"Discovery and Collaboration for Exceptional Health Care"
Research Week Celebrates VA Investigators' Achievements and Affiliations
May 3 2011
WASHINGTON (May 03, 2011) - The Department of Veterans Affairs (VA) is
celebrating exceptional care for Veterans this week, May 2 - 6 as part
of the nationally recognized Research Week. This year's theme,
"Discovery and Collaboration for Exceptional Health Care," celebrates
two crucial elements of VA research: dedicated follow-through on
important research findings to optimize medical therapies for Veterans
and others; and vital research and care collaborations between VA and
academic institutions, other government agencies, and health-related
"VA has a legacy of extraordinary achievement in research and
development," said VA Secretary Eric K. Shinseki. "These achievements
keep us on the cutting edge of health care and ensure we can provide, to
all generations of Veterans, the very best care and services which they
have earned through their service to the Nation."
"At the foundation of VA's collaborative system of world-class care is
VA research-finding the answers to Veterans' needs and advancing the
nation's medical knowledge," said VA Under Secretary for Health Dr.
Robert A. Petzel. "Our continued partnerships with our academic
affiliates allow VA to expedite translation of research from bench to
bedside, ensuring the best care for our Nation's Veterans."
In today's economic climate, the partnerships being recognized during
Research Week are especially crucial for leveraging resources and
maximizing the yield from research investments. "We are proud to join
forces with others who share VA's passion for making life better for
Veterans and all Americans," said VA Chief Research and Development
Officer Dr. Joel Kupersmith. "Partnering with research organizations and
academic partners means breakthrough findings come faster and will
swiftly translate into life-improving therapies for our Veterans."
The theme of Research Week 2011 marks the 65th anniversary of Policy
Memorandum No. 2, an historic agreement which allowed VA to affiliate
with medical schools. VA and the Association of American Medical
Colleges (AAMC) have further strengthened their working relationship
through a data and information-sharing agreement. The new agreement
standardizes data security requirements and processes across
institutions, helping to speed the pace of research and introduction of
new treatments into practice. "This agreement is the latest example in
the VA's rich, and productive history working with the nation's medical
schools to bring about new advances," said AAMC Chief Scientific Officer
Ann C. Bonham, who holds a doctorate. "At the same time, it requires
adherence to the highest standards of privacy protection."
In addition to Research Week activities nationwide at VA medical centers
and partner organizations, on May 5 at VA Central Office in Washington,
DC, distinguished speakers will present their perspectives on VA's
achievements in health research. Presenters will include several
Veterans, as well as Kupersmith; VA Chief of Staff John Gingrich; and
Deputy Under Secretary for Policy and Services Madhulika Agarwal, MD,
MPH. Guest speakers will include Bonham; Col. Greg Gadson, Army Wounded
Warrior Program Commander; E. Albert Reece, MD, PhD, MBA, Vice President
for Medical Affairs and Dean of the University of Maryland School of
Medicine; Gregg Zoroya, USA Today reporter; and Stephen Cochran, Veteran
and country music singer-songwriter, who will moderate a panel of
Veterans discussing their participation in VA research.
Information about Research Week activities being held at VA Central
Office and across the country is available at
VA to Take Applications for New Family Caregiver Program
VA Implementing Enhancements to Existing Services
for Veterans and Their Caregivers
May 4. 2011
WASHINGTON - Today, the Department of Veterans Affairs (VA) published
the interim final rule for implementing the Family Caregiver Program of
the Caregivers and Veterans Omnibus Health Services Act 2010. This new
rule will provide additional support to eligible post-9/11 Veterans who
elect to receive their care in a home setting from a primary Family
"We at VA know that every day is a challenge for our most seriously
injured Veterans and their Family Caregivers," said VA Secretary Eric K.
Shinseki. "I know many Veterans and their Family Caregivers have been
waiting anxiously for this day and I urge them to get their applications
in as soon as possible so they can receive the additional support they
On May 9, staff in VA's Office of Care Management and Social Work will
open the application process for eligible post-9/11 Veterans and Service
members to designate their Family Caregivers.
Additional services for primary Family Caregivers of eligible post-9/11
Veterans and Service members include a stipend, mental health services,
and access to health care insurance, if they are not already entitled to
care or services under a health care plan. Comprehensive Caregiver
training and medical support are other key components of this program.
The program builds on the foundation of Caregiver support now provided
at VA and reflects what families and clinicians have long known; that
Family Caregivers in a home environment can enhance the health and
well-being of Veterans under VA care.
