September 2010 Archives


1700 Sidney Baker, Suite 100

Kerrville, Texas 78028

830-896-1157          Fax 830-896-1175

Walter Schellhase, President                                                                                                                                          Gene Higgins

Bennie Hyde, Vice President                                                                                                                                           Alan Hill

Bill Bacon, Past President and                                                                                                                                         Jack Ledford

Founder                                                                                                                                                                          Gene Ritchie

Board Members                                                                                                                                                            Connie Smith

Dan Bacon                                                                                                                                                                        Bob Waller

Sam Barker                                                                                                                                                                       Dick Yeomans

Joe Benham

1 September 2010

To Whom It May Concern:

In late 2009 Secretary of Veterans Affairs, General Shinseki, initiated a “Lease Land Program” (LLP) described as providing transitional housing for homeless veterans.  The Hill Country Veterans Council has heard many presentations on this program over the past eight months.

Our understanding of this program is covered in detail in the attached summary.  Basically, the Veterans Council will support this proposal ONLY if it is limited to veterans and their families.

The fact is that this is not transitional housing for veterans; rather, it’s government-subsidized housing for anyone needing a low-cost place to live.  Our veterans deserve better.

After extensive review and discussion, and meetings with VA officials and the proposed developer, the Veterans Council Board of Directors has voted to support such a project only if it provides help for veterans, and only veterans.

Our officers have asked for meetings with our U.S. Senate and House members.  If those requested are granted, we will urge that they propose and support legislation specifying that the Lease Land Program be for the benefit of veterans and their families only, and not be just more public housing.

Walter Schellhase                                                                                President                                                                                                              
Hill Country Veterans Council 




September 1, 2010



In order to fully understand the proposed Veterans Homeless Shelter proposed by the VA the Hill Country Veterans Council has been meeting with VA staff from both San Antonio and Kerrville for over six months.  In addition the Council has met with the proposed developer on the project to obtain as much accurate information as possible.  Hence, the Council has prepared a detailed recap of the information accumulated in the hope to clear up some of the misleading information floating around.  For anyone wanting more information or clarification on what is include in the Council’s recap refer to the Council’s web site –


1.                  This project will be known as the River Vista Apartments as promoted under the VA’s “Enhanced-Use-Lease (EUL) Program.

2.                  Project will be a joint venture between Housing & Community Services of San Antonio, MacDonald and Associates of Kerrville, and NRP Group of San Antonio.

3.                  Housing & Community Services will be the on site operator.

4.                  The project will have 12 efficiency, 24 one bedroom and 44 two bedroom units.

5.                  Each will include a living room, private bathroom, full kitchen, with washer-dryer hookup & bedroom with walk-in closet.

6.                  There will be an outside patio with outside storage.

7.                  The design will be of residential type using masonry veneer exteriors.

8.                  There will be two parking spaces for each unit.

9.                  Facility will be on a 5-acre tract leased from the VA for $1.00 per year for 30-75 years.

10.              Private investors using federal tax credits will finance project.  In general tax credits run for 30 years.

11.              Plans specify four (4) full time employees on-site – manager, assistant manager, social worker, and maintenance worker.

12.              Facility will have a designated area for in-house training such as computer skills, personal finance, job interviews, etc.


1.                  This will house veterans and non-veterans, with and without families.

2.                  Veterans will have priority although all occupants will be on a lease.

3.                  Leases will be 6-12 months.

4.                  If the facility is full a priority veteran will have to wait for a non-veteran’s lease to expire.  No non-veterans with a lease will be evicted to make room for a qualified veteran.

5.                  Each unit will be limited to two individuals per bed: a mother, father, and two children could occupy the two-bedroom unit provided the children are of the same sex.

6.                  Male and female veterans and non-veterans will be allowed.

7.                  Community Services will approve all tenants.  VA will not be in the approval process, but will refer veterans to Community Services.

8.                  MacDonald envisions the project being occupied by only veterans.  They do not plan on recruiting tenants from outside of Kerr County.

9.                  There are on going discussions on the possibility of VA employees who meet the income level to be eligible tenants.  In many cases these employees are veterans.


1.                  All apartments are unfurnished.

2.                  There will be no food service.

3.                  Medical care for veterans will be provided by the VA Hospital if they meet qualifications.

4.                  The community will provide medical care for non-veterans until such time as a national health plan is available and in place.

5.                  Lessee transportation has not been finalized.

6.                  Security has not been finalized, but may be provided jointly by VA Security force and City of Kerrville Police.

7.                  There will be no maid service.

8.                  There are no current plans for support of children.

9.                  There will be no drug or alcohol treatment at this facility.  However, the

Community Services will assist in obtaining such treatment if needed.


1.                  Lessee must provide all furnishing, linens, washer & dryer.  Apartment will have stove/oven, refrigerator & dishwasher.

2.                  Lessee must provide all food and be responsible for preparing it.

3.                  Lessee must provide his own transportation such as getting to and from work, shopping, etc. (Note: A van service is being considered.)

4.                  Lessee will be responsible for all housekeeping.

5.                  Lessee cannot exceed the maximum income limits, currently about $28,000 per year.

6.                  Lessee must sign a lease for at least 6 months, but possibly 12 months.

7.                  Leases can be renewed as many times as needed as long as income limits are met.

8.                  All lessees must submit to a criminal background check and drug testing.


1.                  Housing & Community Services will assist veterans and non-veterans in covering the rent.

2.                  Rents will be no more than 30% of 60% of the local median income.

3.                  Housing & Community Services will use sources such as HUD, USDA, Grants, Foundations, etc. to obtain the necessary financial support for each lessee if they are unable to pay on their own.

