SFTT Military News: Week Ending Apr 21, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Kim - North Korea

Grim Military Options Available in Confrontation with North Korea
Three weeks before becoming president, Donald Trump weighed in on the threat of North Korea developing a nuclear warhead capable of reaching the U.S.: “It won’t happen,” he vowed on Twitter. Now planners are contemplating what a U.S. strike to prevent that development might look like, and the options are grim.Analysts estimate North Korea may now possess between 10 and 25 nuclear weapons, with launch vehicles, air force jets, troops and artillery scattered across the country, hidden in caves and massed along the border with South Korea. That’s on top of what the U.S. estimates to be one of the world’s largest chemical weapons stockpiles, a biological weapons research program and an active cyberwarfare capability.  Read more . . .

New Russian Military Base in the Arctic
Visitors to the Russian defense ministry website can now take a “virtual tour” of a new military base in a remote region of the Arctic. The Arctic Trefoil permanent base is in Franz Josef Land, a huge ice-covered, desolate archipelago. The Russian military sees the resource-rich Arctic as a key strategic region. President Vladimir Putin visited the new base, on Alexandra Land, last month. It is built on stilts – to help withstand the extreme cold – and will house 150 personnel on 18-month tours of duty. Winter temperatures typically plunge to minus 40C.  Read more . . .

Head Injuries Can Alter Hundreds of Genes
Head injuries can adversely affect hundreds of genes in the brain that put people at high risk for diseases including Alzheimer’s, Parkinson’s, post-traumatic stress disorder, stroke, ADHD, autism, depression and schizophrenia, life scientists report. The researchers have identified for the first time potential master genes which they believe control hundreds of other genes that are linked to many neurological and psychiatric disorders.  Read more . . .

Veterans with PTSD

New Study Suggests “Post-Traumatic Growth” after PTSD
A new study of military veterans who went through trauma finds that those veterans who have related post-traumatic stress disorder (PTSD) are also more likely to experience ‘post-traumatic growth’ — such as an increased appreciation of life, awareness of new possibilities and enhanced inner strength.   Read more . . .

New Bill May Provide Veterans with Greater Private Care Health Options
President Donald Trump signed a bill Wednesday to temporarily extend a program that lets some veterans seek medical care in the private sector, part of an effort by the president to deliver on a campaign promise. The extension will give Veterans Affairs Secretary David Shulkin time to develop a more comprehensive plan to allow veterans to more easily go outside the VA health system for care. Under the bill Trump signed into law, the VA will be allowed to continue operating its Choice Program until the funding runs out, which is expected early next year. The program was scheduled to expire on Aug. 7 with nearly $1 billion left over.  Read more . . .

New VA Facility in Waco, Texas Targets Brain Injuries
Waco’s Doris Miller Department of Veterans Affairs Medical Center now can provide the gold standard in research and treatment for brain injuries suffered on the battlefield with Thursday’s opening of a 53,000-square-foot facility for the VISN 17 Center of Excellence for Research on Returning War Veterans that sprawls across three floors of Building 93. More than 150 people attended a grand-opening ceremony to mark the occasion, and U.S. Rep. Bill Flores said the Waco VA will become a hub for dealing with the invisible wounds of post traumatic stress disorder and traumatic brain injury that have become part of this country’s global war on terror.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Opioid Abuse: Department of Veterans Affairs Culpability?

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While many families will be celebrating Easter today, I am quite sure that their thoughts will turn to a family member or friend who were among the 52,000 that died of a drug overdose last year.

By comparison, there were only 33,000 traffic fatalities over the same period.  These statistics suggest that substance abuse plays a far greater threat to our society than careless driving.

In an excellent 5-part series by FOX News entitled “Drugged, Inside the Opioid Crisis,” the network explores the devastating impact of opioid abuse in towns across the United States.

In fact, the FOX network claims that 4 out of 5 overdose fatalities can be traced to the initial use of prescription drugs for pain medication.   It is clear that prescription painkillers have caused many innocent victims to become dependent on more lethal drugs like heroin.

Temazepam_10mg_tablets-1

As Stand for The Troops (“SFTT”) has been reporting for several years, Veterans suffering from PTSD have been regularly over-served with a concoction of drugs – primarily opioids – to allow them to cope with pain and other issues.

If there was any doubt about the culpability of the Department of Veterans Affairs (“the VA”) in addicting our Veterans to painkillers rather than treat them, I suggest that you watch the video below:

With 20-20 hindsight most everyone can be on the “right side of history,”  but our Veterans, the VA and Congressional oversight committees have known that opioids was not the proper way to treat Veterans suffering from PTSD and TBI.

Dr. David Cifu:  A State of Denial at the VA

Unfortunately, VA protocols to treat PTSD as articulated by Dr. David Cifu, the senior TBI specialist in the Department of Veterans Affairs’ Veterans Health Administration, have resulted in few lasting benefits for Veterans with PTSD.  Paraphrasing Dr. David Cifu,  “the worse thing you can do for someone with PTSD is not to press them back into action as quickly as possible.  At the VA, we prescribe drugs for those in pain or suffering trauma.”