Starting May 9th, Veterans may download a copy of the Family Caregiver
program application (VA CG 10-10) at www.caregiver.va.gov. The
application enables the Veteran to designate a primary Family Caregiver
and secondary Family Caregivers if needed. Caregiver Support
Coordinators are stationed at every VA medical center and via phone at
1-877-222 VETS (8387) to assist Veterans and their Family Caregivers
with the application process.
"Providing support to Family Caregivers who sacrifice so much to allow
Veterans to remain at home surrounded by their loved ones, is very
important to us at VA. We offer a range of Caregiver support services
including training, counseling and respite care to ensure that our
caregivers have the tools and support they need to continue in their
care giving role," said Deborah Amdur, VA's Chief Consultant for Care
Management and Social Work. "We appreciate the patience, support and
assistance we have received from Veterans, Veterans Service
Organizations, and the greater Caregiver community in shaping this
program and bringing this new VA program to our wounded warriors and
their dedicated Family Caregivers."
Caregivers for Veterans of all eras are eligible for respite care,
education and training on what it means to be a caregiver, how to best
meet the Veteran's care needs, and the importance of self-care when in a
care giving role. The full range of VA services already provided to
Caregivers will continue, and local Caregiver Support Coordinators at
each VA medical center are available to assist Family Caregivers in
identifying benefits and services they may be eligible for. The
Caregiver Support Coordinators are well versed in VA programs and also
have information about other local public, private and non-profit agency
support services that are available to support Veterans and their Family
Caregivers at home.
VA programs for Veterans and their Family Caregivers include:
In-Home and Community Based Care: This includes skilled
home health care, homemaker home health aide services, community adult
day health care and Home Based Primary Care.
Respite Care: Designed to relieve the Family Caregiver
from the constant challenge of caring for a chronically ill or disabled
Veteran at home, respite services can include in-home care, a short stay
in one of VA's community living centers or an environment designed for
adult day health care.
Caregiver education and training programs: VA currently
provides multiple training opportunities which include pre-discharge
care instruction and specialized caregiver programs in multiple severe
traumas such as Traumatic Brain Injury (TBI), Spinal Cord
Injury/Disorders, and Blind Rehabilitation. VA has a Family Caregiver
assistance healthy living center on My HealtheVet, http://www.myhealth.va.gov
, as well as caregiver information on the VA's main Web page health
site; both Websites include information on VA and community resources
and Caregiver health and wellness.
Caregiver support groups and other services: Family
Caregiver support groups, offered in a face to face setting or on the
telephone, provide emotional and peer support, and information. Family
Caregiver services include family counseling, spiritual and pastoral
care, family leisure and recreational activities and temporary lodging
in Fisher Houses.
Other services: VA provides durable medical equipment
and prosthetic and sensory aides to improve function, financial
assistance with home modification to improve access and mobility, and
transportation assistance for some Veterans to and from medical
VA to expand caregivers program
May 3, 2011
WASHINGTON (AP) — The Veterans Affairs Department reversed course
Tuesday and said it will make sure more caregivers of severely
disabled Iraq and Afghanistan veterans can receive the support they
need to help their wounded relatives.
President Barack Obama signed a law in May of last year that
provided a monthly stipend, mental health help and health insurance
to family members who provide around-the-clock care to these
But when the VA announced earlier this year how the caregivers
program would work, advocates and congressional members said it
helped fewer families than they had expected. Among those who likely
were not eligible were Sarah and Ted Wade, who stood with Obama at
the bill signing. Ted Wade lost his right arm and sustained a
traumatic brain injury in a roadside bombing in Iraq in 2004 while
serving with the 82nd Airborne Division.
The VA now says about 3,500 families will be eligible, which is how
many Sen. Patty Murray, the chairman of the Senate Veterans' Affairs
Committee, has said Congress wanted. Under the earlier plan, the VA
said about 10 percent of the critically wounded from the recent
conflicts would be eligible, which was about 850 veterans. The plan
will cost about $770 million over five years.
Under the new plan, veterans eligible are those who sustained a
serious injury who are in need of personal care services. But,
families no longer have to show that the veteran would go to an
institution without the caregiver's help.
The VA says it will begin taking applications on May 9 and the
monthly stipend will be ready by July. To participate, the caregiver
must agree to a home visit and some other requirements.
Deborah Amdur, the VA's chief consultant for care management and
social work, said VA officials considered feedback in making
decisions on how to implement the program, and she feels confident
in how it will be rolled out.
"We have worked very hard to make this a success," Amdur said.
Murray said she'd been so concerned about the original plan that
she'd taken up the issue with Obama. She said she's pleased that the
administration changed its eligibility requirements.
"The VA correctly has responded in a positive way," Murray said.