4.                  It is assumed that most occupants will have employment providing some income, or other funds such as disability income.


1.                  Billing this as a “Veterans Transitional Housing Project” is misleading.  First, this is not a transitional facility.  It is a rental unit based on a 6 to 12 month lease.  Second, the fact is that veterans have no real priority.

2.                  Veterans only have priority if a vacant unit is available at the time a veteran is in need. 

3.                  It appears to be simply another government-sponsored, low-income housing.

4.                  This project will be built on essentially free land - $1 per year.

5.                  In that this program is an initiative of General Shinsekis, Secretary of Veterans Affairs, it would appear this could be on initial step in the merger of VA and ObamaCare.

6.                  Although this is a 30-75-year program, VA expects that there may no longer have a need for such a facility after 8-10 years, it would be occupied by non-veterans.

7.                  The additional burdens to the taxpayer of Kerr County for services (especially medical) for the non-veteran renters and their family should be of concern.

8.                  There will be no drug or alcohol addicted tenant allowed per the contractor.  The combination of banning drugs and alcohol in the faculty and the fact that many veterans with PTSD are known to have substance-abuse problems will sharply limit the value of the project for homeless veterans.

9.                  If enough eligible veterans are not in the area or can not be moved to the area it is easy to assume this will be nothing more than a low-cost government subsidized housing project on the VA Hospital property.

10.              There is some question as to need.  There are over 50 projects in San Antonio operated by SAHA for veterans (disabled and non-disabled) with current vacancies.

11.              HCVC fully support anything that is good for veterans especially on VA property including this project IF IT IS FOR VETERANS  ONLY and their families.

12.              Congress should authorize and fund a total package to meet the medical, educational (including job training) and housing needs of every veteran.  Specifically, treatment for Post Traumatic Stress Disorder and alcohol and /or drug dependency should be included.


1.      The Veterans Council is urging our congressional delegation to sponsor legislation putting into effect the plan proposed in item 12.  We believe that such a plan would attract wide bipartisan support in Congress

2.      The Veterans Council invites all interested persons, organizations, and local government to participate in this effort.                                                                                                                                     

International Study Led by VA-Harvard Physician Yields Insight on Risks from Fatty Arteries
September 3, 2010


WASHINGTON (September 3, 2010)- An international study of clinical data led by a Department of Veterans Affairs (VA)-Harvard University cardiologist found that patients with deposits of fatty plaque in their arteries are at especially high risk for life-threatening cardiovascular events if they have diabetes, disease in multiple arteries or a history of heart attack or stroke.

"This study was an impressive international collaboration that may hold important clinical benefits for Veterans and others with cardiovascular disease," said VA Secretary Eric K. Shinseki. "The results, presented both in a prestigious medical journal and at a major international cardiology meeting, are likely to be of great significance to physicians-particularly cardiologists-in VA and worldwide."

The findings, from a study of more than 45,000 patients in nearly 30 countries, was published online August 30 by the Journal of the American Medical Association and will appear in the journal's September 22 print edition. The results are also being presented this week at the annual meeting of the European Cardiology Society in Sweden.

According to lead author Dr. Deepak Bhatt and colleagues, the findings may guide future clinical trials and help doctors decide which patients need more aggressive treatment. Bhatt is chief of cardiology at the VA Boston Healthcare System and director of the Integrated Interventional Cardiovascular Program at VA and Brigham and Women's Hospital, a teaching affiliate of Harvard Medical School.

The four-year study included patients who had at baseline clinical evidence of atherothrombosis-in which fatty deposits break off from artery walls to form clots-or who had risk factors for the condition.

Ruptured plaque deposits can form clots that block blood flow to the heart or brain, resulting in heart attack or stroke.

Depending on their medical status and history, different groups of patients in the trial were at higher or lower risk for stroke, heart attack, or cardiovascular death. On the low end of the risk scale-7 percent-were those with no diabetes and only risk factors for atherothrombosis. The risk rose to as high as 25 percent for those with clinical evidence of atherothrombosis in multiple arteries and a history of heart attack or stroke. The presence of diabetes also raised the risk considerably.

"Even stable patients with a previous heart attack or stroke are at particularly high risk of recurrence if they have plaque build-up in several different arteries or if they have diabetes," said Bhatt. "These types of patients need aggressive preventive efforts to keep history from repeating itself."

Knowing that "not all atherothrombosis is equal," write Bhatt and colleagues, can help doctors target therapies such as plaque-reducing and clot-busting drugs to those patients who will benefit most. VA Chief Research and Development Officer Dr. Joel Kupersmith adds, "this study illustrates the importance of basic clinical information in determining the best care for the individual patient."

Possible Agent Orange Effects Lead to More Aid for Vets
Sept 6 2010 —

Vietnam veteran Mark Adams doesn’t know if he was exposed to Agent Orange, the chemical that was dumped by the U.S. military in vast quantities over former South Vietnam during the war.

The chemical, which was used in an effort to destroy crops and jungle cover shielding communist guerrilla fighters, has been linked to a number of disabilities and diseases among Vietnam veterans.

Those vets will have an easier path to accessing health care and qualifying for disability compensation under a recent regulation that takes effect in November.

The new rule in the Federal Register by the Department of Veterans Affairs expands the list of health problems the VA will presume are related to Agent Orange and other herbicide exposures — specifically, adding Parkinson’s disease, ischemic heart disease and B-cell leukemias.

