.”

Hagel was also asked whether department policy regarding transgender individuals serving in the military should be revisited now that gays and lesbians are allowed to serve openly.  He called the issue complicated because of its medical component.

“These issues require medical attention. In austere locations where we put our men and women in many cases [those military posts] don’t always offer that kind of opportunity,” he explained.

“I do think it should continually be reviewed … because the bottom line [is] every qualified American who wants to serve our country should have an opportunity, if they fit the qualifications and can do it. This is an area we’ve not defined enough,” Hagel said.

Hagel also said he continues to support Department of Veterans Affairs Secretary Eric K. Shinseki amid reports that some veterans have died because they were unable to receive timely medical care through the VA system.

“There’s no one who understands accountability more than [retired Army] Gen. Shinseki,” Hagel said. “I do support [him], but there’s no margin here.”
The Defense secretary said if these reports prove accurate, “Accountability is going to have to be upheld, because we can never let this kind of outrage, if all of this is true, stand in this country.”

But the situation didn’t start with Shinseki’s term at VA, Hagel emphasized. “This is something that should have been looked at years and years ago. Yes, we missed it.”

FORMER VA PSYCHIATRIST SENTENCED IN MEDICARE FRAUD CASE

FROM:  U.S. JUSTICE DEPARTMENT 
Thursday, March 13, 2014
Former Veterans Affairs Psychiatrist Sentenced for Medicare Fraud

A licensed psychiatrist formerly employed by the Department of Veterans Affairs (VA) was sentenced today to serve 18 months in prison for falsely claiming to provide at-home services to Medicare beneficiaries.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta E. Lynch of the Eastern District of New York and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.

Dr. Mikhail L. Presman, 56, of Brooklyn, N.Y., was sentenced by Judge I. Leo Glasser in the Eastern District of New York.   Presman was sentenced to serve three years of supervised release following his prison term and ordered to forfeit $1.2 million and pay restitution to Medicare.

According to court documents, from Jan. 1, 2006, through May 10, 2013, Presman submitted approximately $4 million in Medicare claims for home treatment of Medicare beneficiaries notwithstanding his full-time salaried position as a psychiatrist at the VA hospital in Brooklyn.   Presman did not provide any treatment to a substantial number of the beneficiaries he claimed to have treated.   For example, Presman submitted claims to Medicare for home medical visits at locations within New York City even though he was physically located in China at the time of these purported home visits.   Presman also submitted claims to Medicare for 55 home medical visits to beneficiaries who were hospitalized on the date of the purported visits.
The case was investigated by the HHS-OIG, with assistance from the VA Office of Inspector General, and brought as part of the Medicare Fraud Strike Force, under the supervision of the U.S. Attorney’s Office for the Eastern District of New York and the Criminal Division’s Fraud Section.   The case was prosecuted by Trial Attorney Bryan D. Fields of the Fraud Section and Assistant United States Attorney Patricia E. Notopoulos of the Eastern District of New York.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 billion.   In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

AGENT ORANGE HEALTH CONCERNS RAISED BY CREWS OF C-123 PROVIDER AIRCRAFT

       Fairchild C-123K Provider  U.S. Air Force

FROM:  DEPARTMENT OF VETERANS AFFAIRS 

Agent Orange Residue on Post-Vietnam War Airplanes

Some Veterans who were crew members on C-123 Provider aircraft, formerly used to spray Agent Orange during the Vietnam War, have raised health concerns about exposure to residual amounts of herbicides on the plane surfaces.
Responding to these concerns, VA asked the Institute of Medicine to study possible health effects. Results are expected in late 2014.
If you have health concerns, talk to your health care provider or local VA Environmental Health Coordinator.

Testing for Agent Orange residue on planes

The U.S. Air Force (USAF) collected and analyzed numerous samples from C-123 aircraft to test for Agent Orange. USAF's risk assessment report (April 27, 2012) (2.3 MB, PDF) found that potential exposures to Agent Orange in C-123 planes used after the Vietnam War were unlikely to have put aircrew or passengers at risk for future health problems. The report’s three conclusions:
There was not enough information and data to conclude how much individual persons would have been exposed to Agent Orange.

It is expected that exposure to Agent Orange in these aircraft after the Vietnam War was lower than exposure during the spraying missions in Vietnam.

