First Steps to Overhaul the Department of Veterans Affairs

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Dr. David Shulkin continues to impress by tackling some rather entrenched “special interest” groups within the Department of Veterans Affairs (“the VA”):

– Personnel;

– Infrastructure

Earlier this week, VA Secretary Shulkin informed a Congress that he was considering closing some 1,100 underutilized VA facilities.  The Associated Press reports that:

Shulkin said the VA had identified more than 430 vacant buildings and 735 that he described as underutilized, costing the federal government $25 million a year. He said the VA would work with Congress in prioritizing buildings for closure and was considering whether to follow a process the Pentagon had used in recent decades to decide which of its underused military bases to shutter, known as Base Realignment and Closure, or BRAC.

“Whether BRAC is a model that we should take a look, we’re beginning that discussion with members of Congress,” Shulkin told a House appropriations subcommittee. “We want to stop supporting our use of maintenance of buildings we don’t need, and we want to reinvest that in buildings we know have capital needs.”

Last week, President Trump signed an Executive Order protecting VA whistleblowers from retaliation in a quest by the VA to shed incompetent employees.

Department of Veterans Affairs

While these measures may seem rather insignificant given the overall size and reach of the VA, they could mark an important change in the direction of the VA to help respond to the needs of Veterans.

The VA has evolved into a mammoth organization intent on serving the needs of all Veterans and their families.  Roughly 60% of the VA’s $180 billion budget (2017 budget) is allocated to mandatory benefits programs.

The VA’s discretionary budget of $78.7 billion is allocated to a variety of Veteran services,  but by far, is the the $65 billion allocated to medical care facilities.   Despite regular reports of shortcomings at VA facilities, the Rand Corporation recently (2016) reported that “the Veterans Affairs health care system generally performs better than or similar to other health care systems on providing safe and effective care to patients.”

While it appears that many Veterans – quite possibly the vast majority – receive quality health services from the VA, many Veterans complain about the timeliness and quality of service provided to them.

Like other healthcare providers in the private sector, the VA has determined what health events are covered, the type of coverage provided and where the health services are administered.

One program that has come under particular attack is the Choice Program, which gives Veterans access to medical services in the private sector if the VA can’t dispense services within 30 days or a VA facility is not located within 40 miles of the Veteran.

At his confirmation hearings, now VA Secretary David Shulkin, requested that Congress expand the coverage of the Choice program and eliminate many of its administrative constraints.  Needless to say, changes in the Choice program would certainly provide a greater number of Veterans with access to private sector care.

In cases of emergency, even minor improvements to the Choice program could be of major benefits to Veterans.

Nevertheless, these changes do not provide Veterans with access to alternative therapy programs not currently approved by the VA.  As SFTT has reported on numerous occasions, PTSD is currently treated with demonstrably ineffective “approved” treatment procedures while far better and less-intrusive programs like hyperbaric oxygen therapy (HBOT) are widely used with success throughout the world.

In effect, there are a number of activities within the VA that can best be performed by third-party services.  In fact, integrating these services with community resources may prove to be more of a long term benefit to the Veteran and his or her family.

Stand for the Troops remains hopeful that Secretary Shulkin and the dedicated employees of the VA will find the right balance in helping Veterans recover their lives.

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Whistleblowers and the Department of Veterans Affairs

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On April 27th, President Trump signed an Executive Order to create the Office of Accountability and Whistleblower Protection within the Department of Veterans Affairs (“the VA”).

According to the AP, VA Secretary David Shulkin said the office will help identify “barriers” that make it difficult for the department to fire or reassign bad employees. Another function of the office will be to help shield whistleblowers from retaliation.

To many, it may seem surprising that a new office within the VA is required to protect “whistleblowers,” since private and public whistleblowers have long been afforded protection under the Whistleblower Protection Act of 1989.

Clearly, additional protection is needed if doctors like Dr. Dale Klein can be relegated to an empty room for bringing VA abuse to the attention of the Inspector General.  Found below is a report for Fox News:

Dr. Dale Klein may be the highest-paid U.S. government employee who literally does nothing while he’s on the clock. A highly rated pain management specialist at the Southeast Missouri John J. Pershing V.A., Klein is paid $250,000 a year to work with veterans, but instead of helping those who served their country, he sits in a small office and does nothing. All day. Every day.