The enhanced benefits are only for caregivers of veterans from the
recent wars. But the VA has said it is improving other existing
programs for caregivers of veterans from all eras. In February, it
created a national caregivers support hotline that has received
about 5,000 calls.
Veterans' service organizations had wanted additional support for
all caregivers of veterans, but Congress was not able to come up
with enough money to do so. The law instructs the VA to report to
Congress within two years about the possibility of providing the
enhanced benefits to all caregivers.
Veteran Program: VA's Genomics Game-Changer Launches Nationwide
May 5, 2011
5, 2011) - An unprecedented Veterans Affairs (VA) research program
that promises to advance the sophisticated science of genomics goes
"It is my honor," said Secretary of Veterans Affairs Eric K.
Shinseki, "to join with so many fellow Veterans in keeping VA at the
leading edge of genomics research. This innovative research program
will support VA's mission to provide Veterans and their families
with the care they
Dr. Robert A. Petzel, VA's Under Secretary for Health said, "The
Veterans Affairs Research and Development Program has launched the
Million Veteran Program, or MVP-an important partnership between VA
and Veterans to learn more about how genes affect health, and thus,
transform health care for Veterans and for all Americans."
The Million Veteran Program is a trailblazing VA effort to
consolidate genetic, military exposure, health, and lifestyle
information together in one single database. The database will be
used only by authorized researchers with VA, other federal health
agencies, and academic institutions within the U.S.-in a secure
manner-to conduct health and wellness studies to determine which
genetic variations are associated with particular health issues. By
identifying gene-health connections, the program could
consequentially advance disease screening, diagnosis, and prognosis
and point the way toward more effective, personalized therapies.
Launched in January at a single VA medical center, MVP is expanding
to achieve the goal of national participation by Veterans receiving
VA care over the next 5 to 7 years. Among those participating are VA
Secretary Eric K. Shinseki, Deputy Secretary W. Scott Gould, and
Chief of Staff John R.
Patient safety and information security are the top priorities in
MVP and all VA research initiatives. To protect Veterans'
confidentiality, blood samples containing genetic material and
health information collected for MVP will be stored in a secure
manner and labeled with a barcode instead of personal information.
The researchers who are approved to access samples and data will not
receive the name, address, social security number or date of birth
of participating Veterans.
Importantly, the data will not move to the researchers, but rather
researchers will come to the data-through the VA GenISIS computing
environment-to increase security.
The program has been developed in close coordination with the VA
Genomic Medicine Program Advisory Committee-comprised of private and
public health, scientific, legal experts in the field of genetics
and Veteran representatives-which advises the Secretary of Veterans
Affairs, and partners such as Veterans Service Organizations, the
Department of Defense, and the National Institutes of Health.
VA is superbly positioned to conduct complex genomics research
thanks to its large, diverse, and altruistic patient population and
other unrivaled assets. "We have a research establishment that is
embedded in an integrated health care system with a state-of-the-art
electronic health record, fully equipped genomic laboratories with
the latest in technology, and top-caliber investigators-most of whom
also provide direct patient care," said Dr. Joel Kupersmith, VA's
chief research and development officer. "The merger of these
distinct attributes-with the Veteran as a partner-make VA uniquely
able to conduct this ground breaking genomic research."
By enabling researchers to analyze and compare the DNA and other
genetic materials of a population of Veterans potentially a
million-strong, MVP represents a powerful tool in genetics research.
For more information about MVP-including the stringent safeguards in
place to protect the privacy and confidentiality of those Veterans
who take part-visit www.research.va.gov/MVP.
REACHING Out to Alzheimer Families
May 7, 2011
Robin Weidberg, daughter of Navy Veteran Raymond
Boop, serves him a classic southern lunch of fried chicken and sweet
“You deserve a break today,” goes the famous advertising slogan.
Researchers and clinicians may not call it a “break” — an
“intervention” would be the more likely term — but that’s exactly
what teams at VA sites nationwide are now preparing to deliver to
thousands of Americans who have one of the most stressful and
demanding jobs around.
The program is called REACH, short for Resources for Enhancing
Alzheimer’s Caregiver Health. It’s now being implemented at VA sites
nationwide, with the goal of providing much-needed support for a
beleaguered caregiver population.
Reducing Caregiver Risk
About 80 percent of care for those with dementia is provided by
family caregivers, but these devoted family members often lack the
skills to manage troubling patient behaviors and their own stress.
As a result, they can be at risk for depression, anxiety and other
health problems. And their aging loved ones with Alzheimer’s are
less likely to be able to remain at home.