Potential Agent Orange exposures were unlikely to have exceeded standards set by regulators or to have put people at risk for future health problems.
How Veterans may have been exposed

During the Vietnam War, the U.S. Air Force used C-123 aircraft to spray Agent Orange to clear jungles that provided enemy cover in Vietnam. At the end of the spraying campaign in 1971, the remaining C-123 planes were reassigned to reserve units in the U.S. for routine cargo and medical evacuation missions spanning the next 10 years.

Crew members aboard one of these post-Vietnam C-123 planes reported smelling strong odors, which raised concerns about Agent Orange exposure – but Agent Orange is odorless. These odors may have come from various chemicals associated with aircraft.

Health effects of Agent Orange residue

The health effects of exposure to Agent Orange residue on airplanes differ from direct contact with liquid Agent Orange. In liquid or spray form, Agent Orange can enter the body through inhalation or ingestion (such as hand-to-mouth contact or getting into food). But in the dry form – for example, adhered to a surface – Agent Orange residue cannot be inhaled or absorbed through the skin, and would be difficult to ingest.

The potential for health effects depends on the amount of Agent Orange present, as well as its ability to enter the body.

After reviewing available scientific reports in 2011 and 2012, VA concluded that the exposure potential in these planes was extremely low and therefore, the risk of long-term health effects is minimal. If crew exposure did occur, it is unlikely that sufficient amounts of dried Agent Orange residue could have entered the body to have caused harm.

We will continue to review new scientific information on this issue as it becomes available.

We’ve also asked the Institute of Medicine of the National Academy of Sciences, an independent non-governmental organization, to study possible health effects from Agent Orange in C-123 post-Vietnam crew members. Results are expected in late 2014.

Research studies on Agent Orange

Research on the health effects of Agent Orange has been extensive and it continues. Diverse populations have been studied, including herbicide sprayers and manufacturers, other Vietnam-era Veterans, and those exposed during industrial accidents. This information helps us to determine what potential health effects may be related to different levels of exposure.

Find out more about research on health effects of Agent Orange.
Health concerns?

If you have health concerns about Agent Orange, talk to your health care provider or local VA Environmental Health Coordinator.
Not enrolled in the VA health care system? Find out if you qualify for VA health care.

Compensation benefits for health problems

The risk of long-term health problems from exposure to Agent Orange residue on post-Vietnam C-123 airplanes is minimal. Veterans may file a claim for disability compensation for health problems they believe are related to exposure to Agent Orange residue on post-Vietnam C-123 airplanes. Veterans must show on a factual basis that they were exposed in order to receive disability compensation for diseases related to Agent Orange exposure.

VA HEALTH CARE REPORT: UTILIZATION BY U.S. VETERANS

FROM:  VETERANS AFFAIRS 

VA Health Care Utilization by Recent Veterans
October 1, 2001 to September 30, 2013.

VA presents a report four times a year containing data on Veterans who have used VA health care and who served in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), or Operation New Dawn (OND).
Findings

Approximately 58 percent (998,004) of all separated OEF/OIF/OND Veterans have used VA health care since October 1, 2001.

Between October 1, 2012 and September 30, 2013, a total of 605,527 of these Veterans accessed VA health care.

The frequency and percent of the three most common diagnoses were: musculoskeletal ailments (590,485 or 59.2 percent); mental disorders (552,169 or 55.3 percent); and symptoms, signs, and ill-defined conditions (conditions that do not have an immediately obvious cause or isolated laboratory test abnormalities) (545,771 or 54.7 percent). A Veteran can have more than one diagnosis.
About the report

The VA health care utilization report is created by comparing a Department of Defense roster of returning Veterans to VA’s electronic inpatient and outpatient health records.

The data used in the report provide valuable information about Veterans who have accessed VA health care. The report does not represent all recent Veterans who have become eligible for VA health care, who have ever served in OEF, OIF, or OND, or who are currently serving in these conflicts.

Carefully designed epidemiology studies are required to answer specific questions about the health of all Veterans who served in Iraq or Afghanistan.