“I sit in a chair and I look at the walls,” the doctor said of his typical workday. “It feels like solitary confinement.”

A double board certified physician and Yale University fellow, Klein said the Department of Veterans Affairs (V.A.) took away his patients and privileges almost a year ago after, he alleges, he blew the whistle on secret wait-lists and wait-time manipulation at the V.A. in Poplar Bluff, Mo., as well as his suspicion that some veterans were reselling their prescriptions on the black market.

While one would like to be optimistic that the new “Whistleblower Office” within the VA would help improved efficiency within the VA, I suspect that there are far too many institutional barriers to be overcome in this mammoth organization.

Department of Veterans Affairs

Size Matters at the Department of Veterans Affairs

The VA’s simple mission laid down by President Abraham Lincoln is “to care for him who shall have borne the battle, and for his widow, and his orphan.”

Needless to say, each person has his or her interpretation of what that VA mission entails, but over time the VA has laid on layers of responsibility to fulfill that mission.   In the military, we often refer to that as “mission creep.”

In effect, the VA – whether pressured by Congress, the President or their own Administration – have taken on responsibilities that may or may not be what was originally intended under President Lincoln’s promise.

More importantly, the VA has centralized most functions under its umbrella to administer to the needs of Veterans.

Employing some 350,000 people and many outside consultants, the VA administers health and benefit programs to millions of Veterans.  In economic terms, one might characterize the VA as a monopoly.

While many of the services provided by the VA are excellent, it would be unrealistic to expect that ALL services are effective.

In fact, the IG, internal VA audits and the IG have reported many irregularities at the VA.  Unmanned Crisis Call Centers, unacceptable patient “wait times” and the heavy reliance on prescription drugs all contribute to public wariness and distrust of the VA.   More importantly, many Veterans reject the services provided by the VA.

SFTT has long argued that the VA is far too large to succeed on every front without compromising their main mission.  Shortly after Dr. David Shulkin was appointed Secretary of the VA, we wrote:

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.  

VA Whistleblowers and David Cox

Dr. Shulkin and others clearly realize that there are serious problems of accountability within the VA.  The April 27, 2017 Executive Order is designed to help “weed out” waste and inefficiencies within the VA.

J. David Cox

J. David Cox

Despite much needed reform within the largely ungovernable VA, I suspect that  J. David Cox, President of the American Federation of Government Employees, will continue to run a destabilizing campaign to block any meaningful reform.

We admire the courage of “whistleblowers,” but Veterans shouldn’t expect great changes considering the entrenched positions of David Cox and his henchmen.

It is reassuring to see Dr. Shulkin take action to confront the serious problems within the VA.  We wish him success in his endeavors and hope that he receives much needed support from our elected leaders to bring radical reform to the VA.

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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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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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Dr. David Cifu: Do Veterans with PTSD Want Him in Their Corner?

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Stand for the Troops (“SFTT”) has written extensively about treating Veterans with PTSD and TBI.  Sadly, much of the publically available literature for brain-related injuries deals with identifying the symptoms and helping Veterans – and their loved ones – cope with terrible consequences of living with PTSD and TBI.

The issue(s) – at least in my mind – are these:

– Is treating the behavioral symptoms of PTSD and TBI enough for Veterans?  

– Have we given up hope in helping Veterans permanently reclaim their lives?

Sadly, treating the symptoms of PTSD/TBI is generally confused with actually providing Veterans with a meaningful long term solution to overcome the debilitating impact of a war-related brain injury.  

Now we learn that the VA is again studying the medicinal benefits of marijuana in treating Veterans with PTSD.   As many Veterans have been experimenting with marijuana for quite some time, I believe that the study will conclude that “medicinal marijuana, if used wisely, can mitigate anxiety, wild mood swings and suicidal thoughts among Veterans suffering from the effects of brain-related injury.”

The phrase in quotes are my words, but I suspect that conclusions of the multi-million dollar clinical study will not differ significantly.

The use of mind-altering drugs – whether medicinal marijuana or opioids – will most certainly help Veterans cope with the debilitating pain and anxiety of PTSD and TBI, but will prescription drugs meaningfully contribute to curing brain injury among Veterans?  