The REACH effort began with two studies sponsored by the National
Institute on aging and National Institute of Nursing Research and
conducted by investigators with VA and several universities. The
researchers tested a six-month intervention designed to ease
caregiver stress. It included 12 individual sessions in the home and
by telephone, complemented by 5 telephone support-group sessions.
The focus is on education, support and skills-building.
In the REACH model, trained “interventionists” teach family
caregivers how to reduce stress, solve problems and manage difficult
behaviors by their family member. Role-playing and other strategies
are used to develop coping skills. A caregiver notebook, written in
very easy-to-understand language, covers dozens of topics, ranging
from the physical care of the person with Alzheimer’s to emotional
and communication issues.
“REACH VA is designed for caregivers who are highly stressed,” says
Jennifer Martindale-Adams, EdD, an investigator with the Memphis VA
Medical Center and the Department of Preventive Medicine at the
University of Tennessee Health Science Center.
“It is easy for staff to use because it is structured, with a
protocol and scripts. It meets the needs of caregivers and Veterans
because it is targeted to their individual concerns through a risk
The material is tailored to family members based on assessments of
where they need the most help. For example, some caregivers might
simply need more knowledge about available resources or Alzheimer’s
symptoms, while others need to learn how to reframe their emotional
“Risk priority assessment is the most innovative part of the
program,” says Linda O. Nichols, PhD, a health educator and lead
investigator for REACH. “Targeting the intervention to the
caregiver’s needs and not just to the behavior problems of the
patient helps to individualize the program and to focus on high-risk
areas first.” She is also with the Memphis VA and the University of
Family members often become caregivers to disabled or ailing
VA Acts on Positive Study Findings
Findings from the REACH studies showed improvements across many
areas. Caregivers reported less “burden” and depression, and
improved emotional well-being overall. They also reported gains in
the areas of self-care and healthy behaviors, social support, and
management of problem behaviors on the part of their loved ones with
Alzheimer’s disease. Plus, they gained an hour a day of time that
was not consumed with caregiving duties.
“The intervention provided that most scarce of caregiver
commodities, time,” wrote Nichols and coauthors in a 2008 journal
“We think the biggest outcome was in the increase in perceived free
time of one hour,” adds MartindaleAdams. “The extra non-caregiving
time could allow the caregivers to do what they wanted.”
Moreover, the extra soul-nourishing hour came relatively cheap — at
a cost of about $5 per day for each caregiver — according to an
analysis by the Memphis group. “We showed that you can do behavioral
interventions,” says Martindale-Adams. “There are a lot of people
who have said they won’t work due to cost.”
Based on these positive results, in 2007 VA began a “translation
project” called REACH VA, designed to parlay REACH into an ongoing
program to help caregivers of Veterans with Alzheimer’s. The first
step was showing how the program could work on a wide scale in VA.
The six-month intervention was delivered at 24 sites in 15 states
through VA’s Home Based Primary Care programs. The Memphis VA
Medical Center coordinated the effort, providing training to the
clinical sites, certification of staff and evaluation of the
By and large, the 127 caregivers who took part in REACH VA — most of
them spouses of Veterans -reported improvements similar to those
seen in the earlier research. Significantly, 96 percent said the
intervention program should be provided by VA to all caregivers. The
full results were reported earlier this year in the Archives of
REACH "interventionists" teach family caregivers how to handle the
stress and work of caring for their family member.
“Most rewarding aspect of my work with VA”
Saudia Major, PhD, a clinical psychologist with the VA Ann Arbor
Healthcare System, has been involved with REACH VA since late 2008.
“It’s been one of the most rewarding aspects of my work here,” she
says. “When I joined the Ann Arbor VA and began making home visits,
I experienced a frequent sense of sadness when I observed the
caregivers. These people, often times spouses of the Veterans,
appeared depressed, teary, isolated, and usually in poor physical
condition due to self-neglect. I found that some caregivers would
attempt to monopolize my time during home visits, understandably due
to lack of support, and I would have to spend a good bit of time
redirecting them and my focus to the Veteran.”
The results from REACH, she says, can often be dramatic.
“It gives caregivers a sense of validation, helps them realize they
are not alone, and that their needs have been heard. With this comes
an increase in self-esteem and self-confidence. We see an
improvement in their caregiving abilities and skills and then we
observe declines in depression and stress. I’ve had a couple of
caregivers tell me that that they felt that I, and the REACH VA
program, saved their lives.”
Shelby Nemeth, one of the caregivers with whom Major has worked,
says she feels “blessed” by the REACH program.
Her husband of 53 years, 85-year-old Lawrence, a Purple Heart
Veteran of the Battle of the Bulge, has had Alzheimer’s since 2003.