NEARLY $ 9 MILLION IN GRANTS APPROVED BY VA FOR TRANSPORTATION, HOUSING OF HOMELESS VETS

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS 
VA Approves $8.8 Million in Grants to Provide Transportation and Renovated Housing for Homeless Veterans
November 12, 2013

WASHINGTON—The Department of Veterans Affairs has approved $8.8 million in grants to fund 164 projects in 37 states, the District of Columbia and Puerto Rico to rehabilitate currently operational transitional housing projects and acquire vans to facilitate the transportation needs of homeless Veterans.
“President Obama has made eliminating Veterans’ homelessness a national priority,” said Secretary of Veterans Affairs Eric K. Shinseki.  “We want every Veteran who faces homelessness to know that VA is here to help.  The Grant and Per Diem Program provides significant assistance to those who need it.”
The grants awarded through the Grant and Per Diem (GPD) Program are for currently operational grantees, who will use this funding to rehabilitate their current project locations to enhance safety, security and privacy for the homeless Veterans they serve.  Additionally, funding for these organizations to acquire vans will assist homeless Veterans with transportation to medical appointments and employment opportunities, as well as enable grantees to conduct outreach within their communities.

GPD helps close gaps in available housing for the nation’s most vulnerable homeless Veterans, including men and women with children, Indian tribal populations, and Veterans with substance use and mental health issues.  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 homeless Veterans programs.

Lisa Pape, National Director of Homeless Programs, which oversees GPD, said, “These grant awards are a reinvestment in the community that will strengthen community services around the country so that homeless Veterans have access to safe and secure housing and receive quality support and services.

“The 2013 GPD grant awards represent an ongoing commitment to VA’s community partners.  These awards will make community-based GPD facilities safer and secure, ensuring that our community partners continue to provide excellent mental health support, employment assistance and job training with the essential component of housing,” Pape added. “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.”

Since 2009, homelessness among Veteran has decreased more than 17 percent.  As part of President Obama’s and Shinseki’s five-year plan to eliminate Veteran homelessness by 2015, VA has committed over $1 billion in fiscal year 2014 to strengthen programs that prevent and treat the many issues that can lead to Veteran homelessness.

More information about VA’s homeless programs is available at www.va.gov/homeless.  Details about the GPD Program are online at www.va.gov/homeless/GPD.asp.

PATIENT-CENTERED CARE FOR VETERANS

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS 
VA Announces Award of Patient-Centered Community Care Contracts
September 19, 2013

Contracts Provide Expanded Access to Community-based Care
WASHINGTON -- The Department of Veterans Affairs announced today that Veterans will have greater access to quality health care through a new initiative:  Patient-Centered Community Care (PCCC).  

“PCCC is an innovative solution that helps VA medical centers continue to provide quality care efficiently,” said Secretary of Veterans Affairs Eric K. Shinseki. “This will be a valuable option for VA medical centers to use to expand our Veterans’ access to care.”

Under PCCC, VA medical centers will have the ability to purchase non-VA medical care for Veterans through contracted medical providers when they cannot readily provide the needed care due to geographic inaccessibility or limited capacity.  Eligible Veterans will have access to inpatient specialty care, outpatient specialty care, mental health care, limited emergency care, and limited newborn care for enrolled female Veterans following the birth of a child.

“PCCC provides a regional contracting vehicle for VA to work with local community providers to give Veterans access to high quality care,” said Dr. Robert Petzel, VA’s Under Secretary for Health.  “It will also help VA in our continued efforts to ensure timely and accessible services are provided to Veterans for non-VA medical care.”

In total, VA has awarded two contracts under PCCC, one to Health Net Federal Services LLC and another to TriWest Healthcare Alliance Corp.  These companies will set up networks in six regions covering the entire country.  VA expects to have these regional contract networks available to its medical centers by the spring of 2014.  The awarded contracts, estimated at $9.4 billion, include one base year and four option years.

PCCC is part of the overall Non-VA Medical Care Program.  It will provide all VA facilities with an additional option to purchase non-VA medical care when required Veteran care services are unavailable within the VA medical facility or when the Veterans benefit from receiving the needed care nearer to their homes.
Among the many benefits to the Veterans and VA under these new contracts, VA will enjoy standardized health care quality metrics, timely return of medical documentation, cost avoidance with fixed rates for services across the board, guaranteed access to care, and enhanced tracking and reporting of non-VA medical care expenditures over traditional non-VA medical care services.

VA HAS IDENTIFIED RESPIRATORY CANCERS ASSOCIATED WITH AGENT ORANGE

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS 

Veterans' Diseases Associated with Agent Orange » Respiratory Cancers

Veterans who develop respiratory cancer (lung, bronchus, larynx, or trachea) and
were exposed to Agent Orange or other herbicides during military service do not have to prove a connection between their disease and service to be eligible to receive VA health care and disability compensation.

