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VSOs urge Congress to address MISSON Act budget fallout
What critical VA programs will be cut in order to ensure the MISSION Act will be paid for? Nikki Wentling reports at Stars and Stripes:
As the Department of Veterans Affairs works toward expanding its use of private-sector doctors, three veterans groups proposed this week that the White House and Congress approve a budget for private care in 2020 that’s nearly double what was appropriated for 2019.
The Veterans of Foreign Wars, Disabled American Veterans and Paralyzed Veterans of America suggested a community care budget of more than $18 billion – up from the $9.4 billion appropriated for fiscal year 2019, which ends Sept. 30. Without an increase in funding, the groups are concerned money for private care could be stripped from the VA health care system.
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The VA plans to post the proposed rules to the Federal Register, where members of the public will be allowed to provide input. The rules were not posted as of Friday.
Some lawmakers on both sides of the aisle have urged Wilkie for more transparency and collaboration about the access standards.
Adrian Atizado, deputy legislative director for Disabled American Veterans, said the groups would update their budget proposal if they received more information from the agency, such as concrete cost estimates.
“Part of the concern is there’s not going to be enough information,” Atizado said. “They may have some information, but very little budget justification… It’s like a fortress over there.”
Primary care is the first line of defense for veterans
For most Americans, the primary care physician blends into other doctor's appointments in a deeply fragmented private health care system. For veterans at the VA, it's something completely different. Read it at Cincinnati.com:
Many healthcare professionals recommend regular visits to a primary care provider, not just when you become sick or injured, but to maintain optimal health and wellness. According to Sara Mohn, an Army veteran and nurse practitioner who provides primary care at the Cincinnati VA Medical Center, primary care is particularly important for Veterans.
“Medically speaking, Veterans are more complex,” Mohn says. “They’re sicker on average, especially when you talk about cardiovascular disease and hypertension. Our Vietnam vets were exposed to Agent Orange, which we know has a correlation with type 2 diabetes and osteoarthritis. And of course we see a lot of Veterans who are in the age group when joints are wearing out.”
To address the specific needs of Veterans, many of whom have multiple health conditions, the Cincinnati VA Medical Center and its regional clinics don’t just rely on a single individual. Each Veteran receives care from a dedicated group of care providers.
“Each of our Veterans is assigned a team with a provider, be it a doctor or a nurse practitioner, a registered nurse, a licensed practical nurse and a clerk. Then when he or she has a problem, they have the number of the team. Embedded within the teams we have social work services, nutrition, clinical psychology and clinical pharmacy,” Mohn says.
This approach allows the VA to provide an umbrella of services tailored to the needs of Veterans. Some services not typically available in private primary care, such as resources for managing food insecurity, are embedded directly into the program.
Executive Privileges
A top VA official has quietly racked up an expensive travel bill. From ProPublica’s Issac Arnsdorf at Task & Purpose:
The official, Darin Selnick, is a senior adviser to VA Secretary Robert Wilkie and has played a key role in developing the administration's controversial new rules on referring veterans to private doctors. The proposal, announced last month, has drawn opposition from some lawmakers and veterans groups.
Selnick lived in Washington during a previous stint in the Trump administration, from January 2017 until March or April 2018, earning a $165,000 salary. He rejoined the VA in late October 2018 and started flying to Washington from California for two weeks out of every month, at taxpayer expense.
Selnick's expenses included $3,885.60 for six round-trip flights in coach, $5,595.46 for 23 nights in hotels and $1,976 for meals, the reports show. The expense reports, which ProPublica obtained through the Freedom of Information Act, cover six trips between Oct. 21, 2018, and Jan. 19, 2019.
“It is unclear to me what role this person has at the VA, and why the VA is paying so much for him to travel back and forth," House veterans committee chairman Mark Takano said in a statement responding to the expense reports. “The funding allocated to VA should be used efficiently and effectively to provide benefits and health care for our veterans."
