October 2007

October 12, 2007

The Social Security Administration has announced that service members can receive expedited processing of disability claims for Social Security benefits. Because the benefits are different from those provided by the Department of Veterans Affairs, they require a separate application. The expedited process is used for service members who become disabled while on active military service on or after October 1, 2001, regardless of where the disability occurs. For more information, visit Social Security’s website at http://www.socialsecurity.gov/woundedwarriors/.

October 12, 2007

The Department of Veterans Affairs is seeking former prisoners of war (POWs) or their family members who are not currently receiving VA benefits and services. Officials are urging them to contact VA to find out if they are eligible for health care, disability compensation or other services. The majority of an estimated 25,000 living former POWs are veterans of World War II who served before the use of Social Security numbers. This has made it difficult for VA officials to track down former military POWs who have not been in contact with the department in recent years. People who know a former POW can ask him or her to contact VA at (800) 827-1000. Details about benefits and services available to former POWs and family members are available at www.vba.va.gov/bln/21/Benefits/POW/index.htm.

October 17, 2007 

Commissioners call for streamlined vets' benefits
From CongressDaily 

By Alyssa Rosenberg

Former Sen. Robert Dole and former Health and Human Services Secretary Donna Shalala told a Senate panel Wednesday that the Defense and Veterans Affairs departments need to streamline and clarify benefits processes.

"In our national survey of injured service members," said Shalala, who co-chaired the President's Commission on Care for America's Returning Wounded Warriors with Dole, "less than half understood the DoD's disability evaluation process. And only 42 percent of retired or separated service members who had filed a VA claim understood the VA process."

That lack of understanding provides a significant obstacle to returning wounded soldiers to active duty or getting them the benefits they need to return to work in civilian life, the senators and witnesses said.

"Today's soldier chooses a military career, and their expectation is the same as it would be for any professional working in any organization across America," said Sen. Richard Burr, R-N.C., Veterans Affairs Committee ranking member. "If one is hurt on the job, one expects quick, effective and relatively hassle-free physical, vocational restoration and support services from the employer."

The commission's first recommendation would simplify the disability process by assigning the Defense Department sole responsibility for performing the physical exam that determines a soldier's fitness to serve. If that exam reveals that a soldier is not fit to serve, the VA should use the results to assign a disability rating, Shalala said.

"DoD should determine fitness standards and provide for the health and readiness of the military workforce," she told the senators. "VA's mission is to care for our nation's veterans by providing appropriate benefits and services."

Retired Lt. Gen. James Scott, chairman of the Veterans' Disability Benefits Commission, told the panel that the current system, which requires independent examinations by Defense and VA, frequently results in inconsistent disability ratings.

Patrick Dunne, the assistant secretary for policy and planning at VA, said the department is running exercises to test a one-examination system, and to make sure it would produce fair, consistent disability ratings and provide quick service.

"We envision it cutting in half the time it takes for a service member to go through [the Disability Evaluation system], from the time the member is referred for a Medical Evaluation Board to the time the member is discharged from active military service and receives his or her first payment from VA," he said.

The commission's second recommendation calls for Congress to provide those service members disabled because of injuries sustained in combat and their families with lifetime health care coverage and pharmacy benefits through the Defense Department's TRICARE program.

Shalala said this health care guarantee would improve veterans' prospects of employment, because it would allow them to consider taking jobs that did not provide full health benefits.

"Many of these young people can take a job, but finding a job that has benefits that will cover their families is a real challenge," she said. "It will change their lives if this benefit is available. They will have a lot more choices."

In addition to calling for comprehensive health care, the commission also recommended that Congress establish a "presumptive eligibility" standard that would make veterans of the Iraq and Afghanistan conflicts eligible for lifetime treatment for post-traumatic stress disorder through the VA.

"We want to make it clear that there ought not to be a time constraint, because PTSD can show up two or three years later," Shalala said. "I think that making it very clear that they have access to services -- lifetime services -- is extremely important."

Shalala asked Congress to restructure the payment of veterans benefits into three categories: transition payments that would provide three months of base pay for veterans finished with rehabilitation, or living expenses for the duration of education or work training programs; earnings loss payments that would compensate soldiers for diminished earning capacity related to their service; and quality of life payments.

"People have a social life. Maybe you won't be able to dance, maybe you won't be able to play the piano; there are things you won't be able to do, and we think it's time it's recognized and paid for," Dole said.

Shalala also said Congress should amend the Family and Medical Leave Act to extend unpaid leave for a family member of a wounded service member from 12 weeks to six months. She also recommended that service members with combat-related injuries be made eligible for an aide and personal attendant benefit to ease the care-giving burden on their family members.

All of these changes to veterans' experiences should be accompanied by modifications of Defense and VA systems, Dole said. One innovation he reported was already under way is the creation of a unit of 50 to 100 recovery coordinators who are currently being trained by the Public Health Service and who will be assigned to wounded service members when they return to the United States.

Dole said a number of the veterans he worked with "each had case manager after case manager. One told us he had over 10 and could never remember what they were managing, never mind their names."

In addition to eliminating turnover, the recovery coordinators will be able to bridge divides between the VA and the Defense Department.

"We thought it best to place these individuals outside of either the DoD or VA," Dole said. "Part of this reasoning was because we were concerned that VA or DoD employees would not be allowed to effectively reach out to the other department, marshaling needed services, with any degree of authority."

The coordinators will be responsible for creating and guiding wounded service members through complete recovery plans, including helping them negotiate a new and simplified network of benefits, and exploring both VA and private sector options.