About respiratory cancers

Respiratory cancers are cancers of the lung, larynx, trachea, and bronchus.
Symptoms vary, depending on the location of the cancer:

Lung cancer—a new cough or cough that doesn't go away, coughing up blood, shortness of breath, chest pain, hoarseness

Cancer of the trachea—dry cough, hoarseness, breathlessness, difficulty swallowing

Cancer of the larynx (at the top of the trachea)—hoarseness, voice changes, sore throat or earache, feeling of a lump in the throat
Cancer of the bronchus—cough, chest pain, coughing blood
Visit Medline Plus to learn more about treatment of cancer and the latest research from the National Institutes of Health.

Guard against lung cancer
Number one rule: Don’t smoke and avoid second-hand smoke. VA can help you every step of the way to quit smoking.

VA benefits for respiratory cancers
Veterans with respiratory cancers (lung, bronchus, larynx, or trachea) who were exposed to Agent Orange or other herbicides during service may be eligible for disability compensation and health care.

Veterans who served in Vietnam, the Korean demilitarized zone or another area where Agent Orange was sprayed may be eligible for an Agent Orange Registry health exam, a free, comprehensive examination.

Surviving spouses, dependent children and dependent parents of Veterans who were exposed to herbicides during military service and died as the result of respiratory cancers may be eligible for survivors' benefits.

Research on respiratory cancers and herbicides used in Vietnam
The Institute of Medicine (IOM) of the National Academy of Sciences concluded in its 1994 report "Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam" and in future updates that there is limited/suggestive evidence of an association between exposure to herbicides (2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram) and respiratory cancers.

In updates to this report, IOM noted that associations linking development of respiratory cancers and exposure to dioxin were found consistently only when herbicide exposures appeared to be high and prolonged.

MULTI-INSTITUTIONAL CONSORTIA ESTABLISHED TO RESEARCH PTSD AND TBI

FROM:  U.S. DEPARTMENT OF DEFENSE 

DoD, VA Establish Two Multi-Institutional Consortia to Research PTSD and TBI

           In response to President Obama's Executive Order, the Departments of Defense (DoD) and Veterans Affairs (VA) highlighted today the establishment of two joint research consortia, at a combined investment of $107 million to research the diagnosis and treatment of post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) over a five-year period.

           "VA is proud to join with its partners in the federal government and the academic community to support the President's vision and invest in research that could lead to innovative, new treatments for TBI and PTSD," said Secretary of Veterans Affairs Eric K. Shinseki. "We must do all we can to deliver the high-quality care our Service members and Veterans have earned and deserve."

           The Consortium to Alleviate PTSD (CAP), a collaborative effort between the University of Texas Health Science Center – San Antonio, San Antonio Military Medical Center, and the Boston VA Medical Center will attempt to develop the most effective diagnostic, prognostic, novel treatment, and rehabilitative strategies to treat acute PTSD and prevent chronic PTSD.

           The Chronic Effects of Neurotrauma Consortium (CENC), a collaborative effort between Virginia Commonwealth University, the Uniformed Services University of the Health Sciences, and the Richmond VA Medical Center will examine the factors which influence the chronic effects of mTBI and common comorbidities in order to improve diagnostic and treatment options.  A key point will be to further the understanding of the relationship between mTBI and neurodegenerative disease.

           Since Sep. 11, 2001, more than 2.5 million American service members have been deployed to Iraq and Afghanistan. Military service exposes service members to a variety of stressors, including risk to life, exposure to death, injury, sustained threat of injury, and the day-to-day family stress inherent in all phases of the military life cycle.

           To improve prevention, diagnosis, and treatment of mental health conditions, the President released an Executive Order directing the Federal agencies to develop a coordinated National Research Action Plan. The Department of Defense (DoD), Department of Veterans Affairs (VA), the Department of Health and Human Services (HHS), and the Department of Education (ED) came forward with a wide-reaching plan to improve scientific understanding, effective treatment,  and reduce occurrences of Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), co-occurring conditions, and suicide.

VA ARTICLE ON MENTAL HEALTH WAIT TIMES

FROM:  U.S. VETERANS ADMINISTRATION
On VA’s Mental Health Wait Times
April 24, 2012 by Alex Horton
When Brian Chevalier was killed in an explosion during a complex ambush, our platoon didn’t take it as an exception to otherwise professional soldiering, or as a mistake that could be corrected on the spot. Chevy’s death was a failure on our part, despite our training, our weapons, and our vigilance. It didn’t matter that the triggerman was hidden from view, or the massive bomb was concealed under concrete. We let him down, and he’s not here because we didn’t keep him safe.