Adams, a recently retired egg farmer who is launching a new business, said because of his service on the front lines as a cavalry platoon leader, he wouldn’t be surprised if he was exposed to the chemical. He applauds the expanded benefits.

“I think there are ramifications from the effect of Agent Orange and it is way beyond what they ever thought,” said Adams, whose troop commander during the war was Eric K. Shinseki, who is now secretary of veterans affairs.

Shinseki said based on requirements of the Agent Orange Act of 1991 and the Institute of Medicine’s 2008 Update on Agent Orange, he determined there was sufficient evidence to add the three additional diseases for the Agent Orange benefit. “It was the right decision, and (President Obama) and I are proud to finally provide this group of veterans the care and benefits they have long deserved,” he said.

Bradley Mayes, director of Boston VA regional office and former director of VA Compensation and Pension Service, said Monday some 150,000 veterans are expected to submit claims within the coming months due to the expanded benefit.

The cost is expected to be at least $39.7 billion in benefits and health care due to the new rules over next decade, according to federal estimates.

After a 60-day congressional review period, VA can begin paying benefits for new claims and may award benefits retroactively for earlier periods. VA encourages Vietnam veterans with the three diseases to submit their applications for access to VA health care and compensation now so the agency can begin development of their claims.

Health Care Coverage Expanded for Vietnam Veterans

August 30, 2010

The Department of Veterans Affairs recently announced it will expand its list of health problems presumed to be related to Agent Orange and herbicide exposures. This change means veterans who were exposed to herbicides during the Vietnam War should be able access disability compensation and health care treatment more easily.

Vietnam Veterans who served between January 9, 1962 and May 7, 1975 may have been exposed to herbicides. The decision to expand benefits comes on the heels of a 2008 study from the Institute of Medicine regarding health issues caused by Agent Orange and other herbicides.

Says Eric K. Shineski, Secretary of Veterans Affairs, about the decision to expand coverage, "It was the right decision, and the President and I are proud to finally provide this group of Veterans the care and benefits they have long deserved."

The VA expects more than 150,000 veterans to apply for Agent Orange claims over the next 18 months.

For more information, refer to the Department of Veterans Affairs' Press Release: VA Health Care and Benefits Provided for Many Vietnam Veterans

Gates Suggests Raising Health Care Premiums for Employed Veterans
Wednesday, September 08, 2010

With the Department of Defense staring at enormous cost increases for its health care program, Defense Secretary Robert Gates is proposing raising premiums for the first time ever since the creation of the Tricare system in 1996.

Health care costs for the Pentagon have ballooned from $19 billion in 2000 to an estimated $50 billion for next year, and $65 billion by 2015. Gates wants to avoid increasing premiums for active-duty personnel and their families. Instead, he’s suggesting charging higher premiums and co-pay fees for retired veterans using Tricare who have access to private health care plans through their current employers.

Gates’ idea is likely to have a tough time gaining approval in Congress, where both Democrats and Republicans have been reluctant to lift Tricare premiums for any military personnel.

September 11, 2010

Filed under: Uncategorized — Tags: chiropractic; Dr. Anthny J. Lisi; VA health care; — veteranclaims @ 7:40 pm

Full Article at: UB chiropractic professor to oversee care at U.S. Department of Veterans Affairs

Anthony J. Lisi, associate professor of clinical sciences at University of Bridgeport, has been selected to oversee chiropractic care at the Veterans Health Administration, which serves more than 7.8 million enrolled veterans and is the nation’s largest health care system.

Dr. Lisi will guide the improvement and expansion of the VHA chiropractic program, which was established in 2004 in response to legislation that requires at least one chiropractor at each of its 21 geographic regions. Currently 38 chiropractors work in 32 VHA sites, and the number is expected to grow.

More than 263,000 veterans from Iraq and more than 7.8 million veterans total make it critical for the VHA to provide chiropractic services, which can play a crucial role in treating various
musculoskeletal problems including traumatic injuries due to explosive devices, less-severe injuries, and general back pain.

“The chiropractic program can now provide another option in the management of our nation’s veterans health care,” said Dr. Lisi. “There had been a lot of interest in this from veterans groups and from VA providers. This is a way to serve those needs.”

Veteran’s retirement benefit

By Jennie L. Phipps ·

Sunday, September 12

A veteran's retirement benefit called Aid and Attendance has been around for nearly 60 years, but is largely overlooked and could be a great retirement planning tool for people who don't think they can afford long-term care insurance.

Any veteran who served at least one day during World War II, the Korean conflict, Vietnam or the Gulf War are potentially eligible for the program. The veteran doesn't have to have any kind of war injury. If you can qualify for a VA loan, chances are you can qualify for this.

Through the Aid and Attendance program, the Department of Veterans  Affairs pays between $1,056 and $1,949 per month for home-based care or care in a facility for single vets, married veterans and their spouses, and surviving spouses.

To qualify, a couple's retirement income can't be higher than $23,396 and a single vet can't make more than $19,736. The income limit for a widow or widower is $12,681. Veterans whose annual earnings exceed that amount may still qualify if their income falls to that level after deducting unreimbursed medical expenses, including the cost of assisted living, home health care, prescription drugs or insurance premiums. In general, the veteran can't have more than $80,000 in liquid assets, not including a home or personal car.

The veteran or spouse must need help with two or more functions of daily living, including bathing, eating, dressing, toileting, etc., have dementia, be blind or be a patient in an assisted-living facility or nursing home because of a mental or physical disability.