She has looked after him around the clock ever since.
“He has his good days and his bad days,” she says. “No, he doesn’t
recognize me. But, he’s comfortable.”
When Major and her team offered to enroll Nemeth in REACH and some
related respite services, at first she thought she would feel guilty
about not being there all the time for her husband. “Then I realized
that my being healthy, letting go of some of that stress, was not
only good for me, but it was just what Lawrence needed, for me to be
strong enough to take care of him.”
For Nemeth, preserving her own health was no small task: a few years
ago, she suffered a heart attack and underwent a quadruple bypass.
She relied on her and Lawrence’s children to help care for him while
“I am so grateful to the VA for the REACH program,” says Nemeth. “I
would absolutely recommend it to other Veteran families.”
Now, REACH VA is being rolled out on a national basis through VA’s
Home-Based Primary Care programs. Training has started on a wide
scale this year and will continue over the next few years.
“The Home-Based Primary Care staff have been amazing in the
translation,” notes Nichols. “They do the work because they see a
The needs of other Veterans and their caregivers — outside the
Alzheimer’s community — will be addressed as REACH VA is modified
for spinal cord injury and traumatic brain injury.
Says Nichols, “We have had wonderful support from VA in moving REACH
from research to a program that will be available to caregivers
around the country.”
VA Partners with Easter Seals to
Train Family Caregivers of Wounded Warriors
May 9, 2011
Applications for Services and Training Taken
Nationwide Starting Today
WASHINGTON (May 9, 2011) - The Department of Veterans Affairs (VA)
and Easter Seals formally announced a partnership to provide
comprehensive Caregiver Training to Family Caregivers of eligible
post-9/11 Veterans as authorized by the Caregivers and Veterans
Omnibus Health Services Act of 2010.
"We at VA are committed to providing the Family Caregivers who share
our sacred duty to care for those 'who have borne the battle' with
the best services available," said Secretary of Veterans Affairs
Shinseki. "We are very pleased to partner with a renowned
such as Easter Seals in developing the best possible training
program for Family Caregivers. Throughout its long history, Easter
Seals has demonstrated its strong commitment to supporting our
Veterans and their families."
"Easter Seals is proud to share our expertise and knowledge with
this important group of Family Caregivers, taking care of loved ones
who returned home with serious injuries after their post 9/11
service to our nation," explained James E. Williams, Jr., president
and chief executive officer of Easter Seals. "We are honored to help
these Veterans and their families."
Starting today, Family Caregivers and Veterans can apply for
services authorized under a VA interim final rule that was published
on May 5.
Eligible Family Caregivers of eligible post-9/11 Veterans will
receive comprehensive training developed by Easter Seals in
collaboration with VA clinical experts. It is part of a package of
new services that also include a monthly stipend, mental health
services and access to medical care under the Civilian Health and
Medical Program of the Department of Veterans Affairs (CHAMPVA), if
the primary Family Caregiver is not entitled to care or services
under a health plan contract.
Easter Seals has been helping people with disabilities and special
needs, and their families, live better lives for more than 90 years.
From child development centers to physical rehabilitation and job
training for people with disabilities, Easter Seals offers a variety
of services to help people address life's challenges and achieve
Family Caregivers of eligible post-9/11 Veterans will have a choice
of how to receive their training. Options will include traditional
classroom training, online learning or a correspondence course. All
Family Caregivers will be expected to complete training as part of
the preparation to start receiving other services under the new
program. The first training courses are expected to start in June,
and monthly stipends, which are backdated to the day applications
are formally submitted, could begin as early as July.
Veterans may download a copy of the Family Caregiver program
application at www.caregiver.va.gov. The application enables the
Veteran to designate a primary Family Caregiver and secondary Family
Caregiver support coordinators are stationed at 153 VA medical
centers and available by phone at 1-877-222 VETS (8387) to assist
Veterans and Family Caregivers with the application process.
Caregivers of Veterans from all eras are also encouraged to use the
website and support line to explore more than two dozen other
services VA provides Caregivers.
# # #
About Easter Seals
Easter Seals is a non-profit provider of services for individuals
with autism, developmental disabilities, physical disabilities and
other special needs. For more than 90 years, it has been offering
help to children and adults living with disabilities and to the
families who love them. Through therapy, training, education and
support services, Easter Seals assists people with disabilities to
live, learn, work and play. If you would like more information on
Easter Seals, visit the Easter Seals website at www.easterseals.com
Court says Congress and
president failed to help veterans
May 10, 2011
NEW YORK (Reuters) -
Accusing Congress and the president of neglecting to take
appropriate action to save veterans' lives, a federal appeals
court called for drastic improvements to the Department of
Veterans' Affairs mental health care system.
