SFTT News: Week of Feb 24, 2017

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Found below are a few 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.

Federal Hiring Freeze Confuses Military Parents
On Wednesday, the base commander informed parents that all part-day Child and Youth Services (CYS) programs at the garrison would end March 1 because they couldn’t replenish employees. That night, the Pentagon granted exemptions from the freeze, according to a Defense Department spokesman. But the exemptions come with disruptions. “This closure is a result of staff shortages due to the Federal Hiring Freeze,” said the Wiesbaden memo from Col. Todd J. Fish. “This hiring freeze prevents CYS from replacing staff who depart for any reason to include normal rotation.”  Read more . . .

Grow the Military the Smart Way
There are real demands for resources across the military, and many personnel and readiness challenges that need fundamental fixes — indeed, these challenges would be masked or even exacerbated by the infusion of more money, people, and platforms. The political debate is focused on quantity but more uniformed personnel is not a solution in and of itself, and lack of money isn’t the only obstacle to smart growth. Troop numbers make for easy talking points, but advocates for rebuilding the military must be able to explain why, what choices come first, and how to sustain it over time.  Update to personnel and readiness practice ought to come as part of this investment — otherwise, we could end up with a large force that isn’t formed to tackle America’s real threats, and undercut needed reforms.  Read more . . .

VA to Scrap Veteran Applications?
A whistleblower in the Atlanta office of the Department of Veterans Affairs warned President Trump on Tuesday that the VA is preparing to throw out hundreds of thousands of benefit applications due to an error the VA itself made during the Obama administration. Scott Davis, a well-known whistleblower who has testified before Congress, wrote an open letter to Trump saying that more than 500,000 of these applications might be scuttled in March unless he intervenes. “I am sending this whistleblower disclosure to your office due to the urgent need for executive intervention,” he wrote. “VA is planning on declaring over 500,000 Veteran applications for VA health care as incomplete and abandoned at the end of March 2017.”  Read more . . .

Dr. David Shulkin, VA Secretary

Dr. David Shulkin Pledges to Rid VA of Abuse
Dr. David Shulkin used his first public statement as the new Veterans Affairs Department secretary on Thursday to pledge management reforms that would remove the VA from a government agency’s “high risk list” for waste, fraud and abuse. “We will implement a plan that directly addresses these risks by building on the progress we have already made,” Shulkin said in response to a Government Accountability Office report naming the VA as a “high risk” agency in its treatment of veterans, handling of claims and efforts to lower wait times.  Read more . . .

Opioid Addiction a Problem for Many Veterans
Former Secretary of Veterans Affairs Robert McDonald said veterans are 10 times more likely to abuse opioids than the civilian population, which likely drives Fayetteville’s numbers up. Jacksonville, another military city in North Carolina, ranks 12th on Castlight’s list of worst locales for opioid abuse. While the military is taking steps now to attack addiction, many veterans question why the military took so long to address a problem the veterans say it created.  Read more . . .

Marijuana PTSD

Clinical Trial for Marijuana to Treat PTSD
The first participant in a clinical trial designed to evaluate the effectiveness of smoking marijuana to treat PTSD in veterans was given cannabis on Monday, according to the organization conducting the study.  The study is the first such trial to evaluate the safety and effectiveness of using marijuana to manage symptoms of post traumatic stress disorder in U.S. veterans, officials with the Multidisciplinary Association for Psychedelic Studies said in a release on Tuesday.  MAPS is a California-based non-profit research organization focused on “the careful uses” of marijuana, according to its website. The study is funded by a $2 million grant from the Colorado Department of Public Health and Environment.  Read more . . .

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

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Will Much Change at the VA with David Shulkin as Secretary?

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Much was made during the election campaign over the failings of the Department of Veterans Affairs (“the VA”) to serve our Veterans effectively.  While President-elect Trump had vowed to overhaul the VA, his selection of Dr. David Shulkin, an Obama administration holdover, as his nominee raises questions over what may change within the VA.

Dr. David Shulkin, VA Secretary

Indeed, the initial Senate confirmation hearings suggest a “love fest” according to Quil Lawrence of NPR.  Found below is the complete Senate confirmation hearing of the VA secretary-nominee’s testimony to the Senate committee:

Personally, I would like to think that Dr. Shulkin is the right person for the job – and he may well be – but I find it curious that not one of the questions at the confirmation hearing directly addressed the implementation of the Commission on Care recommendations. While some of these issues were addressed obliquely at the hearing, it seems to me that there should be a regular status report to the respective Congressional committees on how (or whether) these programs are currently being implemented.

While a good deal of the confirmation hearing was an opportunity for Senators to showcase their “genuine” concern for Veterans and pontificate on the silly rumors of “privatizing the VA,”  the hearing covered many of the same issues that continue to plague the VA.

Nevertheless, I am encouraged by some of the remarks by Dr. Shulkin at his confirmation hearing which are summarized below:

– Commitment to moving care into the community were it makes sense for the Veteran.  Currently, some 31% of health services are provided by local communities compared to 21% when Dr. Shulkin joined the VA.

– Expand Choice Program to ensure that Veterans are able to seek care in their community.

– Work to eliminate disability claims backlog (already significantly reduced) and seek legislation to reform the “outdated appeals process.”

– Need to address “infrastructure issues” . . . and explore expansion of public/private partnerships rather that build medical centers that have “large cost overruns and take too long to build.”

The Veteran’s Choice Program (“the VCP”) is the result of the Veteran’s Choice Act that was enacted to address chronic wait times for Veterans seeking care at VA facilities.  To a large extent, “the VCP” is the brainchild of Dr. Shulkin.

During the confirmation hearings, Dr. Shulkin agreed that the “mileage” requirement to access private medical services (currently 40 miles from a VA facility) shouldn’t be a deciding factor.  In Dr. Shulkin’s opinion, wait times should be the determining criteria.  Couldn’t agree more.

Furthermore, Dr. Shulkin acknowledged that there was far “too much bureaucratic” red tape involved when a Veteran received the green light to seek private care and the required VA approvals to actually receive it.

While praising the work ethic and dedication of nearly all VA employees, he admitted that he was frustrated by current legal constraints to shed the VA of a few bad apples.  Perhaps, he should enlist the support of government labor leader, David Fox, to join him in helping streamline the VA for the benefit of Veterans.

With 314,000 employees and a VA budget of $180 billion (of which only $76 billion is discretionary), SFTT has long believed that the VA is “too big” to succeed in its mission to provide adequate and responsive care to Veterans in need.

The issue is not the “quality of care” provided by the VA, which according to a recent Rand Corporation study compares favorably with private institutions.   The question remains, who gets access to these quality VA services and when?

During his confirmation hearing, Dr. Shulkin stated that only 61% of interviewed Veterans “trust” the VA (up from 41%).   I am quite sure that as the new VA Secretary, Dr. Shulkin, will seek to improve trust levels among Veterans, but ease of access to urgent medical services – whether at the VA or private facilities – is critical.

Furthermore, Veterans should be provided with a wider range of choices in determining the type of treatment they feel is appropriate for their medical condition.  Specifically, it is simply not acceptable that “gatekeepers” at the VA should determine ALL “eligible” treatment procedures.

Certainly, Dr. Shulkin appears to have the “right” temperament for the job, but in my opinion, far more is needed to turn around this largely non-responsive ship that is currently adrift and aloof from meeting the needs of Veterans.

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