Indeed, there is no compelling evidence that the VA has improved the lives of Veterans suffering from PTSD or TBI.  

The VA continues to push its stale and failed agenda that states that the only two effective treatment therapies offered by the VA are:

– Cognitive Behavioral Therapy and,

– Prolonged Exposure Therapy.

To see how badly the VA has failed our Veterans, one only needs to listen to a detailed explanation by Maj. Ben Richards citing his experience with the VA and a summary of failed patient outcomes at the VA. Watch the first two minutes to see Maj. Richards refute all VA claims that they are dealing with the problem effectively.

Conversation with a Veteran Drug Abuse Specialist

Several years ago, I had the opportunity to visit a Community Center in northern New York that was working with high-risk Veterans suffering from PTSD and TBI.  During this visit, I encountered a Drug Abuse Specialist, who had been rescued from addiction through the Veteran Court System.

What he told me shocked me.

– Well over 90% of Veterans returning from Iraq and Afghanistan suffer from substance abuse issues;

– Veterans are well aware that opioids don’t work and have major side-effects (i.e. suicidal thoughts) when combined with other prescription drugs provided by the VA;

– Rather than flush prescription drugs down the toilet, the drug of choice, OxyContin, was pulverized into powder and sold on the black market to civilian drug users;

– A leading supplier of OxyContin to the VA had its sales of the drug fall by more than 60% when Congress forced them to repackage the pills in a gel composite so it couldn’t be sold as a powder on the black market;

– This same pharmaceutical company petitioned Congress to reinstate OxyContin in pill form citing that “it is more effective than gel;”

– VA prescribed drugs don’t provide Veterans with a meaningful road to full recovery.

Sadly, I don’t believe the situation has changed significantly in recent years.

Opioid Abuse in the United States

The magnitude of the addiction problem in the United States can’t be underestimated.  Consider these staggering statistics from the American Society for Addiction Medicine (ASAM):

– Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.

–  The overdose death rate in 2008 was nearly four times the 1999 rate; sales of prescription pain relievers in 2010 were four times those in 1999; and the substance use disorder treatment admission rate in 2009 was six times the 1999 rate.

– In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills.

– Four in five new heroin users started out misusing prescription painkillers.

– 94% of respondents in a 2014 survey of people in treatment for opioid addiction said they chose to use heroin because prescription opioids were “far more expensive and harder to obtain.

Opioids for Veterans: Deja Vu All Over Again

It’s often said that the definition of insanity is doing the same thing over and over again and expecting a different outcome.  As previous articles from SFTT have argued, the VA is in a rut and will continue to pursue well-meaning but demonstrably ineffective procedures to help Veterans with PTSD.  Most tragic.

While one would think that there is compelling evidence for the VA to follow in a different tack, I read a few days ago that OxyContin is again being tested to treat PTSD and substance abuse.

How much longer to our Veterans need to suffer from the VA bureaucracy and autocratic controls that remains largely unresponsive to their very real needs?   Based on the evidence, it seems that the VA management philosophy of benign neglect will continue to persist.  How sad!

Easter Advice from Veteran Wives Who Care

On Facebook, I recently came across this wonderful advice from Wives of PTSD Vets and Military.  I quote this useful advice below:

“If there is anything you have learned from your experience that you would tell those who are new to PTSD and the VA, what would it be?

Just A FEW of mine would be:

1. Staying on top of the VA and the veteran’s care is a full time job by itself. It is important to stay on top of it or they will fall through the cracks. Don’t wait for the VA to call. You call the VA.
2. Always research the severe side effects, and interactions of ALL medications including over the counter.
3. Always be aware of their moods, anniversaries (if possible), and seek help if you see them slipping downward.
4. Have a safety plan.
5. Find ways to communicate with your spouse. Use of code words, safety words etc are extremely helpful for us. Our new one is trust tree, which means either one of has something important to say, and the other one can’t judge, flip out, or start an argument. So far, it’s working. I’ll make a post later for it.

These are only a few off the top of my head. I have a lot more in depth ones that I will write about after while. What things have you learned or did you wish you knew when starting this roller coaster ride called PTSD?”

While one can only hope that this pragmatic spouse finds a sympathetic ear at the VA, “effective treatment” still seems out of reach.

In summary, may our brave Veterans and their families and friends get the HONEST SUPPORT THEY DESERVE.

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SFTT Military News: Week Ending Apr 14, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Military Revamping Retirement System to Attract Millennials
In a bid to lure millennials, the U.S. military is making the most sweeping changes to its retirement program since World War II. Gone are the days when only a 20-year veteran leaves the service with a nest egg. Going forward, those who serve as little as two years will return to civilian life with retirement savings. The new system introduces 401(k)-type savings for military personnel while downsizing the traditional pension benefit—a trade the corporate world has been making for 35 years. The new design also comes with a stepped-up effort to provide service members with the education they will need to make the most of a system that demands more individual involvement.  Read more . . .