State Veterans Affairs offices can provide further information and help with qualifying. The VA warns that there are organizations out there offering this help for a fee. Paying for this assistance is unnecessary and charging for it is possibly illegal, so don't pay.

Veterans Journal: VA publishes regulation to aid Vietnam veterans exposed to Agent Orange

Monday, September 13, 2010

Veterans exposed to Agent Orange and other herbicides while serving in Vietnam and other areas will have an easier path to health care and to qualify for disability compensation with the publication of a new rule of the Department of Veterans Affairs that expands the list of health problems the VA will presume to be related to herbicide exposures.

The final regulation was published Aug.31 in the Federal Register.

Drawing on a 2008 study by the Institute of Medicine, the VA is adding Parkinson’s disease and ischemic heart disease and is expanding chronic lymphocytic leukemia to include all chronic B cell leukemias, such as hairy cell leukemia, as problems presumed to have been caused by herbicide exposure.

Veterans who served in Vietnam during the war and who have a “presumed” illness do not have to prove an association between their medical problems and their military service. By helping veterans overcome evidentiary requirements, this presumption simplifies and speeds up the application process and ensures that veterans receive the benefits they deserve.

Veterans who served in Vietnam between Jan. 9, 1962, and May 7, 1975, are presumed to have been exposed to herbicides. More than 150,000 veterans are expected to submit Agent Orange claims in the next 12 to 18 months, many of whom are potentially eligible for retroactive disability payments based on past claims.

This historic regulation is subject to a 60-day congressional review period before implementation. After the review period, the VA can begin paying benefits. The VA encourages Vietnam veterans with these three diseases to submit their applications for access to VA health care and compensation now so the agency can begin development of their claims.

Individuals can go to to get an understanding of how to file a claim, as well as what evidence is needed by VA to make a decision about disability compensation or survivors’ benefits.

Additional information about Agent Orange and VA’s services for veterans exposed to the chemical is available at www.public- The regulation is available on the Office of the Federal Register website at

Washington, Sep 15 -

Washington, D.C. —Congressman Steve Buyer (IN-04) on Wednesday introduced a bill, H.R. 6127, to provide medical care to National Guard veterans who served in the Qarmat Ali region of Iraq during Operation Iraqi Freedom.

The Qarmat Ali Veterans Health Care Eligibility Extension Act would provide for the continued provision of health care services to certain veterans who were exposed to sodium dichromate while serving as a member of the Armed Forces at or near the water injection plant at Qarmat Ali, Iraq. Buyer issued the following statement upon the introduction of the bill:

“Recently, a number of Army National Guardsmen, including soldiers from my home state of Indiana as well as Oregon, West Virginia, South Carolina and individual augmentees from other states were notified by VA that they were possibly exposed to toxins during their service in Iraq.

These brave men and women were tasked with guarding the Qarmat Ali water treatment facility and in doing so were exposed to a toxic chemical known as sodium dichromate. Health problems associated with such exposure include respiratory issues, skin lesions, burns, increased rates of lung cancer, and other ear, nose, throat, and skin disorders.

While I commend the VA for their efforts to contact these veterans and create a Qarmat Ali Registry to aggressively track and treat them as part of the Gulf War Registry, it is also important for them to have immediate access to VA’s high quality health care system.

Some of the Qarmat Ali veterans who separated from service following their deployment in 2003 may no longer be eligible to enroll in VA health care under the five-year open enrollment period Congress established for non-service connected veterans. As a result, they must first file a claim and seek a service-connected disability rating before enrolling in the VA health care system and gaining access to the comprehensive medical care VA provides.

H.R. 6127 would correct this unintended gap in services by extending the enrollment eligibility period for Qarmat Ali veterans by five years from the date of notification. This would allow them to immediately begin receiving services at VA medical facilities for any and all of their health care needs. Appropriate preventative care can substantially improve health outcomes and the quality of life for our honored heroes.

The men and women of these National Guard units completed their mission and served our country well. It was hard for me to discover that despite their safe return, their service may continue to be put them at risk. In particular, I am very sensitive to the Hoosiers and all other servicemembers who may have been injured. Breaking down barriers to needed care is the very least we, as a grateful nation, can do for the men and women who fight for our freedoms, in Qarmat Ali and around the world.”

Returning Vets Help
Sept 17, 2010

Returning Combat Veterans

American Solider with U.S. Flag The South Texas Veterans Health Care is grateful to the men and women who risk their lives to fight terrorism in Afghanistan, Iraq and many other places around the world.

Contact Information

If you have served in Operation Iraqi Freedom or Operation Enduring Freedom, please contact us in any of the following ways —

Local VA Launches Rural Transportation Program
Sept 18th, 2010

The Temple Veterans Affairs center rolled out a pilot transportation program this month that could change how veterans nationwide are served in rural areas.

Reporter: Micah T. Williams
Email Address:

TEMPLE (September 17, 2010)-The wheels on the bus will soon go round-and-round all through the countryside.

Temple is among four cities nationwide involved in a new program that is expected to serve as a model for how the Veterans Affairs healthcare system will serve veterans who reside in rural areas.

Temple VA Assistant Director Del Ng said response to the program, which launched earlier this month, has been good from veterans.

"Everyone is so excited about this brand new program and comments that we get from our veterans is that it's long over due," Ng said.

The program currently serves veterans in Bell and Coryell counties along Texas 36 between Temple and Jonesboro, however once all twelve vehicles are in service, it will expand to a 50-mile radius around Temple.

Temple VA Voluntary Services Specialist Kevin Bergan said the center hired two travel coordinators and is in the process of purchasing a computer system that can plan daily routes according to the needs of veterans.

