Women Veterans Task Force Draft Plan Released

Posted on May 16, 2012 by Patrick

Veterans for Common Sense Supporter here is your chance to weigh in on female veteran’s issues. Don’t let it pass you by. Below is the official VA notice complete with instructions.

VA Seeks Public Comment on Strategies

 

WASHINGTON – The Department of Veterans Affairs is releasing for public comment a draft of its strategic report to address key issues facing women Veterans. The plan outlines steps for improvements to care and services for women Veterans that are sustainable, accountable and a part of the department’s culture and operations.

 

“Expanding care and services to women Veterans is too important to limit ourselves solely to the views within the department, so we are seeking feedback from all stakeholders, most importantly women Veterans themselves,” said Secretary of Veterans Affairs Eric K. Shinseki. “The VA must be visionary and agile enough to anticipate and adjust not only to the coming increase in women Veterans, but also to the complexity and longevity of treatment needs.”

 

Shinseki formed a task force to develop an action plan to address women Veterans’ issues.  Since then, the group has conducted a broad survey of department experts to identify those issues and organize them by priority.  The draft report is an interim step prior to VA finalizing its overall plan.

 

The report comes at an important juncture in VA’s history that demands a review of the quality, quantity, and types of services and programs it provides to women Veterans.  The number of women Veterans using VA has increased 83 percent in the past decade, from about 160,000 to over 292,000 between fiscal years 2000 and 2009, compared with a 50 percent increase in men.

 

Women are now the fastest growing cohort within the Veteran community. In 2011, about 1.8 million or 8 percent of the 22.2 million Veterans were women. The male Veteran population is projected to decrease from 20.2 million men in 2010 to 16.7 million by 2020. In contrast, the number of women Veterans will increase from 1.8 million in 2011 to 2 million in 2020, at which time women will make up 10.7 percent of the total Veteran population.

 

VA is training providers in basic and advanced topics in women’s health through mini-residencies, and over 1200 providers have currently received training. Comprehensive women’s health care can be provided within three different models of care, including comprehensive women’s clinics; separate, but shared, space women’s clinics; or integrated primary care clinics.  All of these clinic models ensure that women receive all of their primary health care (prevention, medical, and routine gynecologic care) by a single primary care provider. A network of medical directors and program managers who coordinate care for women Veterans now encompasses all 153 medical centers in the VA Health Care System.

 

The public notice and instructions for how to submit comments will be posted at www.regulations.gov.  The draft written report will be open for comment for 30 days, and responders will have a number of options to provide both electronic and written feedback.  Readers will also be able to participate in a public discussion board on the Internet at: http://vawomenvetstratplan.uservoice.com/forums/159415-general.

 

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Clinic in Afghanistan is first stop for US troops recovering from brain trauma

Posted on May 15, 2012 by Patrick

By JEREMY SCHWARTZ

Austin American-Statesman
Published: May 14, 2012

  • Bagram hospital stats
Chart showing average number of amputations and traumatic brain injuries, per month, suffered by U.S. soldiers in Iraq and Afghanistan wars, 2003-2011.
AUSTIN AMERICAN-STATESMAN

Bagram hospital

Map of Afghanistan locating Bagram Air Base, just north of Kabul.
AUSTIN AMERICAN-STATESMAN

The first room they go to is small and dark, with a single bed in the corner and a blanket hung over the window. The building is covered in a hardened foam that muffles the constant drone of the Apache helicopters, Warthog attack jets and massive cargo planes coming and going from the airfield at this base just north of Kabul.

One of the major lessons of the Iraq and Afghanistan wars is that quick treatment and rest after a blast can reduce such long-term symptoms as depression, mood swings and thinking difficulties. For service members who have suffered a traumatic brain injury, this clinic can dramatically improve quality of life in the years to come.

Thousands of troops who suffered a brain injury earlier in the wars went right back into the fight without missing a beat. All too often, commanders and soldiers themselves, unable to see the brain injury, did not give the wound the attention it needed. More than 200,000 American service members, about 10 percent of the troops who served in Iraq and Afghanistan, have been diagnosed with TBI, and many more have probably gone undiagnosed, according to veteran advocates. Some will suffer psychological and physical problems such as personality shifts, increased impulsivity and epilepsy in the years to come because they received additional brain trauma before their initial injury was given a chance to heal.

But as the war ended in Iraq and begins to wind down in Afghanistan, military officials have begun paying better attention to TBI, especially the more prevalent mild brain injuries, which include concussions. In 2010, the Department of Defense ordered mandatory TBI screening for soldiers who have suffered a blow to the head, were in a vehicle accident or were near a blast. Troops who show signs of brain injury after a screening that tests memory and concentration are taken to one of seven brain injury clinics in Afghanistan, where they receive forced rest and cognitive therapy.

In eastern Afghanistan, troops are airlifted to Craig Joint Theater Hospital at Bagram Air Base, where they spend from three to seven days at the nine-bed brain injury clinic. Nearly all return to duty after going through the program. “If they get to us early enough, we send 100 percent back to their units,” said Air Force Maj. Katherine Brown, an occupational therapist and the officer in charge of the clinic.

Brown said that when service members arrive, they are often disoriented and confused and have problems with their balance. They are encouraged not to do anything but sleep for that first day.

“Usually, if they take advantage of the rest period, they feel much better the next day,” she said.

Rest is perhaps the most important aspect of the recovery process, but in combat areas, where soldiers and Marines share tents and live on bare-bones bases, quiet areas are hard to find.

After their initial rest at Bagram, patients go to a day room, where they can watch TV, but not traditional soldier fare. “The brain is not ready for a lot of stimulation,” Brown said. “They don’t watch war movies, action movies. We start them out on 30-minute comedies.” On a recent afternoon, a recovering soldier relaxed in front of an Ashton Kutcher romantic comedy.