Expanded U.S. Military Push in Yemen?
Amid reports President Trump is considering more American military help for the Saudi-led fight in Yemen, U.S. lawmakers are urging caution, if not an about-face. Four U.S. senators have offered legislation to limit arms sales to Riyadh over its troubled Yemen campaign. Fifty-five members of the U.S. House called on Trump in a letter to end both U.S. refueling for Saudi coalition warplanes and logistical assistance for the Saudi-led bombings in Yemen — and they said Trump must seek congressional approval before he deepens U.S. military involvement.  Read more . . .

Department of Veterans Affairs

Another VA Hospital Criticized by the Inspector General
In a scathing report, the Inspector General for the Department of Veterans Affairs listed a range of overlooked and long-standing problems at the Washington, D.C., VA Medical Center “sufficient to potentially compromise patient safety.” The risk to the 98,000 vets served by medical center in the nation’s capital was so high that the office of Inspector General Michael Missal took the unusual step of issuing a preliminary report to alert new VA Secretary Dr. David Shulkin to the danger.  Read more . . .

Future of the US Military Health System
Three components are needed for a high-performing military. First, the health of military personnel affects “readiness and battlefield performance.” So, health is not only a personnel matter, but also a national security issue. Second, maintaining the health of service members requires “everything from nutritious meals to medical services.”  Third, health care benefits help to attract and retain men and women in the armed services.  Nevertheless, the Military Health System “is a major cost” to the federal government, and the growth of that system “threatens other defense priorities” and attracts “criticism and proposals to reform military health care.”  Read more . . .

Oxycontin and PTSD

Oxycontin Being Tested (Again) for Treatment of PTSD
Nightmares. Obsessive thoughts. Avoiding particular places. Sudden outbursts. Fearing you’re in danger. Survivor guilt. These experiences – manifestations of post-traumatic stress disorder (PTSD) – are part of life for up to 1 in 3 U.S. combat veterans and active military personnel. That’s more than triple the prevalence of PTSD in the population at large. About two-thirds of those with PTSD struggle with alcohol abuse. A new trial may hold new hope for these military personnel through treatment with oxytocin, sometimes referred to as the “love hormone.”  Read more . . .

Tonix Drug PTSD Study Enters Phase 3
Tonix Pharmaceuticals Holding Corp. announced today that it has enrolled the first participant in the Phase 3 HONOR study of TNX-102 SL 5.6 mg, for the treatment of posttraumatic stress disorder (PTSD). “Enrolling the first participant in the HONOR study is an important event not only to Tonix, but potentially to millions who suffer worldwide from both civilian and military-related PTSD,” said Seth Lederman, M.D., Tonix’s president and chief executive officer. “The HONOR study is designed to confirm the clinical benefit of TNX-102 SL to improve PTSD symptoms across several measures as demonstrated in our Phase 2 AtEase study in military-related PTSD.”   Read more . . .

VA Launches New “Quality of Care” Website
The Department of Veterans Affairs unveiled a new website Wednesday aimed at providing information on the quality of care at VA medical centers, touting new accountability even as it grappled with fresh questions of patient safety in its beleaguered health system. The VA website, www.accesstocare.va.gov, is a work in progress. It provides preliminary data on the VA’s 1,700 health facilities, along with more than a dozen private-sector hospitals and national averages. Three years after a wait-time scandal at the Phoenix VA medical center, the website offers comparative data on wait times as well as veterans’ satisfaction ratings in getting timely appointments.  Read more . . .

 

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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VA Secretary David Shulkin: Glass Half Full?

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Department of Veterans Affairs (“the VA”) Secretary, Dr. David Shulkin means well, but it is not surprising that his leadership is being undermined by the same chronic conditions that have plagued other VA Secretaries.

Dr. David Shulkin, VA Secretary

THE VA IS SIMPLY TOO LARGE TO SUCCEED IN ITS MISSION

This week brings yet three more examples of the chronic problems facing the VA:

The VA still can’t FIX the Suicide Hotline

Secretary Shulkin Needs Senate Approval to Fire VA Employees

VA Dropping Veteran Caregivers from Their Rolls

Indeed, this litany of weekly crises is not dissimilar from scandals that have surfaced under the leadership of other VA secretaries.

What follows is a well-choreographed skit designed to reassure the public and Veterans that all is well in the Music Man’s River City.

“New Crisis” at the VA attracts national media;

VA Secretary assures Congressional subcommittee that problem will be fixed;

Congressmen get public facetime preaching to the converted;

– VA Secretary Shulkin sulks back to his office to prepare for next week’s Congressional hearing;

VA Labor Union blocks any constructive legislation that would allow the Secretary Shulkin to implement much-needed change within the VA.    Why?  Just ask J. David Cox, President of the American Federation of Government Employees, who once threatened a VA Secretary with “physical violence” for suggesting a change to the status quo.

For those who have followed this same tragic charade for many years, it is clearly evident that the VA is too big to succeed.  In the words of Nassim Taleb, the VA is fragile.

In my opinion, NO AMOUNT OF MONEY or CHANGE IN LEADERSHIP or ENACTMENT OF NEW LEGISLATION will bring about A MORE RESPONSIVE VA.