Just like physical trauma, psychological trauma can occur in a matter of seconds, but the consequences are felt for a lifetime. We arm troops for conflict—we teach them to shoot, move as a team, and patch each other up—but there is no equivalent steeling once they become civilians. Part of that is the complex nature of mental health; you can protect flesh and organs with armor, but what can shield the mind from the horrors of war?

After more than a decade of conflict, the rising demand for mental health services—coupled with the tragedy of Veteran suicides—has shown we must do more. Just like our platoon couldn’t save Chevy, we fail when a Veteran turns to suicide instead of help, or leaves a VA facility because no appointments are available, or when the culture and language of the military creates a divide between clinicians and Veterans.

VA has taken steps to treat all aspects of the problem—from nightmares to short tempers to suicide—by increasing its mental health budget in the last three years by 39 percent. Additionally, the Department announced the hiring of an additional 1,900 mental health staffers across the country—an increase of nearly 10 percent. The boost will bring in what Vets need—over 1,600 nurses, psychiatrists, psychologists, social workers, licensed professional counselors, and marriage and family therapists, as well as 300 support staff to assist in the heavy lift. This is one boost in an ongoing assessment of all VA mental health operations that has been underway since 2011.

That would go far to ease what a recent VA Inspector General report identified as a major issue: Veterans are not being seen for mental health appointments as quickly as had been reported.

According to the investigation, the Veterans Health Administration met its goal of fully evaluating patients within 14 days only about 49 percent of the time. The remaining 51 percent waited an average of 50 days for full evaluations (though situations considered mental health emergencies are handled differently). For follow-up treatments, the report indicated an appointment is scheduled within 14 days about 88 percent of the time. When seconds and minutes count—as they do in combat—VA did not meet its own standard.
Many Veterans seek basic mental health care each day. That’s why the staff increase isn’t meant to simply prevent suicides before they happen. It’s about providing increased availability of appointments and resources. But more fundamentally, it helps VA build a community of care that includes trained mental health clinicians, peer support specialists, outreach workers, group support and more to promote the wellness of Veterans. It’s that kind of deep community involvement in mental health treatment—much like a military unit—that we hope improves lives.

When a Veteran calls and says he or she needs help, and we say the first available appointment is several weeks away, we have failed that Veteran by our own standard. It’s past time to say we will fix the problem, or that solutions are on the horizon. The best we can do now is to honor the living and the dead by being advocates and taking the failures we accumulate not as statistics, but scars. It should grind us up; eat at us and shock us. It should drive us. We must face the idea that thousands of returned Veterans need assistance every single day. Then we must look forward, anticipate their needs, and do better. Each of us owes that much to the Vet out there, in a dark place, looking to us to help heal the trauma inflicted on our behalf.

Chevy is not coming back. The failure to protect him haunts the men of second platoon, whose men can never say, “We’ll work to prevent this from happening in the future.” Like in war, future responses don’t make up for past failures. There are still men and women coming home healthy on the outside but eventually succumbing to mental wounds sustained in combat. Chevy’s death made us look sharper, shoot straighter, and move quicker. It’s our memory of failure that helped us protect each other’s life.

THE CIVIL WAR AND HONORING THE WAR DEAD

FROM:  VETERANS AFFAIRS
PHOTO: AFTERMATH AT GETTYSBURG
The Civil War’s Legacy of Honoring War Dead
April 18, 2012 by Alex Horton
We’ve all been taught the consequences of the U.S. Civil War since childhood. How it led to the emancipation of slaves, solidified state and federal rights, and further made the case for women’s suffrage. But the unprecedented carnage of the war also transformed the attitude of how the nation honors its military dead; a tradition now indelible to the American spirit.

That was the premise behind a talk given by Harvard University President Dr. Drew Faust at VA central office in Washington today. Through her research, Dr. Faust found that the Civil War fundamentally changed the way our country handled death on the battlefield. Both the Union and Confederacy were ill equipped to bury fallen troops in a dignified manner, and death notifications sent to families were informal and happenstance, if they happened at all. Unmarked and hasty graves littered fields and farms near battlefields where hundreds of thousands of men struggled and died.