The 9th Circuit U.S.
Court of Appeals, in a 104-page decision issued on Tuesday,
cited the failure of the political branches to address what it
called the VA's "egregious problems" and "unchecked
incompetence" in delivering mental health services to veterans.
That failure, the
three-judge panel held, violated the veterans' due process
rights under the U.S. Constitution.
The court cited
examples of veterans with severe depression or post-traumatic
stress disorder having to wait over eight weeks for mental
health referrals, with some committing suicide in the interim.
veterans are on waiting lists for mental health care, the court
wrote, with no procedure for challenging the delays. The court
added that those delays can mean "the difference between life
and death," with an average of 18 veterans committing suicide
organizations, Veterans for Common Sense and Veterans United for
Truth Inc, had sued the VA in 2007 over the government's
"shameful failures" to care for wounded veterans. The California
district court dismissed the groups' claims, finding that the
court lacked jurisdiction to implement or meddle with the
agency's mental health plan.
panel comprised of 9th Circuit judges Alex Kozinski, Procter Hug
and Stephen Reinhardt acknowledged that the court's intervention
in the agency's affairs was an "extraordinary step" and one
better suited for Congress or the president.
In the opinion,
written by Reinhardt, the panel concluded that the political
branches had "so completely and chronically failed" to respect
veterans' rights that the court had to intervene.
"No more veterans
should be compelled to agonize or perish while the government
fails to perform its obligations," the opinion said.
The VA did not
immediately respond to a request for comment.
Heather Moser, a
lawyer for the veterans' groups, said the decision was
"monumental" for recognizing that veterans' have a
constitutional right to mental health care in a timely manner.
The 9th Circuit
panel sent the case back to the lower court to determine what
changes are necessary to ensure that veterans in need of mental
health care receive prompt treatment and those with urgent
problems receive immediate help.
Terry Baynes; Editing by
Untouchable! Vets’ $52 Billion Health Care Plan
By Merrill Goozner, The Fiscal Times
May 12, 2011
This story comes from our partner
Rep. Jack Kingston, a Georgia Republican, leaned forward in his seat at
a Wednesday armed services appropriations hearing and practically begged
the Pentagon’s top health care official for tips on how to explain a
proposed hike in military retiree health care fees to constituents and
the news media back home.
“There is this pressure for free health care for life for veterans,”
explained Kingston, who represents many veterans in his Savannah area
district. Jonathan Woodson, the assistant secretary of defense for
health affairs, replied that “Congress never meant for the health care
benefit” for 5.3 million military retirees and their family members “to
be entirely free.”
The exchange illustrates how difficult it is for legislators on Capitol
Hill to make even minor changes to military budgets that have come to be
seen as largely untouchable – even a small adjustment to a copayment
requirement in a health insurance program that has turned out to be a
sweet deal for military pensioners.
Members of the military can retire after 20 years with a full pension
and heavily subsidized health care for life. It is one of the chief
drivers of rapidly rising military health care spending, which has
tripled in the past decade to more than $52 billion a year.
It’s not the only factor driving higher military health spending, to be
sure. The system also provides care for the health needs of the
military’s 3.8 million active duty personnel and family members. After
ten years of war, that health care system is beset with a host of
problems ranging from the special needs of tens of thousands of severely
wounded veterans of Iraq and Afghanistan; to the 20,000 traumatic brain
injuries incurred every year; to the uncounted tens of thousands more
suffering from post traumatic stress disorder.
In addition, the military, like the rest of society, is trying to figure
out ways to slow down the rapidly rising cost of care for those it
covers both in and out of the military. In one effort to combat that
problem, the Obama administration in its 2012 budget calls for
increasing retirees’ co-insurance, currently $230 a year for individuals
and $460 for families, by 13 percent; indexing it for medical inflation;
and lifting co-pays on doctor and hospital visits and drugs. This would
mark the first increase in these charges since 1996, according to
It’s an approach to holding down costs that has long been used by the
private sector with little success. The amount of money raised through
the higher co-pays is small, and it rarely leads people to stop using
marginally effective or unnecessary care.
The proposal drew immediate fire from veterans groups, which in turn
received support from members of both political parties. A House Armed
Services subcommittee on military personnel two weeks ago postponed the
fee increases for at least one year on TRICARE Prime, the health
maintenance organization-like plan that is the largest military health
care program. However, with the Pentagon under pressure to cut costs,
moves are underway in Congress to restore the fee increase for next
year, but index its annual increase to the cost-of-living, rather than
medical inflation, which is far higher.