The VA has become a bureaucracy that answers only to itself and is not responsive to the needs of Veterans.  Frankly, the VA has lost its way and very little will change unless the VA is broken down into far smaller manageable components.

While smaller components of the VA will invariably fail, A SMALLER AND LESS CENTRALIZED VA WON’T COMPROMISE THE FULL MISSION.  

Will “change you can believe in” actually take place?  I think not, considering the entrenched political interest in maintaining the status quo and the patronage of a large block of voters represented by J. David Cox.

As presently configured, there is no possible way that the VA can fulfill President Abraham Lincoln’s promise: “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans.

As argued on several other occasions, the VA should be reconfigured to concentrate on those Veteran functions which require centralization.  All other activities should be assigned to smaller VA components or outsourced (with supervision) to the private sector.

For instance, the VA centralized suicide crisis line makes little sense.   Aside from the fact that the crisis line is currently non-responsive (and has been for a long period of time), it seems evident that we should allocate responsive resources far closer to a high-risk Veteran.

Let’s face it, few jumpers have been talked down off the ledge by a Call Center.  If you want to deal with high-risk Veterans in urgent need of support, get human resources to them as quickly as possible.  THINK LOCAL and COMMUNITY-BASED SERVICES.

While this more decentralized approach may not resolve the current Crisis Center problems, it would be far easier to manage and control at a local level.  Better yet, high-risk Veterans will benefit from a far more responsive human touch by local communities that truly care.

For Veterans, BIG IS NOT BEAUTIFUL!   Many Veterans see a largely unresponsive institution that seems more preoccupied with statistical adherence to protocol than positive patient outcomes. Wouldn’t it be wonderful if we could turn that perception around?

From the perspective of the VA, it is a lot easier to say that “we need more resources to deal with current shortcomings,” rather than face the reality that the VA has become a dysfunctional bureaucracy.

The Titanic

The ability to turn around the “Titanic” VA was lost many years ago.  Going forward, we must chop down the VA into far smaller component “passenger ships”  with accountability and leadership that can truly effect meaningful change.

Sure, one or more of these smaller components may fail, but not ALL Veterans will be held hostage by the continued failure in leadership of an INSTITUTION THAT IS TOO BIG TO SUCCEED.

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SFTT Military News: Week of April 7, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

US Military Options in Syria
Trump said that Tuesday’s attack “crossed a lot of lines” for him and that his “attitude towards Syria and Assad has changed very much.” And Trump told some members of Congress that he’s considering military action in Syria in response, a source familiar with the calls told CNN on condition of anonymity. Trump has not yet spelled out what his administration will do, if anything. But inevitably, speculation is focused on whether he might embark on military action where former US President Barack Obama did not. So what are the possible military options for the US in Syria?  Read more . . .

Budget Gridlock Could Harm Military
Lawmakers must finalize a budget for the remainder of fiscal 2017 by the end of April or trigger a partial government shutdown. In recent days, talk of a continuing resolution to fund the government through the end of September has slowly built in the halls of Congress, raising concerns among defense officials who say that would cause tremendous funding headaches for the military.  Army Chief of Staff Gen. Mark Milley warned that with the U.S. facing foreign threats and wars against terrorism, it is no time to risk national security by closing the year with a continuing resolution or returning to statutory budget caps.  Read more . . .

sftt_soldier

Being a Military Advisor in the Middle East is Not Easy
Americans are currently advising Iraqi troops in a vicious fight against ISIS in Mosul, and the United States has almost doubled, to nearly 1,000, the number of U.S. soldiers and Marines on the ground in northern Syria just in the past month. But training local fighters is a risky job that’s hard to do right, especially in the Middle East, which is splintered into groups with conflicts that go back centuries. Those divisions can be religious (Sunni vs. Shiite), ethnic (Arab vs. Kurd) and national (Turkey vs. Syria). An advisor’s job is made all that much harder by the fact that the divisions overlap.  Read more . . .

Taliban to Focus on Vulnerable Provinces in 2017
“There will be an increase in attacks in those provinces that are on the verge of collapse,” Taliban spokesman Zabihullah Mujahid told Stars and Stripes. While in the past the group had single units covering several provinces, Mujahid said: “This year, we have a unit for every province in the country.” The ability to control the capitals of Afghanistan’s 34 provinces appears to be the barometer that U.S. and NATO forces use to measure success in the Afghan conflict. Occupying a capital has been a top priority of the Taliban, and some fear this could be the year they finally succeed.  Read more . . .

Common Antibiotic Helps Inhibit Fear Memories
Researchers from University College London and the University of Zurich recently discovered a startling side-effect of the common antibiotic doxycycline – it can disrupt and suppress the formation of fear memories in the brain. This fascinating discovery could not only lead to novel treatments for PTSD, but also offers scientists a clue to how the brain forms lasting fear and threat memories.  Read more . . .

Can Ayahuasca Reduce Dependence on Addictive Drugs?
Combat-related PTSD is notoriously difficult to treat and in theory ayahuasca can work as a form of drug-assisted exposure therapy. When traumatised people repeatedly avoid fear-inducing situations this only serves to maintain and reinforce the deeply ingrained conditioning that underlies their illness. The idea is that by dredging up traumatic memories and exposing them to conscious awareness within a safe, controlled environment, ayahuasca allows the brain to reassess and extinguish conditioned fear responses.  Read more . .

