Tuesday, February 19, 2019

MISSION Act Math, Big Travel Bills, and the Primary Care Defense The Veterans Healthcare Policy Institute

The Veterans Healthcare Policy Institute<execdirector@veteranspolicy.org>
To    

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.

…

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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The Week in Veterans' Health Care News

VeteransPolicy.org<execdirector@veteranspolicy.org>
To  

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.

…

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.
Copyright © 2019 Veterans Healthcare Policy Institute, All rights reserved.
You’ve subscribed to the Veterans Healthcare Policy Institute newsletter (formerly FFVHC).

Our mailing address is:
Veterans Healthcare Policy Institute
4081 Norton Ave
Oakland, CA 94602-4013

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2/21 The Assassination and Legacy of Malcolm X

Charlie Welch<cwelch@tecschange.org>
Via  Act-MA <act-ma-bounces@act-ma.org>
To  act-ma@act-ma.org  
Asalaamu`alaykum,

Join The Taha Collective and Harvard Islamic Society this February 21st
on the anniversary of the fateful day of the assassination of Malcolm X,
to appreciate and honor Malcolm's legacy, understand why he is relevant
to us today, and to understand the unexplored details behind his
assassination.

Our special guest speaker is Shareef Nasir, a documentary filmmaker
currently finishing up a film called "Behind the Trigger: The Killing of
Malcolm X". Through exclusive first-hand accounts, he explores the
events that led up to the death of Malcolm X, the aftermath and the
social context of Malcolm's life.

He has also produced "The Evolution of the Nation of Islam." A film that
chronicles the history of Elijah Muhammad's Nation of Islam and the
remarkable account of a people's journey from a separatist movement to
universal humanity.

Shareef is a graduate of San Francisco State University and the
University of California Los Angeles. He resides in California.

Hosted by The Taha Collective
<https://www.facebook.com/Tahacollective/?eid=ARA8vO_ACAdJR7z8KjzImQdo0j9VwK1FeAZv0P0MOPlMGcSzrATwLKdcEml3OSpaZJnaQamW2GEi60Xc>
and Harvard Islamic Society
<https://www.facebook.com/harvardislamicsociety/?eid=ARBP3pbaYOi8eJGdHkrU1QVptsXhjf2jY2C-dt1LX0uaA2gUiRmoN43MC59hoMcCJix7QabzyjnyJvwT>

Thursday at 6 PM – 9 PM
Ticknor Lounge
<https://www.facebook.com/pages/Ticknor-Lounge/140885052619537?eid=ARCiKPe4YDJzpOxFjsE7iaKYHstAAwFHXXMADiZEV54zJcnhWxn-BUK9RhVof31f8T9uvsc1MZ1TSL3y>

1279 Massachusetts Ave, Cambridge, Massachusetts

https://www.facebook.com/events/396644691096347/
_______________________________________________
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Act-MA@act-ma.org
http://act-ma.org/mailman/listinfo/act-ma_act-ma.org
To set options or unsubscribe
http://act-ma.org/mailman/options/act-ma_act-ma.org
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Amazing #FakeTrumpEmergency protests today - 50,000 people, 277 events

MoveOn Civic Action Iram Ali<moveon-help@list.moveon.org>
To  Alfred F Johnson  
Dear MoveOn member,
277 events. 48 states. At least 50,000 attendees. That's what power looks like.
Alfred, Donald Trump may control the White House for the moment, but we are not giving up on what this country can be. And today, tens of thousands of MoveOn members and allies hit the streets to build a vision of a country where all people—including those seeking asylum, immigrants, Muslims, and Black and brown communities—can fully thrive. A country where we won't be pitted against each other for any politician's agenda. A country where no president can place himself above the law.
From Cambridge to Boise, D.C. to Austin, Atlanta to Missoula, New York City to Honolulu, Cape Girardeau to Seattle, protestors came together to show that we will not stand for Trump's fake national emergency in order to advance his anti-immigrant agenda. 
Trump’s fake national emergency is just the latest in his planned, orchestrated series of attacks—from ending DACA to the Muslim Ban to family separation—designed to enact his racist policies. And Trump is grossly over-reaching and shredding the Constitution in order to advance his white supremacist agenda. 
But we were ready. Thanks to a network of MoveOn member hosts, many of whom have been training and preparing for over a year for a moment like this, we were able to show up in force and push back. 
This enormous undertaking was also only possible because coalition partners around the country, including MoveOn, the ACLU, Win Without War, and CREDO, who have been planning together to be ready to mobilize in a moment such as this for over a year. And partners, including United We Dream, Indivisible, PFAW, CPD, SEIU, AFT, AFSCME, NEA, Sierra Club, ResistBot, and over 100 more allies, joined forces in the crucial hours and days after Trump's announcement.
That's how—with just 72 hours notice—we were able to do the impossible.
Tens of thousands of us sent the message loud and clear to Trump that we will not tolerate him building walls, banning Muslims, or attacking immigrant, Muslim, and Black and brown communities. And we won't let him get away with asserting he can unilaterally place himself above the law.
We were also joined by members of Congress—including Reps. Ayanna Pressley (MA), Maxine Waters (CA), Pramila Jayapal (WA), Jerry Nadler (NY), Jan Schakowsky (IL), Joaquin Castro (TX), amongst others—who joined protests in their home states. And the entire world seems to be watching too. There was even a solidarity protest all the way in Barcelona, Spain! 
The fight isn't over to defend and protect communities that have been under attack during the Trump Administration, but, together we've shown the power that we carry.
At this point, Trump could be in office for another two years. The damage he could do in that time is enormous. But when the entire progressive movement stands up together, we can force Congress to act, mitigating the damage.
And that's not all: A grassroots army like ours means that once Democrats finally hold power, they will have a mandate that we helped established and a powerful base of activists (that's us) who will ensure they enact the progressive policies we need to create the world we want to live in.
Can you chip in $5 a month to help ensure we can keep going strong with national mobilizations in moments that demand outrage?
Thanks for all your work in this fight so far, Alfred.
And thanks for all you do.
–Iram, Corinne, Kate, Emma, Chris, Liia, Erik, Katie, Scott, and the rest of the team
(And if you're on not on Facebook, click here to watch it on YouTube.)
Want to support our work? The MoveOn community will work every moment, day by day and year by year, to resist Trump's agenda, contain the damage, defeat hate with love, and begin the process of swinging the nation's pendulum back toward sanity, decency, and the kind of future that we must never give up on. And to do it we need your ongoing support, now more than ever. Will you stand with us?
Contributions to MoveOn.org Civic Action are not tax deductible as charitable contributions for federal income tax purposes. This email was sent to Alfred Johnson on February 19th, 2019. To change your email address or update your contact info, click here. To remove yourself from this list, click here.

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