Still, even that is causing queasiness among legislators leery of
crossing veterans, whose entitlements remain sacrosanct. They’re getting
an earful from groups like the Veterans of Foreign Wars, whose chief
spokesman, Joe Davis, told The Fiscal Times on Wednesday that “we don’t
want any increases and we don’t want it tied to any outside factor, not
COLA, not anything.
When asked how he could justify his position when everyone else,
including other government employees, had seen their health care co-pays
and co-insurance rise in recent years, he replied: “How can you put
military people and the rest of society on parity, especially after ten
years of war. This is a health care benefit that people were promised by
their recruiters. We paid for that benefit up front by 20 or more years
in the military.”
The military is trying several other tactics to reduce its soaring
health care costs. In recent years, it has funneled more of its retirees
into coordinated care programs, which hopefully will better manage the
costs of ex-soldiers and their family members with chronic diseases.
They’ve also given special prices for people who use a mail order house
for pharmaceuticals, which can substantially lower cost. The military
already uses a preferred drug list, known as a formulary, which imposes
significantly higher co-pays for drugs not on the list.
“We are proposing minor changes to out-of-pocket costs that are
exceptionally modest, manageable and remain well below the
inflation-adjusted out-of-pockets costs enjoyed in 1995, when TRICARE
Prime was first introduced,” Woodson testified before the House Armed
Services Appropriations subcommittee on health. The proposed increase
amounts to $2.50 per month for single retirees and $5 a month for
Caring for the rising number of seriously wounded soldiers from the wars
in Afghanistan and Iraq is also driving military health care costs
skyward, and will for years. The military now employs 4,280 staff in 29
“Warrior Transition Units” to care for the 10,011 wounded, ill or
injured soldiers still in the military. More than 40,000 wounded
soldiers have passed through the program since June 2007, with just
16,000 returning to their former units.
The military is also grappling with a rising tide of substance abuse
cases, often related to chronic use of prescription pain medications
initially given after being wounded. Lt. General Eric Schoomaker, the
surgeon general of the army, told the subcommittee that immediate
treatment of battlefield injuries with opium-derived drugs and other
painkillers can reduce incidences of post-traumatic stress disorder by
But the army is now looking at alternatives for reducing use of the
drugs for chronic pain, such as acupuncture, yoga, and biofeedback,
Schoomaker said. However, it could wind up increasing the military
health care bill. “There is a good evidence-based case” for these
approaches,” he said. “But to be perfectly blunt, the reimbursement
system is not adequate.”
Meanwhile, the army is also in the midst of a major five-year, $5
billion program to rebuild its far-flung hospital network, both on
domestic bases and abroad. It has asked for a 30 percent increase in its
construction budget to $1.3 billion for next year.
Heading the list is the total reconstruction of the Landstuhl Medical
Center in Germany, which has served as the way station for wounded
soldiers from the Middle East but also serves the 170,000 U.S. military
personnel and their families stationed in that country. The 122-bed
project heads the wish-list for this year’s appropriation.
While some critics seeking to pare military budgets have called for
shutting down the German bases, which have housed 50,000 U.S. troops and
their families since the end of World War II, the army is digging in for
the long haul. “This is a very important time for rebuilding and
replacing our facilities,” Schoomaker said about the hospital projects.
Post-traumatic Stress Disorder (PTSD) App Helps Thousands
May 16, 2011
WASHINGTON (May 17, 2011) - The PTSD Coach smartphone application (app),
launched in April by the Department of Veterans Affairs (VA) and the
Department of Defense (DoD), has already helped more than 5,000 users
connect with important mental health information and resources.
"This new tool is about helping Veterans and Servicemembers when and
where they need it," said Secretary of Veterans Affairs Eric K.
Shinseki. "We are encouraged so many have already downloaded this
resource and hope many more will utilize this convenient tool to access
Since its launch, the PTSD Coach app has been downloaded by thousands of
individuals. While 96 percent of the users so far are located in the
United States, the app has also been downloaded in 25 other countries.
The app lets users track their PTSD symptoms, links them with public and
personalized sources of support, provides accurate information about
PTSD, and teaches helpful strategies for managing PTSD symptoms on the
Currently, the PTSD Coach app has received perfect customer review
scores on the iTunes App Store. Comments from Veterans and family
members are overwhelmingly positive and one user describes the app as "a
must for every spouse who has a family member with PTSD." Professionals
have sent positive reviews, suggestions and offers to collaborate on
research evaluating the PTSD Coach app.
The app has also already proven to be a useful tool for the staff at the
Veterans Crisis Line. Within the first two hours of the app's official
launch, the Crisis Line staff were contacted by a distressed Veteran who
reported being instructed by the app to call the crisis line and was
subsequently given an appointment at the local VA medical center.