J. David Cox

J. David Cox

Legislation Needed to Fire Incompetent Employees at the VA
A bill to give Department of Veterans Affairs Secretary David Shulkin authority to quickly fire incompetent employees faces a major battle in the Senate, although it has his backing and has already passed the House. Shulkin came out in favor of the legislation after realizing he couldn’t immediately fire an employee caught watching pornography at work.  While the VA Accountability First Act of 2017 passed the House, only 10 Democrats voted in support.  The ranking member of the House Committee on Veterans Affairs, Democratic Rep. Tim Walz, voted against the bill.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Veterans Treatment Courts: Smart Justice

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Several years ago, I had the honor to meet Judge John Schwartz, one of the early pioneers in promoting the benefits of  Veteran Treatment Courts.

Drug Treatment Courts

Drug Courts began to emerge in the nineties to deal more effectively with a growing drug problem in the United States.  As I wrote earlier,

Since the mid-1990, the US judicial system has recognized the need to deal with drug-related criminal activity and have established some 2,600 Drug Treatment Courts in the United States.  Drug treatment courts are specialized community courts designed to help stop the abuse of drugs, alcohol, and related criminal activity. Non-violent offenders who have been charged with simple possession of drugs are given the option to receive treatment instead of a jail sentence.   These programs have proven to be remarkably successful for reducing the level of recidivism in our prison system.

Capitalizing on the infrastructure and success of the Drug Treatment Courts, some 50 or so Veteran Courts have sprung up across the United States to deal with veterans who have committed a crime while suffering from substance abuse.  In many cases, these troubled vets have the support of other Vets (often from the Vietnam era) who “mentor” their military colleagues through the rehabilitation process.

Since then, Veteran Treatment Courts exist in every state in the United States.  These Courts provide Veterans with PTSD and substance abuse issues with an alternative to serving time in a federal or state penitentiary.

As the video from Justice for Vets explains below, Vet Courts provide Veterans with a second chance to recover their lives with the support of wise counsel from fellow Veterans, judicial system and law enforcement officers.

Aside from the fact that this appears to be a most sensible way to provide brave Veterans with the steady supportive counsel of a fellow Veteran, the Vet Court system has also reduced our prison population and cut recidivism by almost two-thirds.

While the Veteran Court system was largely the inspiration of community judges, law enforcement officers and a supportive community, the Department of Veterans Affairs (“the VA”) has been playing an active role in supporting these local and State programs since 2008.

Currently, there are approximately 220 Veteran Treatment Courts functioning in the United States with many other communities seeking to establish similar programs of their own. In fact, Justice for Vets recently provides a great deal of direct support and information for communities seeking to establish their own Veteran Treatment Court.

While 2017 applications for Justice for Vets support are currently closed, communities interested in this initiative would do well to contact Justice for Vets for more information on the Veteran Treatment Court Application Process.

Now, there are some – perhaps, many – who are opposed to any “special treatment” provided to people who break the law.  Nevertheless, the “cost” of incarcerating individuals who break drug laws and their exposure to hardened criminals seem to outweigh any potential long-term benefit to society.

For years, the VA has been serving up a cocktail of drugs to Veterans suffering from PTSD.  Only now have we come to the realization that this may not have been the proper way to deal with this serious problem.  In fact, opioid abuse is now an epidemic across the U.S.   One could argue that our Veteran population was well aware of this problem long before it hit mainstream America.

Should Veterans be subjected to incarceration, because the VA support system erred so badly?  I think not!

In May, we celebrate Drug Court Professionals across the United States who have contributed both their time, money and expertise to combat drug abuse in the United States.  If your community is currently planning – or thinking about – establishing a proactive response to drug abuse then you may well want to register for the NADCP Training conference that will be held this year in Washington, D.C. from July 9 – 12.

Justice for Veterans is a co-sponsor of this training conference and SFTT salutes those professionals who are giving their time and energy to fight drug abuse in America.

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SFTT News: Highlights for Week Ending Mar 31, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Lightweight Military Helmet

New Lightweight Combat Helmet Introduced
The Advanced Combat Helmet Gen II will replace the legacy Advanced Combat Helmet, which was fielded about 15 years ago. The service earlier this month awarded Revision Military, based in Essex Junction in Vermont, a contract worth about $98 million to make 293,870 of the new helmets. Made of high-density polyethylene instead of the current helmet’s Kevlar, the ACH Gen II weighs about 2.5 pounds in size large — about a 24-percent weight reduction, officials from Program Executive Office Soldier said at Fort Belvoir in Virginia.  Read more . . .

Iran Called a Destabilizing Influence in Middle East by Military Brass
The nation’s top military official in the Middle East on Wednesday said Iran is one of the greatest threats to the U.S. today and has increased its “destabilizing role” in the region. “I believe that Iran is operating in what I call a gray zone,” Commander of the U.S. Central Command, Army Gen. Joseph Votel, told the House Armed Services Committee in testimony Wednesday. “And it’s an area between normal competition between states — and it’s just short of open conflict.”  Read more . . .