While the Department of Defense (“DoD”) and the Department of Veterans Affairs (“the VA”) have largely agreed that prescription drugs is not the answer, there is little evidence that the DoD or VA are clearly committed to provide Veterans with a clear path to full recovery.

Dr. David Cifu

Dr. David Cifu

In fact, the VA, represented by its spokesperson, Dr. David Cifu, continues to push a 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.

As the SFTT and others have pointed out, the VA has little – if anything – positive to show in having treating tens of thousand of Veterans with PTSD and TBI with these therapy programs.  You don’t have to be a brain surgeon (sorry for the very poor pun) or even Dr. David Cifu to recognize that currently recommended VA therapy programs have failed Veterans miserably.

Nevertheless, Veterans, the public and countless Congressional committees continue to listen to the same irresponsible dribble year-after-year and buy the same stale argument that Veterans are getting the best treatment possible.  To use a popular phrase, a little “fact-checking” would go a long to way to dispelling this insipid myth.

Dr. David Cifu represents what is wrong with the VA:   A lack of willingness to consider other alternatives.   As Judge and Jury on what constitutes “authorized therapy programs,” the VA has effectively precluded thousands of Veterans from seeking “out of network” solutions that appear to provide a far better long-term outcome.

The VA claims otherwise as we have seen in a long battle over the efficacy of Hyperbaric Oxygen Therapy (“HBOT”) in treating Veterans with PTSD and TBI.  Dr. David Cifu stands behind questionable studies that suggest that there is insufficient clinical evidence to support the thesis that HBOT can improve brain function.   In fact, Dr. Paul Harch, cites plenty of evidence in an academic study for the National Library of Medicine (Medical Gas Research) that conclusively demonstrates the lack of substance to Dr. Cifu’s bland and misleading opinions.

It is difficult to know whether new leadership within the VA will lead to more openness in providing Veterans with PTSD/TBI the support they require in finding therapy programs that work, but unless gatekeepers like Dr. David Cifu can be shown a quick exit, it is unlikely that much will change.

Our brave Veterans deserve far better than the sad and tragic delusional claims of Dr. Cifu.

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Service Dogs: Helping Some Veterans Cope with PTSD

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Service Dogs for PTSD

Photo via Pixabay by Skeeze

Soldiers returning from deployment sometimes bring the trauma of war home with them. Being injured themselves or witnessing others injured or dying, can have lasting physical and emotional effects on our military men and women. Symptoms of Post Traumatic Stress Disorder, or PTSD, can surface immediately or take years to appear. These symptoms can include sleeplessness, recurring nightmares or memories, anger, fear, feeling numb, and suicidal thoughts. These symptoms can be alleviated with medications and/or by the use of service dogs.

Service Dogs for Veterans and What They Do

A service dog is one that is trained to specifically perform tasks for the benefit of an individual with a physical, mental, sensory, psychiatric, or intellectual disability. Service dogs meant specifically for PTSD therapy, provide many benefits to their veteran companions. These dogs provide emotional support, unconditional love, and a partner that has the veteran’s back. Panic attacks, flashbacks, depression, and stress subside. Many vets get better sleep knowing their dog is standing watch through the night for them.

Taking an active role in training and giving the dog positive feedback can help the veteran have purpose and goals. They see that they are having a positive impact and receiving unconditional love from the dog in return. The dog can also be the veteran’s reason to move around, get some exercise, or leave the house.

Bonding with the dogs has been found to have biological effects elevating levels of oxytocin, which helps overcome paranoia, improves trust, and other important social abilities to alleviate some PTSD symptoms. When the dogs help vets feel safe and protected, anxiety levels, feelings of depression, drug use, violence, and suicidal thoughts decrease.

Service dogs can also reduce medical and psychiatric costs when used as an alternative to drug therapy. Reducing bills will reduce stress on the veteran and their family.

Impact of Service Dogs on Veterans with PTSD

These dogs offer non-stop unconditional love. When military personnel return to civilian life adjustment can be difficult, and sometimes the skills that they have acquired in the field are not the skills they can put toward a career back home. A dog will show them the same respect no matter what job they do, and that can be extremely comforting.

Service dogs can also foster a feeling of safety and trust in veterans. After going through particular experiences overseas, it may be difficult for veterans to trust their environment and feel completely safe. Dogs can offer a stable routine, be vigilant through the night (so the vet doesn’t have to), and be ever faithful and trustworthy.