But the technology is not even fully developed yet for the computer system.

Ng told News 10 the Temple VA is looking for a vendor to customize the computer system so that it works with technology developed by the VA healthcare system, to track patients’ needs and provide information that would be used by bus attendants to deal with any problems the patients may encounter on the road.

The program is expected to be fully functional by the end of November.

Other cities participating in the pilot transportation program include Muskogee, Okla; Salt Lake City and Ann Arbor, Mich.

Veterans who need a ride to the Temple VA can call (254) 743-0740 or request pickup at the time their appointment is scheduled.

From wire services
Sept 19th


WASHINGTON — Secretary of Veterans Affairs Eric K. Shinseki wants former American prisoners of war to be aware of the benefits and services available to them as Americans across the nation show respect and appreciation during POW-MIA National Recognition Day.

“These veterans made great sacrifices for their country in time of war, and it is our nation’s turn to honor them by reinforcing to them the full range of compensation, health care and benefits they have earned,” said Shinseki.

The Department of Veterans Affairs has expanded policies to cover increasing numbers of former prisoners of war.

Special benefits for former POWs include enrollment in medical care for treatment at VA hospitals and clinics without co-payments and disability compensation for injuries and diseases that are associated with internment.

Former POWs also generally are entitled to a presumption of service connection for certain diseases, based on the length of captivity and the severity of their conditions.

Free dental treatment for any dental condition also is available to former POWs. These benefits are in addition to regular veterans’ benefits and services to which they already are entitled.

A benefit for survivors of former POWs includes Dependency and Indemnity Compensation, which is a monthly benefit that may be payable to the surviving spouse, children and in some cases parents.

More than 15,000 POWs are receiving VA benefits for service-connected injuries, diseases, or illnesses. VA is asking former POWs not using VA benefits to contact the agency at 800-827-1000 to find out if they may be eligible for disability compensation and other services.

Veterans also can apply online at href="http:///" target="_blank">http:/// or contact their coordinator for former POWs located at each VA regional office. <>

Information about VA services for former POWs is available at http:///

Sens. Burr, Webb Raise Questions Over Whether Covering Common Conditions Might Raise Costs Too High

Though the last U.S. troops left Vietnam in 1973, many veterans still live with the war. And at a Senate Veterans Affairs Committee hearing Thursday at the U.S. Capitol, senators expressed concerns for everything from oversight to deficit spending in the discussion over whether to allow three new conditions to the Agent Orange Act. The legislation allows for compensation to veterans for the health effects from herbicide American planes sprayed to root out the Viet Cong.

On August 31, the U.S. Department of Veterans Affairs approved three new ailments to the list of “presumptive” causes within the Agent Orange Act — ischemic heart disease, Parkinson’s Disease and hairy cell leukemia. The VA will be able to process new claims — as well as compensate earlier ones — at the end of October unless Congress votes to block it. VA officials estimate that this could add 250,000 new disability claims and cost about $42 billion over the next ten years.

Some have balked at the cost of providing more resources to health care given the deficit. President Obama’s Deficit Committee Co-Chairman, and former chair of the Veterans Affairs committee, Alan Simpson told the Associated Press about the Agent Orange Act rule-making authority, “The irony (is) that the veterans who saved this country are now, in a way, not helping us to save the country in this fiscal mess.” The group VoteVets called for his resignation, and Simpson has not apologized for the remarks. (Simpson did not respond to repeated requests for comment to TAI through the Deficit Commission.)

Alan Oates, chairman of the Vietnam Veterans of America Committee on Agent Orange, thought that was offensive. “It’s a slap in the face,” he said to TAI. Oates, who was exposed to Agent Orange in Vietnam and has Parkinson’s Disease (one of the ailments recently added to the Agent Orange Act by the VA), added, “It’s taking care of some of the budget problems on the backs of veterans. When you send veterans into war, that there’s a cost for that, there’s a cost for health care once that war’s over.”

Others at the hearing also thought the idea was ludicrous because health care for returning veterans was a given. Sen. Bernie Sanders (I-Vt.), said, “This is part of the ongoing cost of war, more than guns and bullets and airplanes.” On the scientific link between Agent Orange and ischemic heart disease, Sanders said to VA Sec. Eric Shinseki, “I think we’re asking you to play God and you’re doing a good job but you’re not God.” He added, “Who is smart enough to make a determination? I’m not.”

Ischemic heart disease drew the most skepticism from the panel since it is common in older men (17 percent of men ages 60-69 have it, and 26 percent of men ages 70-79 have it).

Sens. Richard Burr (R-N.C.) and Jim Webb (D-Va.) have also raised other concerns about the new measure. “Heart disease is a common phenomenon regardless of potential exposure to Agent Orange,” said Sen. Webb in a letter to Shineski. “I have spent my entire adult life one way or the other involved in veterans law. But I do think we need to have practical, proper procedures,” he added. (However, at the hearing, Webb balked at the notion that his hesitation was about cost. “This is not about cost, it’s not,” he said in Thursday.)

Burr has also spoken of similar concerns. “At some point we will have to look at the definition of exposure,” he told the AP.

Burr, the ranking Republican on the committee, was not present at the hearing and was co-chairing the Senate Energy and Natural Resources Committee. (If Alaska Sen. Lisa Murkowski loses her re-election this November as a write-in candidate, then Burr is next in line to be ranking member of the committee.) Burr met with Sec. Shinseki on Thursday, and said his concerns had been answered satisfactorily. He said in a press release, “At the end of our discussion I was convinced that he [Gen. Shinseki] and his agency are prepared to handle these needed changes.”