Kim - North Korea

Dissecting US Policy Toward North Korea
Since the Clinton years, the US has considered military action and imposed strict sanctions against North Korea in an effort to curb its nuclear program — but none of it has worked amid fundamental misunderstandings about the shadowy Kim regime. US and UN sanctions on North Korea have sought to cripple the regime through restricting access to commerce and banking, but despite limited successes here and there, North Korea now regularly demonstrates a variety of potent and expensive nuclear arms in open defiance of the international community at large.  Read more . . .

Chinese Military Growth and Sophistication Attracts Attention
China’s rapid development of new destroyers, amphibs, stealth fighters and long-range weapons is quickly increasing its ability to threaten the United States and massively expand expeditionary military operations around the globe, according to a Congressional report. A detailed report from Congressional experts, called the 2016 US-China Economic and Security Review Commission, specifies China’s growing provocations and global expeditionary exercises along with its fast-increasing ability to project worldwide military power.   Read more . . .

Highlights of NPR Interview with VA Secretary Dr. David Shulkin
Secretary of Veterans Affairs David Shulkin says the Department of Veterans Affairs “is on a path toward recovery.” “We have a clear mandate to do better, [and] to make sure that we’re honoring our mission to serve our veterans,” Shulkin told NPR’s Morning Edition. Shulkin discussed his current priorities for the Department of Veterans Affairs, including how the money from the Veterans Choice program has been spent, and his approach to the persistently high rate of suicide among military veterans, with NPR’s Rachel Martin. The interview has been edited for length and clarity.  Read more . . .

New Diagnosis Tools for Veterans with PTSD?
Researchers are working at brain banks around the country to see what is going on inside the heads of veterans like Fadley. They are examining the brains of deceased veterans in hopes of knowing more accurately what effects trauma ― psychological or physical ― has had on the brain. That could someday lead to better diagnostic tests, treatments, clues into where PTSD originates and evolves.  Read more . . .

Agent Orange Effects Still Felt Today
An estimated 11.4 million gallons of the chemical pesticide known as Agent Orange were sprayed over millions of acres of Vietnam forests from 1962 to 1970. The United States Department of Veterans Affairs has long acknowledged the link between the substance and diseases like cancer in veterans, but when veterans began reporting having children with birth defects, the VA stayed mostly mum. But a joint investigation by ProPublica and the Virginian-Pilot published Friday revealed the odds of having a child born with birth defects were found to be a third higher for veterans exposed to Agent Orange than for those who weren’t. The investigation also determined that the VA had collected information about the link between birth defects and Agent Orange during examinations of more than 668,000 veterans but never adequately scrutinized it.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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Will the VA Provide Better Service to Veterans?

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With much fanfare, Dr. David Shulkin, the new Secretary for the Department of Veterans Affairs (“the VA”), has moved quickly to address some of the recurring problems at the VA.

Dr. David Shulkin, VA Secretary

As the first VA Secretary without a military background, Dr. Shulkin appears committed to resolve several pressing concerns:

– Speedier processing of Veteran benefit claims and,

– Eliminate unnecessary bureaucracy and artificial constraints on “out-of-network” support for Veterans (Choice Program).

Indeed, Secretary Shulkin recently unveiled a 10 Point Plan to modernize the VA:

1. Firing bad employees

2. Extending the Choice program

3. Choice 2.0

4. Improving VA infrastructure

5. ‘World-class’ services

6. Better VA-DoD partnerships

7. Better electronic records

8. Stopping suicide

9. Appeals modernization

10. Internal improvements 

While there is little in these Powerpoint presentation bullet points that anyone would quibble with, implementing these broad goals tends to be far more complicated than listing the goals.   Unless there are rigorous benchmarks to assess progress toward achieving these goals, then this “goal-setting” exercise is rather fruitless.

In fact, it is difficult to reconcile the need for increased hiring within the VA unless one sees clear and conclusive evidence that “bad employees” are being fired.  In fact, the VA is recommending a hiring surge to deal with a backlog of benefit claims, a situation that has persisted for 4 years.

Are more employees needed or does the VA lack the “right” mix of employees to implement Shulkin’s 10 point plan?

For instance, State and Local VA coverage varies radically across the US.  For example, NPR reported in 2015 “that spending is nearly $30,000 per patient in San Francisco, and less than $7,000 per patient in Lubbock, Texas. Nationally, the average is just under $10,000. In places where more veterans are enrolled in VA health benefit plans, spending per veteran did tend to be higher.”   Why?  This is a huge variance that is not well explained.

Aligning the VA to Achieve Measurable Goals

As one looks at Shulkin’s proposed goals, it would be useful to determine their priority and the level of commitment (personnel and capital expenditure) that is required to attain them.  Furthermore, what are the benchmarks to chart progress toward achieving those goals.

For instance, “stopping Veteran suicides” is a goal that would find few naysayers.  Nevertheless, it is difficult to reconcile that goal with the sad fact that 30% of suicide watch calls are not currently attended by the Veteran Crisis Center.  Indeed, I find it disturbing that the Suicide Crisis Line has been centralized under the VA in the name of “efficiency.”