Veterans sometimes have difficulty with relationships after departing the military because they are accustomed to giving and receiving orders. Dogs respond well to authority and don’t mind taking orders. The flip side is that by taking care of the dog’s needs, the veteran can also get used to recognizing and responding to the needs of others.

Service Dogs are also protective. They will be by the veteran’s side whenever needed and have their back like their buddies did on the battlefield. They will provide security and calm without judgment. The dog will not mind if you’ve had a bad day and be there to help heal emotional wounds. For this reason, PTSD service dogs are also a great help to veterans suffering from substance abuse disorders.

In an article by Mark Thompson called “What a Dog Can Do for PTSD”, an Army vet named Luis Carlos Montalvan was quoted as saying, “But for all veterans, I think, the companionship and unwavering support mean the most. So many veterans are isolated and withdrawn when they return. A dog is a way to reconnect, without fear of judgment or misunderstanding.

Check out the Department of Veteran’s Affairs for information on the VA’s service dog program by CLICKING HERE.

Here are a few of the dozens of programs to help if you are a vet or know one who could benefit from a service dog:

PawsandStripes.org

OperationWeAreHere.com

PawsForVeterans.com

SoldiersBestFriend.org

TenderLovingCanines.org

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Veterans with PTSD: Why a Dog May be Your Best Friend

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Veterans with PTSD:  Relief may be around the corner.  Practically, every day one sees Veterans with PTSD coming out from under the dark clouds of depression with the support of a canine companion.

Service Dogs and Veterans

I certainly am not qualified to speculate on the benefits that a service dog provides Veterans suffering from PTSD or other mental impairments, but there does appear to be genuine love and understanding between a Veteran and his or her companion dog.

Sadly, the Department of Veterans Affairs (“the VA”) does not provide “service dogs” to Veterans suffering from PTSD.  In fact, the VA only provides limited benefits to those service members with an approved VA disability:

VA will pay for veterinary care and the equipment (e.g. harness and/or backpack) required for optimal use of the dog. Veterinary care includes prescribed medications, office visits for medical procedures, and dental procedures where the dog is sedated (one sedated dental procedure will be covered annually). Vaccinations should be current when the dog is provided to the Veteran through an accredited agency. Subsequent vaccinations will be covered by VA. Prescribed food will be reviewed on a case-by-case basis.

Veterinary care does not include over-the-counter medications, food, treats and non-sedated dental care. Flea and tick medications are considered over-the-counter and are the responsibility of the Veteran along with over-the-counter dental care products (bones, dental treats, etc.). Grooming, boarding and other routine expenses are not covered.

The VA differentiates between a “guide dog” (for Veterans that are blind) and a “service dog” as follows:  to help those with severe to profound hearing loss by alerting the individual to a variety of sounds or someone with a physical impairment that substantially limits mobility  by assisting in the performance of a wide variety of tasks depending on need and training (e.g. opening doors, retrieving, etc.).

Currently, the VA does not provide Service Dogs to Veterans suffering from PTSD because “there is not enough research yet to know if dogs actually help treat PTSD and its symptoms.”  Studies are now underway to evaluate the benefits of service dogs to Veterans suffering from PTSD and TBI, but these results will not be available for several years.

Nevertheless, many Veterans can attest to the healing benefits of having a service dog regardless of the VA’s propensity to study the issue further.  Found below is a video of a Navy Seal who explains the emotional well-being of his service dog.

While the VA continues its research, many privately-funded organization have sprung up across the United States to provide trained service dogs to many Veterans seeking canine support to help them cope with PTSD and TBI. Found below is a list of just a few of these organizations which provide Veterans with canine support that is still under consideration by the VA.

Train a Dog Save a Warrior:  SFTT’s Rescue Coalition Partner providing service dogs to Veterans dealing with the silent wounds of war.

Paws for Veterans:  A privately-funded program which rescues dogs from shelters and then trains both the Veterans and their service dogs.

Vets Adopt Pets:  A list of several programs across the United States to help pair Veterans with “support” pets.

This Able Veteran:   A service dog program designed to help Veterans cope with PTSD and recover their lives.

Canine Angels USA:  Another program which rescues dogs for animal shelters and trains them to work with Veterans suffering from PTSD and TBI.