Webb said in the letter to Shinseki, “The discussions were you could develop a chronological map overlay of where defoliants had been used, and then develop a nexus in someone’s service record on whether they had been in those areas. From that you could say whether these conditions would be presumptively acquired.” But many of the panelists at Thursday’s hearing said, that there’s little reliable data about what exposure was over forty years ago — therefore making it difficult, if not impossible, to pinpoint causality. Oates agreed. “Putting the burden back on the veteran to prove exposure when there was so much misuse of the project would be impossible. Veterans can’t account for every moment and every place they were, they had a job to do,” he said to TAI.

The science linking ischemic heart disease to Agent Orange exposure suggests a “limited/suggestive connection” according to the Institute Of Medicine in its 682-page 2008 report. Of course, it’s difficult to pinpoint any individual case to dioxin exposure, as opposed to other risk factors such as high cholesterol, smoking, genetics or other factors.

Linda Birnbaum, director of the National Institute of Environmental Health Sciences at NIH and director of the National Toxicology Program at the Department Health and Human Services, said, “in humans, dioxin is not causing a unique cardiovascular disease, but increases the risk of developing ischemic heart disease, which has a significant background incidence.” As for the time that had passed between the Vietnam War and now, she said, “Dioxin can permanently alter gene expression. Especially in Vietnam, a young man under additional stress that early — dioxin exposure adds to additional factors.”

The United States government sprayed 20 million gallons of herbicides, mostly Agent Orange, a dioxin compound,during the Vietnam War to defoliate forest with the aim of depriving the Viet Cong and the Army of the Republic of Vietnam from cover, from 1962 until 1971. The agent had obvious ecological effects of killing crops, but also had significant health effects on both veterans and the Vietnamese people. In veterans, the agent has been shown to caused an elevated risk of soft tissue cancers, Hodgkin’s disease, Non-Hodgkin’s lymphoma, spina bifida (in the children of veterans), soft-tissue sarcoma and chloracne.

The Agent Orange Act passed both houses of Congress unanimously in 1991. The act gave the VA the power to add new diseases to the list based on scientific literature reviews done by the Institute of Medicine.

September 26, 2010

VA defends Agent Orange, heart disease links

By Associated Press ,

WASHINGTON (AP) — Veterans Affairs Secretary Eric Shinseki on Thursday defended an expensive proposal to extend disability payments to Vietnam veterans who get heart disease, saying studies show a significant link between the ailment and the toxic defoliant Agent Orange

Responding to concerns about the costs of a rapidly expanding program, Shinseki told the Senate Veterans Affairs Committee that the law requires his agency to grant automatic benefits for diseases that are scientifically associated with Agent Orange. It leaves him no discretion to weigh costs or other considerations, he said, such as the fact that heart disease occurs commonly in men in their 60s and is strongly linked to smoking, poor diet and other factors.

Shinseki, a Vietnam veteran wounded in combat, said six of nine rigorous studies reviewed by the agency showed strong associations between the herbicide and heart disease. The evidence "more than satisfies" the law's requirements, he said.

Past studies on the link have been inconclusive, and the National Academy of Sciences says there is only a "modest" association, with no way to control for other risk factors. The VA acknowledges that the lack of data about soldiers' exposure to the defoliant makes it impossible to determine what role it may play in specific cases.

That has led some to question the proposal to add the disease — along with Parkinson's disease and certain types of leukemia — to a growing list of ailments qualifying for a program that Congress set up in 1991.

The agency estimates that the additions, set to take effect next month, could cost up to $67 billion in the next decade. The average veteran getting benefits for heart disease would receive about $1,000 per month, with many also getting new health care benefits.

Most lawmakers said Thursday they'll support the plan. But several raised concerns about covering common diseases and suggested the law be revisited.

"We have sometimes up here an uncomfortable duty to ask the hard questions," said Sen. Jim Webb, D–Va., a Vietnam combat veteran. He said there are too many unknowns about cause and effect, with little information specifically on exposure in Vietnam and no process for accounting for other risk factors.

Sen. Scott Brown, R–Mass., said Congress has a "moral obligation" to veterans "while also taking into consideration the financial obligations of these decisions."

The Associated Press reported last month that some 270,000 Vietnam veterans — more than one–quarter of the 1 million receiving disability checks — are getting compensation for type 2 diabetes, making it the most frequently compensated disability among the war's veterans.

Anthony Principi, the VA secretary under President George W. Bush who approved diabetes for the program, told lawmakers the agency needs more scientific guidance on the decisions. He also suggested a compromise in which the government could offer health care but not disability payments for illnesses where evidence is uncertain.

Associated Press writer Mike Baker in Raleigh, N.C., contributed to this report.

September 26, 2010

Ally for health of military women

A bill in Congress would provide $3 million for a health-services pilot program in South Jersey.

By Edward Colimore

Inquirer Staff Writer

When she heard about the proposal, Lt. Col. Terese Acocella liked it immediately. Health care specifically attuned to thousands of women in the military simply makes sense, she said.

After 25 years in the New Jersey Army National Guard, including a year in Iraq, Acocella knows the needs of female service members - and how different they are from those of their male counterparts.

A $3 million pilot program, part of the defense appropriations bill that Congress is considering, would establish a Women Veterans and Service Members Joint Health Resource Center in South Jersey.

The effort, which could be replicated across the country, would provide "navigators" to connect women in the military and female veterans to health care, including gynecological, obstetric, and breast exams, available through the Department of Veterans Affairs and civilian facilities.