Perhaps, Dr. Shulkin and his staff have some measurable goals.  If so, they should be made public and both the Executive Body and Congressional Oversight Committees should receive regular updates from the VA on progress to date in achieving mutually agreeable goals.

Is this likely to happen?  Most certainly not!  This is an anathema to Big Government.

Is Firing Bad Employees Really Going to Occur?

With 365,000 employees, there are certainly going to be a few “bad eggs.”  While Dr. Shulkin praised the vast majority of VA employees, he told a cheering crowd  that “We’re going to make sure that the secretary has the authority to make sure that those (sic “bad”) employees … are leaving the VA system.”

J. David Cox

J. David Cox

Really?  It seems to anyone who has taken more than a cursory look at staffing within the VA, that David Cox, the President of the American Federation of Government Employees, will be calling the shots rather than Dr. Shulkin.

In most cases, distinguishing between a “bad” employee and an inefficient one is largely subjective.  Given the protection afforded by employees at the VA, it is highly unlikely that both the bad and inefficient employees will be “leaving the VA system” anytime soon.

In effect, this places a greater burden on both ” the good” and the many efficient and competent employees within the VA.  With little say or control on managing the workforce, I find it highly unlikely that Dr. Shulkin will be able to fulfill his promise to fire “bad” employees.

More importantly, it is unlikely that he will be able to realign staffing levels to implement his 10-point plan.

And Speaking of Bad Apples:  How About Dr. David Cifu?

If Secretary Shulkin is really serious about dealing with “Veteran suicides” and providing Veterans with alternative treatment for Veterans with PTSD, he would do well to question the credentials of Dr. David Cifu and others within the VA who continue to block Veteran access to better treatment alternatives.

When one looks at Secretary Shulkin’s complex agenda, one should focus on the signs that change is actually occurring.  Personally, I don’t expect to see much change over the next couple of years, unless there are clear bookmarks to measure that change.  Sadly, it seems likely that we will be looking at the same litany of complaints a couple years down the road.

Dr. Shulkin, I admire your bravado and enthusiasm, but question whether you have the right tools and authority at your disposal to bring about a much needed reform within the VA.

Veterans should be hopeful, but not too optimistic.

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SFTT News: Week Ending Mar 24, 2017

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Found below are a few military news items that caught my attention this past week. I am hopeful that the titles and short commentary will encourage SFTT readers to click on the embedded links to read more on subjects that may be of interest to them.

If you have subjects of topical interest, please do not hesitate to reach out. Contact SFTT.

Does President Trump’s Military Budget Help “Grunts?”
Trump, who positions himself as the champion of the working class, has promised to pump billions more into the military. Yet the initial numbers suggest those who really benefit will be the ones who always benefit: the big defense contractors and their enablers at the Pentagon and Congress. The last people to see that flood of spending will be the ones most likely to fight and die: the grunts.   Read more . . .

All Laser Military by 2025?
Lasers have been a mainstay of sci-fi battles for decades. But making them practical for the battlefield has proven difficult. Now, private contractors and government agencies have developed weapons systems that are making science fiction a reality. This was made evident when Lockheed Martin and the US Army recently announced, a successful test of a 60-kilowatt (kW) laser. This one was twice as powerful as one they assessed in 2015.  Read more . . .

Changes in Tactics Required for “Megacity” Warfare?
Speaking at the Future of War Conference 2017 hosted by New America in Washington, D.C., Gen. Mark Milley said that the character of warfare will likely go through a fundamental shift over the next decade. The world’s population is steadily moving toward living in megacities. Currently, there are about a dozen of these huge urban areas with populations of more than 10 million. By mid-century, “we are going to have at least 50 or more,” Milley said.  Read more . . .

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Assessment of New NATO-Russia Balance
Twenty-five years after the end of the Cold War, the military balance between NATO and Russia, after years of inattention, has again become the focus of intense concern and even alarm in some Western quarters. From NATO’s vantage point, Russia poses a serious military threat to its eastern flank—and to Euro-Atlantic security more broadly—for three reasons.  Read more . . .

VA Recommends Hiring “Surge” to Deal with Disability Claims
The Department of Veterans Affairs (VA) is warning the backlog for veterans appealing decisions involving disability benefits will grow if the Trump administration goes ahead with its harsh budget cuts. Waiting times could grow to as much as eight-and-a-half years. A Government Accountability Office (GAO) report on Veterans Affairs Disability Benefits released on Thursday found staff resources at the agency had not kept pace with increased pending appeals, and concluded that additional staff were needed.  Read more . . .

Criticism of VA Suicide Hotline
The VA suicide hotline is still sending nearly a third of calls to outside back-up centers despite pledges by Veterans Affairs officials to stop the practice last year after a scathing report found the centers had routed veterans to voicemail, an inspector general investigation found. The VA opened a new call center and hired more staff to answer phones, but as of November, 30% of calls — or 14,600 that month — rolled over to backup centers.  Read more . . .