Crisis Line staff have begun to regularly recommend this resource to
The app is one of the first in a series of jointly-designed resources by
the VA National Center for PTSD and DoD's National Center for Telehealth
and Technology to help Servicemembers and Veterans manage their
readjustment challenges and get anonymous assistance. Given the
popularity of mobile devices, VA and DoD hope to reach tens of thousands
of Veterans, Servicemembers, and their family members with the new suite
Information on the PTSD Coach app is on the VA's National Center for
PTSD Website: http://www.ptsd.va.gov/public/pages/PTSDCoach.asp. More
apps from DoD's National Center for Telehealth and Technology
<http://t2health.org/apps> can be found at:
VA Processing Hundreds of Applications for New Family Caregiver Benefits
in First Week
May 18, 2011
WASHINGTON (May 18, 2011)- In the first week for open applications, the
Department of Veterans Affairs (VA) has assisted more than 625 Veterans,
Servicemembers and their Family Caregivers in applying for new services
under the Caregivers and Veterans Omnibus Health Services Act 2010.
"We are off to a good start having helped hundreds to apply, but we know
there are thousands more who will qualify and need to apply today," said
Secretary of Veterans Affairs Eric K. Shinseki. "I encourage eligible
Veterans and their Family Caregivers to apply now to receive the
benefits they have earned."
New services for primary Family Caregivers of eligible post-9/11
Veterans include a stipend, mental health services, and access to health
care insurance, if they are not already entitled to care or services
under a health plan. The stipend portion of this service will be
backdated to the date of the application. Comprehensive Caregiver
training and medical support are other key components of this program.
VA began processing applications for eligible post-9/11 Veterans and
Servicemembers to designate a Primary Family Caregiver on May 9, 2011.
On top of receiving the 625 plus applications, Caregiver Support
Coordinators have also assisted nearly 1,200 other Caregivers in finding
more than two dozen other Caregiver benefits VA provides.
Applications can be processed by telephone through the Caregiver Support
Line at (855) 260-3274, in person at a VA medical Center with a
Caregiver Support Coordinator, by mail or online at www.caregiver.va.gov
with the new Caregiver Application (VA Form 1010-CG). The website
application also features a chat option that provides the Family
Caregiver with a live representative to assist in completing the
Women on war front more likely to get post-traumatic stress
disorder than men, study finds
By Shari Roan, Los Angeles Times
12:35 PM PDT, May 19, 2011
Women deployed in the wars in Iraq
and Afghanistan are emerging as a group especially vulnerable to
post-traumatic stress disorder, researchers reported this week at
annual meeting of the American Psychiatric Assn.
More than 230,000 women have served in Iraq and Afghanistan since
2001, according to a Los Angeles Times story published in April on
PTSD among female military personnel. Women, however, have been
denied insurance coverage for treatment for PTSD at a higher rate
than men because of a former stipulation that required combat
experience to qualify for the benefit. Under rule changes enacted
last year, any veteran deployed to a combat zone can seek care for
PTSD. But the story noted that VA officials know little about the
scope of the problem among women.
In the study, presented this week, researchers studied 922 National
Guard members -- including 91 women -- under mandatory deployment to
Iraq in 2008. The guard members were screened using mental-health
measures before deployment and three months after deployment. The
study found that women were much more likely than men to meet the
criteria for PTSD after returning home -- 18.7% of women had PTSD
compared with 8.7% of men. There were no significant differences
between men and women in their level of combat exposure.
The women were much less likely to feel well-prepared for combat
before deployment and were more likely to report a lack of unit
cohesion during deployment. Unit cohesion is the mutual support and
bonds of friendship among members of a military unit. Another study
presented at the APA meeting found such cohesion is emerging as a
major factor in determining the mental-health effects of combat on
U.S. Army researchers surveyed 1,600 soldiers from two combat
brigades who had been deployed once. They found that unit cohesion
was a key factor in whether soldiers developed thoughts of
suicide."Despite the evolving role of women in the military, few
studies have examined gender-relevant issues in combat deployment,"
wrote the authors of the study on PTSD among women, led by the
Department of Veterans Affairs-New Jersey Health Care System. "This
study suggests that women may be at greater risk than men of
developing combat-related PTSD in part because they are less likely
to develop confidence in their own military preparedness or receive
social support in the form of unit cohesion."
Although women are well-trained for combat and other aspects of
military deployment, the authors noted, "training regimens may
nevertheless fail to adequately address physiological differences
between men and women, leaving women feeling less prepared for
deployment to combat zones."