Flashback: VA Sec. David Shulkin’s Travel Turbulence
Quick Links:
- The New York Times: Readers respond to a column that advocated for VA privatization.
- Fortune: The VA’s partnership with Apple gives the tech giant just what it needed to break into the healthcare market.
- WBRC Birgingham: Honor veterans by providing good healthcare
- The News & Observer: Are there 30,000 uninsured veterans in North Carolina? This article does a PolitiFact check and breaks down veterans’ eligibility for VA care.
- The New York Times: A journalist reflects on the media’s blind spots in reporting on veterans.
The importance of good digital design
Veterans health care applications increased by 50 percent after the VA.gov redesign and relaunch. From NextGov.com:
“It was so anticlimactic,” said Jacobs, who leads the U.S. Digital Service branch at Veterans Affairs. “There was no drama, there were no fireworks. It was the quietest launch you never heard about.”
The revamped VA.gov was intended to make it easier for veterans to access the agency’s most popular services, and the team is already seeing its efforts pay off, according to Chris Johnston, the program manager for the project.
Between the site’s relaunch on Nov. 7 and Jan. 16, veterans submitted 51 percent more online health care applications than they did during the same period the year before, Johnston told Nextgov. Applications for G.I. bill education benefits also increased 9 percent, and customer experience scores improved as well.
“In the private sector, if you did something that gave you a 50 percent boost overnight, you'd get a $1 million bonus and a month of vacation,” he said.
Saving lives in rural Oklahoma
A community rallies for veterans in a mental health desert. Read more at Fox 25 Oklahoma City:
One of the biggest issues in rural Oklahoma is access to essential services, particularly mental health care. All too often, law enforcement officers become the mental health first responders. However, it is not always necessary for someone to go to jail if they are simply struggling with a mental health issue explains Ada police officer Joe Machetta.
“It's just a whole different experience when you look at something other people don't have a perspective on,” Machetta explained of responding to incidents that involve veterans who are experience the effects of PTSD.
Machetta is a veteran himself and he's also the police liaison to the newly formed Pontotoc County Veterans Rally Point.
“It just seemed like in my job I had already seen several times where we had ran into veterans that really needed help,” Machetta told FOX 25. “You just look at them and you're like, man I wish I could do something for them but they really wasn't a whole lot we could do.”
Military women need better reproductive care
A West Point Graduate and retired Army colonel writes at The Hill’s Opinion Page:
The three categories of reproductive care studied were access to birth control, to infertility services, and to abortion care. Two conclusions merit immediate attention. The first finding is the high rate of infertility among military women. More than 30 percent of military women reported having problems getting pregnant when actively trying to do so, with the highest percentage coming from military women currently serving. This figure is dramatically higher than the national average which, according to the Centers for Disease Control, sits at around 12 percent for civilian women.
Unfortunately for military women, treatment options are limited by cost, location, and accessibility. Only six military hospitals offer the full range of infertility treatments, but they have long waits lists. Moreover, service women have to pay some of the costs for their own treatment. A service woman who is not able to get care at one of the six designated treatment facilities must use Tricare insurance at a civilian provider. However, Tricare limits coverage to some tests and procedures, and it excludes in vitro fertilization. Service women report paying between $15,000 and $20,000 for just one round of in vitro fertilization treatment.
Women veterans are even more limited in their options for reproductive care. In order to get any kind of Veterans Health Administration infertility care, a woman veteran must be able to show that her infertility is service connected. If she is unable to establish service connected infertility, she will be treated on a random basis depending on the veterans hospital and the provider that she sees. Some are totally denied care, while others receive limited care. None will receive in vitro fertilization treatments.
Interviews show that women who reported infertility believe that their infertility may be the result of military service and related to exposure to toxins on the job, during deployments, and on military installations where they live. One infertile woman officer who had three deployments to Iraq believes contaminated water, overheated plastic water bottles, and poor air quality due to burn pits and other air pollutants might be to blame. |
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