Refugees with PTSD Handle Stress Differently
PTSD is a mental health disorder that makes a person re-experience a traumatic event. “What we discovered was that a gene associated with a person’s mental health became overactive in refugees with PTSD and wasn’t able to respond the right way when working with the body’s stress defense system,” said Bengt Arnetz, a professor of family medicine who led the study. The methyl CpG binding protein 2 gene, or MECP2, helps control the normal function of nerve cells and plays an important role in mental health and the body’s ability to handle stress. The findings are being presented at the American Psychosomatic Society’s annual meeting on March 18.  Read more . . .

Drop me an email at info@sftt.org if you believe that there are other subjects that are newsworthy.

Feel you should do more to help our brave men and women who wear the uniform or our Veterans? Consider donating to Stand For The Troops

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2017 Veterans Affairs Budget: Breaking Down the Numbers

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Politicians from both sides of the political spectrum tend to use budget data in much the same way a magician conjures a rabbit out of a top hat.  Sadly, the Department of Veterans Affairs (the VA”) budget – in the hands of a politician – often becomes an instrument of posturing for voters rather than a management tool to efficiently allocate limited funds and resources to our Veteran population.

In analyzing the 2017 VA Budget, it is useful to analyze a few broad parameters to help pinpoint the “macro” issues.  Certainly, the VA can operate more efficiently, but this assumes that the VA management is committed to insure that Veterans receive the best care possible.

Unfortunately, management efficiency within the VA is beyond the scope of this very preliminary analysis of the 2017 VA budget.

SFTT’s focus is on how well – in “macro” terms – the 2017 VA budget actually benefits Veterans.

Discretionary vs Mandated Spending at the VA

According to the Department of Veterans Affairs, “The President’s 2017 Budget includes $182.3 billion for VA in 2017.  This includes $78.7 billion in discretionary resources and $103.6 billion in mandatory funding.  Our (sic the VA) discretionary budget request represents an increase of $3.6 billion, or 4.9 percent, over the 2016 enacted level.”

Department of Veterans Affairs

In effect, discretionary spending at the VA has been spared the axe of many other government programs.  As stated above, discretionary spending at the VA is projected to increase 4.9%.  This analysis will focus only on discretionary spending to determine whether the proposed increase actually benefits Veterans.

Discretionary spending represents only 43% of the total VA budget, while some 57% is allocated toward “mandatory programs” that support Veterans who meet predetermined criteria.   Needless to say, eligibility for Veterans to tap into those “mandatory” programs are largely determined by the VA. Many question the rationale and the process used by VA administrators to determine eligibility and the level of compensation.

Analyzing the Discretionary Spending Increases at the VA

All too often we confuse an “increased budget” with better service or improved end-user outcomes.  In the case of the VA the “end-user” is a Veteran who avails himself or herself of VA services.

To explain this apparent paradox, I cite the following example.  For instance, if the entire 4.9% budget increase is allocated to existing staff, then Veterans will receive NO better service or end-user outcomes UNLESS operating efficiencies occur within the VA.  In effect, you are relying on the VA’s NEW management to perform a better job than their predecessors rather than expecting the increased budget allocation to improve the lives of Veterans.

The same logic could be applied to price increases for drugs, third-party consulting services and other discretionary contractual obligations.

The budget is cleverly designed to avoid breaking out staff salary expenses.  Instead it focuses on programs such as “Benefits Claims Processing,” “Medical Care, and “Information Technology.”  Therefore,  it is rather difficult (if not impossible) to breakout budgeted expenses to obtain a better understanding to the cost-benefit relationships.

What is clear, is that the Department of Veterans Affairs hires well over 350,000 full-time employees and staffing has increased by roughly 10% over the past two years.  The good news is that over 32% of VA staffing are Veterans:

Veterans Affairs Budget

Without getting into the details of the budget, it is difficult to know whether taxpayer dollars are being spent efficiently within the VA.  With an average annual salary of approximately $50,000 (estimated national average), total VA staff expenses should exceed $18 billion.  To this, one needs to tack on an additional 30% (estimated) in staff-related expenses (social security, severance pay, pension plan, unemployment insurance, etc).

Therefore, it is reasonable to assume that roughly one-third of the “discretionary” budget is allocated toward staff.  It would be most interesting to know, how much money is allocated to third-party contractors, consultants and part-time employees.

Fitch reports that on average, “staff expenses” represent 54% of total operating expenses of privately run hospitals.  As such, the “scratch-pad” analysis above suggests that the VA is woefully understaffed (i.e. 1/3 of discretionary expenses) or that staff expenses and outside contractor expenses are much higher as a percentage of total discretionary spending.

The issue is not to question whether these staffing and compensation levels are appropriate, but to determine whether the end-user (i.e. the Veteran) is receiving the full benefit of this budgetary increase.

I suspect not, but it is next to impossible to determine how funds are allocated and whether they are done so efficiently.

While the new administration appears to be sending the “right” message to the VA, the current budget seems rather superficial and I detect little that represents a major change in direction of a huge government entity that seems more interested in defending its turf than representing the interests of all Veterans.

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