August 2009 Archives

August 7, 2009

Veterans Health Care Budget Reform and Transparency Act Clears Senate  

Moving another major step towards ensuring sufficient, timely and predictable funding for veterans health care programs, the Senate yesterday approved the Veterans Health Care Budget Reform and Transparency Act (S. 423 / H.R. 1016).  The legislation must now be reconciled with a slightly different House version approved in June before it can be sent to President Obama, who has promised to sign it into law.  

Recent VA News Releases

To view and download VA news release, please visit the following Internet address:

Secretary Shinseki Announces Expansion of Counseling for Combat Veterans
Additional 28 New Community Vet Centers

WASHINGTON (August 14, 2009) - Today, Secretary of Veterans Affairs Eric K. Shinseki announced that combat Veterans will receive readjustment counseling and other assistance in 28 additional communities across the country where the Department of Veterans Affairs (VA) will establish Vet Centers in 2010.

"VA is committed to providing high-quality outreach and readjustment counseling to all combat Veterans," Secretary Shinseki said. "These 28 new Vet Centers will address the growing need for those services."

The community-based Vet Centers -- already in all 50 states -- are a key component of VA's mental health program, providing Veterans with mental health screening and post-traumatic stress disorder (PTSD) counseling.

The existing 232 centers conduct community outreach to offer counseling on employment, family issues and education to combat Veterans and family members, as well as bereavement counseling for families of servicemembers killed on active duty and counseling for Veterans who were sexually harassed on active duty.

Vet Center services are earned through service in a combat zone or area of hostility and are provided at no cost to Veterans or their families.
They are staffed by small multi-disciplinary teams, which may include social workers, psychologists, psychiatric nurses, master's-level counselors and outreach specialists. Over 70 percent of Vet Center employees are Veterans themselves, a majority of whom served in combat zones.

The Vet Center program was established in 1979 by Congress, recognizing that many Vietnam Veterans were still having readjustment problems. In 2008, the Vet Center program provided over 1.1 million visits to over 167,000 Veterans, including over 53,000 visits by more than 14,500 Veteran families. More information about Vet Centers can be found at

Communities Receiving New VA Vet Centers

American Samoa
Arizona -- Mohave and Yuma Counties
California -- San Luis Obispo County
Delaware - Sussex County
Florida -Marion, Lake, Collier, Okaloosa and Bay Counties
Georgia - Muscogee and Richmond Counties
Hawaii - Western Oahu
Indiana - St. Joseph County
Louisiana - Rapides Parish
Michigan - Grand Traverse County, also serving Wexford County
Missouri - Boone County
Montana - Cascade and Flathead Counties
Ohio - Stark County
Oregon - Deschutes County
Pennsylvania - Lancaster County
South Carolina - Horry County
Texas - Jefferson and Taylor Counties
Utah - Washington County
Washington - Walla Walla County, also serving Umatilla County, Oregon
Wisconsin - LaCrosse County, also serving Monroe County

August 26, 2009

Study: Decentralization Helped Turn VHA Around


The reorganization of the Veterans Health Administration away from a centralized system to a set of regional networks funded according to the number and type of patients each network serves helped the agency successfully carry out a large-scale quality improvement effort in the 1990s, according to Harvard Professor Ashish Jha, who has studied VHA extensively.

Jha's conclusions are part of a Congressional Budget Office assessment of the VHA's quality initiatives requested by the House Veterans' Affairs and Appropriations Committees.

The agency provides medical services through about 150 medical centers, and over 900 outpatient clinics and other facilities to more than 5 million veterans a year at a cost of over $40 billion.

According to the report, beginning in the mid 1990s VHA eliminated underutilized inpatient beds and facilities, expanded outpatient clinics, and restructured eligibility rules.

VHA has achieved improvements in the quality indicators it measures and for which it holds its staff accountable, CBO concluded

Data Tracking a Key Component


The CBO report said many of VHA's quality improvement programs use data from computerized clinical records to track both process and outcome measures, including risk-adjusted mortality and morbidity and that those programs have helped VHA to recognize problems in specific health care facilities as well as to improve performance throughout the agency. 

Jha's study also cites data collection and feedback through external peer reviews, performance contracts and incentives and health IT efforts that resulted in, for example, the VistA graphical user interface in use at VHA facilities as other key factors helping the VHA improve.

CBO said the agency's "strong focus by management on key quality indicators can substantially improve performance, at least in terms of process indicators such as the administration of recommended laboratory tests or vaccinations.

It also noted that rapid increases in annual appropriations for VHA, efforts to reduce waiting lists within the system, and expansion of mental health and other specialized services have contributed to the recent growth in spending per enrollee which is roughly comparable to rises in spending per Medicare

Recent VA News Releases
To view and download VA news release, please visit the following Internet address:

Secretary Shinseki Moves to Simplify PTSD Compensation Rules

WASHINGTON (Aug. 24, 2009) - Secretary of Veterans Affairs Eric K.

Shinseki announced the Department of Veterans Affairs (VA) is taking steps to assist Veterans seeking compensation for Post-Traumatic Stress Disorder (PTSD).

"The hidden wounds of war are being addressed vigorously and comprehensively by this administration as we move VA forward in its transformation to the 21st century," said Secretary Shinseki.

The VA is publishing a proposed regulation today in the Federal Register to make it easier for a Veteran to claim service connection for PTSD by reducing the evidence needed if the stressor claimed by a Veteran is related to fear of hostile military or terrorist activity. Comments on the proposed rule will be accepted over the next 60 days. A final regulation will be published after consideration of all comments received.

Under the new rule, VA would not require corroboration of a stressor related to fear of hostile military or terrorist activity if a VA psychiatrist or psychologist confirms that the stressful experience recalled by a Veteran adequately supports a diagnosis of PTSD and the Veteran's symptoms are related to the claimed stressor.

Previously, claims adjudicators were required to corroborate that a non-combat Veteran actually experienced a stressor related to hostile military activity. This rule would simplify the development that is required for these cases.

PTSD is a recognized anxiety disorder that can follow seeing or experiencing an event that involves actual or threatened death or serious injury to which a person responds with intense fear, helplessness or horror, and is not uncommon in war.

Feelings of fear, confusion or anger often subside, but if the feelings don't go away or get worse, a Veteran may have PTSD.

VA is bolstering its mental health capacity to serve combat Veterans, adding thousands of new professionals to its rolls in the last four years. The Department also has established a suicide prevention helpline (1-800-273-TALK) and Web site available for online chat in the evenings at

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