As the VA continues to “study” the self-evident benefits of a service dog, many well-intentioned private organizations across the United States are already providing much needed training and support for Veterans seeking a canine companion.

In many cases, these organizations are rescuing dogs for animal shelters to help provide these Veterans with a healing companion.

Thanks to the steadfast dedication of many wonderful people, the lives of countless Veterans have been improved.  On behalf of our Veterans, SFTT thanks you for your continued kindness and generosity!

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Veterans Affairs: Hope on the Way for Those Suffering from PTSD and TBI?

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With the expected change in the administration of the Department of Veterans Affairs (“the VA”), hope could well be on its way to provide more effective and timely treatment for the tens of thousands of Veterans suffering from PTSD and TBI.

Regardless of one’s political affiliation, the VA doesn’t seem to have a handle on treating Veterans with serious brain injury.  One hopes that the “new” VA will be more open to alternative therapy provided in the private sector, rather than current dogmatic approaches that have produced few – if any – positive approaches to treating PTSD and TBI. Maj. Ben Richards explains in far more detail below:

I just finished watching an exceptional documentary on PBS by Bob Woodruff entitled Medical Medicine Beyond the Battlefield.   The video, which may be watched below if you can spare 58 minutes – details some incredible medical breakthroughs in helping Veterans recover their lives after they have lost limbs in combat.  Truly miraculous!

Approximately 36 minutes into the video, Mr. Woodruff focuses on how the VA is dealing with brain injury.  Shortly thereafter, he chronicles the issues faced by Elana Duffy, an intelligence Sgt. First Class who suffered traumatic brain injury while serving in Iraq (39 minutes).

It is evident that the VA is not making as much progress in treating neurological disorders as they are on other medical rehabilitation fronts.

While concerted efforts are being made to understand and treat PTSD traumatic brain injury, it appears that “progress” within the VA has been impeded by dogmatic positions maintained by Dr. David Cifu and others. In effect, Veterans suffering from PTSD and TBI are given few treatment alternatives outside the narrowly defined treatment programs so vigorously defended by VA administrators.

SFTT has long held the view – based on feedback from many Veterans – that the VA is not in a position to provide the necessary care and treatment to truly help Veterans suffering from PTSD and TBI.   This is a huge problem for Veterans and their families and one needs to “think outside the box” or the confines of VA orthodoxy to embrace new treatment alternatives.

It is terribly sad that the VA has become a political ping pong ball to the chagrin of many Veterans. The release of the Commission on Care report recommending 18 major reforms within the VA triggered an immediate backlash from employees and lobbyists who felt threatened  by the findings.

J. David Cox

J. David Cox

Like others, “I was appalled by the outburst of J. David Cox, the President of the American Federation of Government Employees, who threatened VA Secretary with ‘physical violence.’Cox was ‘prepared to whoop Bob McDonald’s a – -,’ he said. ‘He’s going to start treating us as the labor partner … or we will whoop his a – -, I promise you.'”

Against this particularly toxic background, it is difficult to know whether a new VA Secretary will be able to implement the reforms outlined in the Commission on Care report.

Former U.S. Senator Scott Brown to Head Department of Veterans Affairs?

According to recent information, former U.S. Senator Scott Brown of Massachusetts is apparently a front-runner for the post of Secretary of Department of Veterans Affairs in the new Trump administration.

As reported in the Boston Herald and several other respected media sources, Scott Brown is

 . . . under consideration for the Cabinet post of Veterans Affairs secretary — said he would create a 24-7 manned hotline for suicidal soldiers, take back bonuses and raises awarded to incompetent VA staffers and outsource PTSD and other serious mental health cases to private professionals.

“People are hurting and they need some real help,” Brown said last night, hours after he spoke with President-elect Donald Trump. “There are some great angels working in the VA right now and they need a morale boost.”

If true, this could very well accelerate outsourcing the treatment of Veterans suffering from PTSD and TBI to private healthcare providers.   Sen. Brown is quoted as saying, “The VA’s trying to do it all — they can’t. We need to outsource that and get those people help right away.”

There is no way of knowing whether Sen. Brown will be offered the job of VA Secretary or will be confirmed to this “cabinet-level” position, but implementing the steps recommended by the Commission on Care would be a major step forward in getting Veterans the help they deserve.

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