Dunne said the hiring of 100 patient advocates would also help veterans negotiate the disability system.

"These men and women, often veterans themselves, recognize the difficulty in understanding the many different programs and processes which come into play," he said.

Dole also said that service members soon will have access to a customized Web portal that would provide them with information specific to their situation, further minimizing confusion about benefits. That system is in the testing phase.

Dole and Shalala's final recommendation sought full support for the Walter Reed Army Medical Center until it closes, to prevent any veterans from being victimized by deteriorating conditions.

But they concluded that it is time for a paradigm shift in delivering benefits to service members and veterans.

"Someone's got to stand up and say it's a different kind of warfare, it's a different kind of generation," Dole said. "Maybe we ought to move ahead."

October 19, 2007 

Lawmakers probe health care staffing shortages at VA
From CongressDaily 

By Brittany R. Ballenstedt 
In the face of a critical shortage of health care professionals at the Veterans Health Administration, stronger incentives are needed to attract top talent into the workforce, group representatives told a House subcommittee Thursday.

"Shortages in health care staff threaten the VHA's ability to provide quality care and treatment to veterans," Joseph Wilson, assistant director of veterans affairs and rehabilitation for the American Legion, told the House Veterans' Affairs Subcommittee on Health.

By 2020, nurse and physician retirements are expected to create a shortage of about 24,000 physicians and almost 1 million nurses nationwide, according to government estimates. Further complicating the shortage is a lack of teaching faculty and classroom space in universities, which caused more than 42,000 qualified applicants to be turned away from nursing schools last year, the American Association of Colleges of Nursing reported separately.

Joy Ilem, assistant national legislative director for Disabled American Veterans, testified that VHA's shortage of nursing staff, coupled with inadequate funding, has resulted in hiring freezes in some hospitals. VHA has required overtime, reduced flexibility in tours of duty for nurses, and limited locality pay, she said.

Additionally, the increasing need for rehabilitation services among veterans is boosting demand for physical therapists across the VA system, said Jeffrey Newman, chief of physical therapy at the Minneapolis VA Medical Center. The VA has not kept pace with current professional practice standards, he said. VA qualification standards, for example, only require a therapist to obtain a bachelor's degree and do not recognize the doctorate of physical therapy degree, he said.

"Not only is this severely out of date with current minimal education requirements, but it is not competitive with clinical settings outside the VA system," Newman said.

William Feeley, deputy undersecretary of health for operations and management at the VA, said that while the VA is facing workforce challenges, it has effectively boosted its efforts to attract quality professionals.

In April, for example, the agency launched the VA Nursing Academy, designed to increase the number of nursing faculty in schools, increase student nursing enrollment by 1,000 and promote innovations in nursing education through enhanced clinical rotations in the VA. "VHA research shows that students who perform clinical rotations at a VA facility are more likely to consider VA as an employer following graduation," Feeley said.

The VA also provides new hires with student loan repayments, with an average payout of $17,000, Feeley said. In addition, employees may receive scholarships of up to $32,000 to obtain additional health care degrees, he said.

In 2006, VHA contracted with CACI Strategic Communications to conduct a pilot program to test and recommend innovative recruitment methods for hard-to-fill health care professions. CACI conducted a 60-day study at the North Florida and South Georgia Veterans Health System, with the goal of increasing the number of qualified applicants coming into the system as well as reducing the administrative time between application receipt and job offer.

The marketing campaign generated 10,261 inquiries into new nursing positions, with 115 of those resulting in applications, said Jim Bender, communications services manager for CACI. The study also found that VA's hiring times can be reduced from 72 days to 25 days, largely by automation to eliminate delays in paper-based mail and processing, he said.

Still, witnesses noted that funding is critical to the VA's recruitment and retention needs and urged lawmakers to provide the financial support and direction necessary to address short- and long-term health care needs. Witnesses also recommended that the committee provide oversight to ensure sufficient staffing levels and regulate the VA's use of mandatory overtime.

"While we applaud what VA is trying to do in improving its nursing programs, these competitive strategies are yet to be fully developed or deployed," Ilem said. "Congress must provide sufficient funding through regular appropriations that are provided on time, to support programs to recruit and retain."

October 23, 2007

Mrs. Robin Gutierrez, Chief Administrator for the Kerrville V. A. Medical Center , (KVAMC), gave the briefing for Mr. Tim Shea, Director of the South Texas Veterans Health Care Services, (STVHCS). She presented the STVHC’S monthly dashboard which indicates by color code and numerical percentages as to where the (STVHCS) stands; improvements and needed improvements according to specific criteria established by the Dept. of Veterans Affairs to rate all V. A. facilities.

There is at present, 22 key drivers; several with 10 specific categories. For example: ten specialty clinics, each rated for “new patients, established patients, waiting times”. Happily great improvements have been made in these categories, and almost all others except “missed opportunities” i.e. “patient no shows”. Your help is needed in this category since only we patients have control. Please Help Out Your Fellow Vets by Calling In So Your Slot Maybe Used By Another Waiting Vet.

Another key driver: “Patient Satisfaction”. The council has noted that health care and other key indicators are receiving high marks, yet patients’ satisfaction lags far behind and ratings are consistently unsatisfactory. Since both of these categories are derived from patient inputs, both council and the V. A. are at a real loss on what needs to be done to resolve this enigma? 

For a printable copy of the STVHC's monthly dashboard, please click here.

Comments to us or the V. A. would be greatly appreciated.