Proposed by Virtua, the South Jersey nonprofit health system, it also would provide information and referrals for treatment of traumatic brain injuries and behavioral health programs for issues ranging from stress to trauma from sexual assault.

Female veterans "may not have health insurance through a job and may not be married and have spousal insurance," said Acocella, 45, of Hunterdon County, a member of the state's Commission on Women Veterans, which assesses female veterans' needs and the programs required to meet them.

"There are veterans who are senior citizens with limited health insurance," she added.

The women's program proposal was developed over more than a year during meetings between Virtua representatives; Col. Gina Grosso, commander of Joint Base McGuire-Dix-Lakehurst; and U.S. Rep. John Adler (D., N.J.).

It passed the House Appropriations subcommittee on defense in July and must go before the full House and Senate for approval before going to the president.

More than 200,000 of the 1.5 million members of the military are women, Defense Department officials said, a proportion that has been rising. Twenty percent of new recruits are women, officials said.

The female veteran population also is growing. The Department of Veterans Affairs provided health care to more than 281,000 women in 2008, an increase of 12 percent from 2006, and an additional 17 percent increase was projected by 2033, according to a federal Government Accounting Office report.

With these statistics come more cases of sexual trauma, divorce, depression, post-traumatic stress disorder, and other health problems involving women, prompting federal officials to look at other avenues of care.

"Our grateful country can do more to honor our women veterans," said Adler, who has pushed for funding of the resource center and who will provide a follow-up report on the effort to the House Committee on Veterans' Affairs.

About 13,500 female veterans live in South Jersey, said Stephen Kolesk, vice president and chief operating officer at Virtua Memorial Hospital in Mount Holly. The median age of female veterans nationally is 47; the median for male vets is 61.

"We are very involved taking care of warriors coming through the Joint Base," Kolesk said. "It's a major demobilizing center, and women veterans come with their significant special needs."

Virtua's "strengths are in women's health programs," said Stephanie Fendrick, assistant vice president for Virtua's Women's and Children's Programs of Excellence.

"We can navigate them to services at Virtua and the VA," she said. "There may be gaps, and we would work to fill the need."

The resource center would be developed with the Warrior Transition Program at the Joint Base, but its location or locations have not been determined, Kolesk said.

"Research will have to determine where women are and what level of service needs there are in a given community," said Richard Miller, Virtua's president and chief executive officer.

If Congress votes to fund the pilot program, "we're talking about dollars that we hope will be allocated for 2011," said Fred Hipp, Virtua's vice president of government relations.

"We expect the vote will come later this year, before this Congress ends its work."

September 27, 2010

VA Expands Veterans Relationship Management System
The Department of Veterans Affairs has announced the launch of a long-term initiative designed
to improve veterans' access to health care benefits information by giving veterans better
online tools and self-service capabilities.

By the end of the year the "Veterans Relationship Management" initiative will deliver improved
telephone services to enable veterans to reach a call center agent faster, VA said.

The department is also looking to transform how veterans interact with the department by
leveraging technology to make it better and more efficient.

"Veterans will have a better experience when they contact VA for assistance, and our employees
will be able to quickly convey accurate, up-to-date information through call centers and the
Internet," said VA secretary Eric Shinseki.

Already veterans have access through in some benefit areas, including
military personnel records, VA home loan eligibility certificates, and status information on
compensation and pension claims.

As part of VRM, veterans and service members now only need sign on once to complete transactions
without having to re-enter information, said VA.

It said additional VRM enhancements would be rolled out in six-month increments.

VA Publishes Final Regulation on "Presumptive" Illnesses for Gulf War and Iraq, Afghanistan Veterans

WASHINGTON (September 28, 2010) - Secretary of Veterans Affairs Eric K.

Shinseki today announced the publication of a final regulation in the Federal Register that makes it easier for Veterans to obtain Department of Veterans Affairs (VA) health care and disability compensation for certain diseases associated with service in Southwest Asia (including

Iraq) or Afghanistan.

"This is part of historic changes in how VA considers Gulf War Veterans'

illnesses," said Secretary Shinseki. "By setting up scientifically based presumptions of service connection, we give these deserving Veterans a simple way to obtain the medical and compensation benefits they earned in service to our country."

The final regulation establishes new presumptions of service connection for nine specific infectious diseases associated with military service in Southwest Asia beginning on or after the start of the first Gulf War on Aug. 2, 1990, through the conflict in Iraq and on or after Sept. 19, 2001, in Afghanistan.

The final regulation reflects a determination of a positive association between service in Southwest Asia or Afghanistan and nine diseases and includes information about the long-term health effects potentially associated with these diseases: Brucellosis, Campylobacter jejuni, Coxiella Burnetii (Q fever), Malaria, Mycobacterium tuberculosis, Nontyphoid Salmonella, Shigella, Visceral leishmaniasis and West Nile virus.

With the final rule, a Veteran will only have to show service in Southwest Asia or Afghanistan and that he or she had one of the nine diseases within a certain time after service and has a current disability as a result of that disease, subject to certain time limits for seven of the diseases. Most of these diseases would be diagnosed within one year of return from service, through some conditions may manifest at a later time.

For non-presumptive conditions, a Veteran is required to provide medical evidence to establish an actual connection between military service in Southwest Asia or Afghanistan and a specific disease.

The decision to add these presumptives was made after reviewing the 2006 report of the National Academy of Sciences Institute of Medicine (NASIOM), titled, "Gulf War and Health Volume 5: Infectious Diseases."