Humanitarian ideas and the dignity of the human spirit were transformed in the crucible of war, and an emerging sense of responsibility for our war dead led to drastic shift in government obligations.

Edmund Whitman, an Army officer and a quartermaster during the war, led the effort. Whitman inspected cemeteries and battlefields across the south from 1865-1869, examined informal records, and conducted interviews to find out locations of fallen troops. He oversaw the reinterment of over 100,000 Union soldiers. About 300,000 were reburied in 74 national cemeteries, which now fall under the purview of the National Park Service.
As Dr. Faust noted, it was Whitman’s mission to put human faces and human cost to the war, and to recognize the sacrifices of so many of our own. His work helped to establish the notion that those who fell in battle are to be honored, and it’s our duty as citizens to remember and cherish that.

It’s difficult to fathom the damage of the war. An estimated 600,000 soldiers from both sides were killed; if the war were fought today with the same casualty rate, six million would lay dead. But it’s also hard to imagine a time when the care of our slain troops was an afterthought—an annoyance to both troops in the field and folks in the halls of government. It’s now one of VA’s most sacred obligations, but it took a war of staggering magnitude for our nation to realize it had a duty to honor the dead as much as they honored us.

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.

VETERANS AFFAIRS AND OCCUPATIONAL THRAPY

FROM:  U.S. DEPARTMENT OF VETERANS AFFAIRS
Occupational Therapy: Helping Vets Live an Independent Life
“He Taught Us All A Lesson.”
Occupational therapy (OT) is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities.

As the largest health care system in the nation, VA is the single largest employer of occupational therapists. According to Eric Lipton of the VA Palo Alto Health Care System, the primary goal of VA’s occupational therapists is to help Veterans optimize their functional performance in areas that are meaningful to their lives.
Lipton is currently Occupational Therapy Supervisor for the VA Palo Alto Health Care System. Prior to becoming supervisor, he primarily worked with Veterans in Community Living Centers (CLC).

Occupational Therapists use a holistic approach and address activities of daily living, such as dressing, bathing and grooming, as well as more advanced activities such as cooking, shopping, driving, parenting, and returning to work.

Occupational Therapists use a holistic approach and address activities of daily living, such as dressing, bathing and grooming, as well as more advanced activities such as cooking, shopping, driving, parenting, and returning to work.

They are skilled at assessing performance, analyzing the components of tasks, and helping to improve performance through adapting the way a person is performing the task, the use of equipment, or by adapting the environment.
“I can’t believe I get paid to do this.”

Help for Vets of All Ages
VA occupational therapists work with individuals who suffer from a mentally, physically, developmentally or emotionally disabling condition by utilizing treatments that develop, recover, or maintain clients’ activities of daily living.
VA works with thousands of Veterans of all ages.
The therapist helps clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function.
Mr. Lipton describes an example of just one of his patients:
“One Veteran had Amyotrophic lateral sclerosis (commonly called Lou Gehrig’s disease).
“I needed to address different areas as his disease progressed. The initial focus was on retraining for activities of daily living, and eventually became how to maximize his comfort as he was dying. The Veteran went from utilizing a walker to a scooter, and eventually to a highly adapted power wheelchair.

“When it got to the point that he could only move his head, OT treatment shifted to maintaining his ability to safely operate his power wheelchair independently, keeping him well positioned, emphasizing wound prevention, preventing his body from becoming contracted, and pain management.

“I will never forget his spirit as he participated in life until the end. The image I remember most is seeing him with a big smile, dancing by just moving his head to the beat. He taught us all a lesson how to live life to the fullest, and I feel OT helped to facilitate that.”
Dedicated to his profession, Lipton explains his commitment to helping Vets overcome some of the hurdles life has given them.

“I have had the great honor to work with Veterans who represent a very large span of American history, including Veterans from World War I all the way to the current Global War on Terror. They have made huge sacrifices that often have long-term consequences to their health.
“That’s why the VA Health Care System is so important. We really understand the specialized needs of our Veterans.”

Wide Variety of Occupational Therapy Treatments
The focus of occupational therapy treatment in a VA Community Living Center (CLC) varies greatly, depending on the needs of the Veteran being served. Occupational Therapists in this setting may work with a patient following a stroke to be able to safely and independently dress, bathe, and cook so they can return home.
Another Veteran may have a spinal cord injury and live at the CLC. Their occupational therapy treatment may be focused on the operation of a power wheelchair, preventing pressure ulcers, and maintaining strength and range of motion. Or a Veteran may have Alzheimer’s disease and the focus may be to keep the Veteran safe and as functional as possible by adapting the environment or through staff or caregiver training.
Lipton feels “lucky” to be working with Vets.