The 2006 report differed from the four prior reports by looking at the long-term health effects of certain diseases determined to be pertinent to Gulf War Veterans. Secretary Shinseki decided to include Afghanistan Veterans in these presumptions because NAS found that the nine diseases are also prevalent in that country.

The 1998 Persian Gulf War Veterans Act requires the Secretary to review NAS reports that study scientific information and possible associations between illnesses and exposure to toxic agents by Veterans who served in the Persian Gulf War.

While the decision to add the nine new presumptives predates VA's Gulf War Veterans' Illnesses Task Force (GWVI-TF), the overarching responsibility of the GWVI-TF is to regain Gulf War Veterans' confidence in VA's health care, benefits, and services and reconfirm VA is 100 percent committed to Veterans of all eras. The GWVI-TF began in fall

2009 and is not a static, one-time initiative but will continue to build on its work with annual reports issued every August. The group's focus centers on unanswered Gulf War Veterans' health issues, improving access to benefits, ensuring cutting edge research into treatments, and to make sure Veterans' concerns are heard and addressed. This includes continuing to solicit Veterans, experts, advocates and stakeholders to share their views to better inform the important work of the GWVI-TF.

The GWVI-TF Report can be found at

Disability compensation is a non-taxable monetary benefit paid to Veterans who are disabled as a result of an injury or illness that was incurred or aggravated during active military service.

Last year, VA received more than one million claims for disability compensation and pension. VA provides compensation and pension benefits to over 3.8 million Veterans and beneficiaries.

Currently, the basic monthly rate of compensation ranges from $123 to

$2,673 for Veterans without any dependents.

For information about health problems associated with military service in Southwest Asia and Afghanistan, and related VA programs, go to and

For information about how to apply for disability compensation, go to or

Are veterans with PTSD at higher risk for medical illnesses?

By Lia Steakley

Previous research has shown that up to 31 percent of veterans returning from combat experience depression or post-traumatic stress disorder (PTSD). Now a study lead by Susan M. Frayne, MD, Stanford researcher and associate professor of medicine at the VA Palo Alto Health Care System, points to an association between PTSD and additional medical illnesses.

In the study (subscription required), researchers examined data for over 90,000 men and women who use Veterans Health Administration (VHA) services to compare the number of diagnosed medical conditions suffered by returning soldiers with PTSD and those with no mental health condition. The findings, which were published this month in the Journal of General Internal Medicine, showed the burden of medical illness was greater for those with PTSD than for those with no mental health issues, with women worse off than men.

LiveScience reports:

The researchers offer several possibilities for why the small group of PTSD sufferers tended to have from more medical conditions. PTSD itself may somehow increase the risk of medical illness – though that has yet to be proven.

"One way this could happen is that PTSD can cause changes in the neuroendocrine system in the body, which might affect other biological processes," Frayne explained.

PTSD could also have associations with certain health behaviors that can negatively affect physical health, such as smoking or alcohol use.

Another possibility is that whatever trauma led to PTSD also triggered the other medical conditions. A roadside bomb explosion might expose a veteran to broken bones or brain injury, as well as cause the emotional trauma related to PTSD.

Previously: Can training soldiers to meditate combat PTSD?

VA's Disclosure Policy Lauded in New England Journal of Medicine

WASHINGTON (September 29, 2010)- The Department of Veterans Affairs (VA) policy on disclosure of adverse medical events was praised as a "valuable resource for all health care institutions" in an article in a recent issue of the New England Journal of Medicine.

"At VA we strive every day to deliver superior health care," said Dr.

Robert Petzel, VA's Under Secretary for Health. "When mistakes occur, we immediately acknowledge them and learn how we can do better in the future."

Adverse events, such as incomplete cleaning of medical instruments, may affect significant numbers of patients over time. However, prompt disclosure also presents an opportunity to quickly assess risk to patients and to learn how to improve health care delivery and processes.

The article, entitled The Disclosure Dilemma, states that although many health care organizations have adopted policies encouraging disclosure of adverse events to individual patients, these policies seldom address large scale adverse events. It adds, however, that VA's own disclosure policy is "a notable exception."

The authors, including Denise Dudzinski, Ph.D., an associate professor and Director of Graduate Studies at the Department of Bioethics & Humanities at the University of Washington School of Medicine in Seattle, go on to say that VA's policy outlines "a clear and systematic process" for disclosure decisions regarding large scale adverse events -a process that can include convening a multidisciplinary advisory board with representation from diverse stakeholder groups and experts, including ethicists. A co-author of the article is VA employee Mary Beth Foglia, RN, Ph.D., of the National Center for Ethics in Health Care and affiliate faculty at the Department of Bioethics and Humanities the University of Washington.

The VA policy endorses transparency and expresses an obligation to disclose adverse events that cause harm to patients. Its provisions can include the convening of a multidisciplinary advisory board to review large-scale adverse events, recommend whether to disclose and provide guidance on the manner of disclosure.

The authors of the article conclude with the following observation, which summarizes VA's philosophy on the matter: "Disclosure should be the norm, even when the probability of harm is extremely low. Although risks to the institution are associated with disclosure, they are outweighed by the institution's obligation to be transparent and to rectify unanticipated patient harm."

For additional information, contact the VA Office of Public Affairs at 202-461-7600.

September 30, 2010

Information from Alan Hill

HR 4667 has passed the House 03/22/2010, passed the Senate on 09/22/2010

and sent to the President to sign on 09/23/2010. This bill is to increase Veterans

Compensation pay as of 12/01/2010. Checked for verification

on 09/30/2010 at 1520 hours CST.