“My favorite work setting was working on a unit that specialized in gero-psychiatry (treating mental illness in the elderly). I felt lucky to be working there. It was a great opportunity to work with Veterans who still want to contribute to the world.
“I led therapeutic groups and the patients were fully engaged in the activities. It was energizing for both the patients and staff. I consistently walked away thinking, ‘I love working here. I can’t believe I get paid to do this.’
“I would love to see the profession of occupational therapy, the VA Health Care System, and health care in general, focus more on preventive health and wellness. We can dramatically impact quality of life by teaching people how to engage in healthier lifestyle habits. Occupational Therapists are well suited to doing this, as we take a holistic approach when working with people.”

April is Occupational Therapy Month, a perfect time to reflect on the work VA does to help Veterans live a full and productive life.

VA WORKS TO END VETERAN HOMELESSNESS

FROM AMERICAN FORCES PRESS SERVICE

VA Makes Progress on Pledge to End Veteran Homelessness

By Donna Miles
WASHINGTON, April 3, 2012 - The Veterans Affairs Department is making progress on its pledge to end homelessness among veterans, with a focus on getting all homeless veterans off the streets by 2015, VA Secretary Eric K. Shinseki told American Forces Press Service.

Shinseki joined President Barack Obama in announcing the plan in November 2009, proclaiming that no veteran should ever have to be living on the streets.

VA is working toward that goal, Shinseki told Congress last month, reporting that the number of homeless veterans on a given night dropped from 76,300 in 2010 to about 67,500 in 2011. The next goal, he said, is to drive those numbers down to 35,000 by the end of fiscal 2013, and ultimately, to zero.

As Shinseki set out to transform VA after arriving in 2009, he made the homeless issue a top priority in getting to the bottom of what he viewed as an institutional problem.

"Homelessness among veterans was a demonstration to me that we didn't have all our programs knitted together," he said. "As good as we thought we were doing in health care and other benefits, ... we had people who were slipping through the gaps in our programs -- most visibly, the homeless."

Getting homeless veterans off the streets, particularly within such a tight timeline, would be the driving force in creating positive change throughout VA, he explained.

"If you say you are going to end homelessness, then you have to be good at everything else," he said. "If you declare to end it, you have to figure out all the pieces that contribute to it so you can begin solving the pieces in order for the whole to be solved."

That, he said, requires making sure VA is addressing the root causes behind homelessness.

It means more than simply getting veterans into school; it means making sure they graduate, he explained. It's not just sending them for vocational training; it's ensuring they finish the training and are postured to land a job.

"That's how you beat homelessness," Shinseki said. "It's not the front door. It's the back door. What did they gain out of the program?"

To support this effort, VA's budget request for fiscal 2013 includes nearly $1.4 billion for programs designed to prevent or end homelessness among veterans. This represents a 33 percent increase, or $333 million, over the 2012 funding level.

The additional funding will provide grants and technical assistance to community nonprofit organizations to maintain veterans and their families in current housing or get them quickly into new housing. It also will provide grants and per diem payments for community-based organizations offering transitional housing to 32,000 veterans.

Shinseki also plans to hire 200 coordinators to help homeless veterans with disability claims, housing problems, job and vocational opportunities and problems with the courts.

Since announcing his homeless initiative, Shinseki said, he's come to understand that dealing with homelessness is really a two-part challenge.

It's one thing to get homeless veterans physically off the streets in what he calls the "rescue" part of the challenge. Shinseki said he feels confident that this part of the mission to be completed by 2015, as promised.

But the less visible and more challenging part of the problem, he said, is addressing a population that's at risk of becoming homeless. These, Shinseki explained, are veterans who are "one paycheck, one mortgage payment, one more missed utility bill away from being evicted."

"We never see that. But if we are going to truly end homelessness, we have to have a better picture of [that]... and go into prevention mode," Shinseki said. "Otherwise, you will never be able to solve this."

So while he expects the rescue mission to wrap up in 2015, Shinseki said, he'll be able to dedicate more resources toward an ongoing prevention effort.

"If you don't stop this faucet, you never end homelessness," he said.