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At this point, some soldiers ask to return to their units. “We tell them it’s not safe for them or their teammates if they go back before they’re ready,” Brown said. “If they are not ready to deal with something coming at them, they can’t be in a war situation.”

In a third building, improving patients perform cognitive reasoning exercises such as Sudoku, Foosball and Origami (at this point, soldiers are also allowed to watch war movies again). Patients also begin doing exercises in which they have to move their eyes up and down, such as passing drills with volleyballs. Quick eye movement can be affected by brain injuries but is key to surviving in a war zone.

Brown said that she is working with the Department of Defense on developing TBI rehabilitation protocols, which she said have not been well-researched.

After completing the course, patients might be referred to counselors in the hospital’s combat stress department. Others might need more physical rehabilitation. But most return to their units on the battlefield.

“Everybody who comes through these doors are miracles,” Brown said. “Six inches the other way and they wouldn’t be with us.”

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Military Looks To Redefine PTSD, Without Stigma

Posted on May 15, 2012 by Patrick
From NPR
 by LARRY ABRAMSON
May 14, 2012

The military and the Department of Veterans Affairs say they want more veterans and service members to get appropriate treatment for post-traumatic stress disorder, or PTSD.

That’s why they’re tweaking the way they define and treat PTSD. But if this approach works, it could add to the backlog of PTSD cases.

For years, the standard definition for post-traumatic stress disorder had a key feature that didn’t fit for the military. It said that the standard victim responds to the trauma he or she has experienced with “helplessness and fear.”

Elspeth Cameron Ritchie, a former psychiatrist with the Army, says that may be true for civilians. But, she says, military people are trained to do just the opposite.

“When the IED, the improvised explosive device, goes off, they pick up their weapon, lay down suppressing fire, drag their buddies into safety and go on about doing what they’re trained to do,” she says.

Encouraging Treatment

New Army guidance says, don’t expect military men and woman to respond to trauma this way. Even if they are “soldiering through” the pain, they may still need treatment for post-traumatic stress.

This is just one of a number of adjustments the military and the VA are making — they’re essentially giving the benefit of the doubt to people who show signs of stress.

Ritchie says opening up the definition will allow more service members to get treatment.

“So that you bring in people who are doing exactly what they’ve been trained to do and make sure they get the care and treatment they need,” she says.

Many of our young men and women coming back don’t want to go to a mental health therapist. But they will go someplace and learn skills for wellness to increase their resiliency.

- Elaine Miller-Karas, director of the Trauma Resource Institute

The new Army guidance clarifies other pieces of the PTSD diagnosis that might mean one thing for civilians, and something completely different in the military.

Take “malingering,” or faking illness. Dr. Charles Hoge of the Army Surgeon General’s office says that for a service member, that word could lead to denial of benefits, or even punishment.

“These are legitimate diagnoses, but they do have different implications and ramifications in the military because of the administrative processes that can happen around those types of diagnoses,” he says.

Removing The Stigma

Through these changes, the Army and the Department of Veterans Affairs are hoping to peel away the stigma still associated with this condition. In doing so, there’s also a good chance that more people will seek treatment. And that could add to the growing number of PTSD cases in the military.

The VA recently announced it will hire more therapists, doctors and support staff, in an effort to shorten the long wait times for an appointment in some places.

Dr. Mary Schohn, director of mental health operations at the VA, says rural areas are a particular problem. So the agency is sponsoring special training internships.

“So some of the last internship positions that have opened up have been in rural areas because we know that people who tend to train in areas are more likely to stay there,” she says.

But some say no amount of hiring can keep pace with the growing number of cases.

“There aren’t enough therapists in our country to deal with the number of individuals coming back with traumatic stress symptoms,” says Elaine Miller-Karas, director of the Trauma Resource Institute, based on the West Coast.

Alternative Approaches

Miller-Karas says that simply rounding up enough psychiatrists and therapists for all these men and women isn’t enough. Alternative approaches are essential, she says — relaxation techniques, exercise and other ways to help people who don’t want to be labeled with a disorder.

“Many of our young men and women coming back don’t want to go to a mental health therapist. But they will go someplace and learn skills for wellness to increase their resiliency,” she says. Miller-Karas is focusing on training community health workers and family members in coping with post-traumatic stress.

Hoge of the Army’s Surgeon General’s office says says clinicians usually turn to traditional talk therapy and medication first because they’ve been tested. “But if they don’t work, clinicians will very often move to treatments that don’t have as strong evidence,” he says.

Proven or not, alternative therapies may be needed to manage the workload created by all the troops seeking help.

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Soldiers death in Afghanistan ruled a suicide

Posted on May 15, 2012 by Patrick

APPLETON WI — A 25-year-old Appleton soldier who died last year in Afghanistan committed suicide, said the U.S. Army agency that investigated the death.

The U.S. Army Criminal Investigation Command, based in Quantico, Va., concluded this spring that Garrick Eppinger Jr. died Sept. 17 from a self-inflicted gunshot wound. He was serving with the Army Reserve’s Appleton-based 395th Ordnance Company.

The Armed Forces Medical Examiner classified the death as a suicide. The full report from the Army’s six-month investigation was not available Monday.

Eppinger’s family has yet to receive the report, and declined comment when contacted Monday.

Little information has been released about the death. Eppinger’s family said they were told he was shot while serving at Bagram Air Base, where he worked a desk job as a supply specialist for a munitions post.

More than 500 people attended Eppinger’s funeral in October in Appleton. He was buried with full military honors.

Eppinger leaves behind a 2-year-old daughter. He is a 2004 graduate of Appleton North High School.

Eppinger was awarded several military medals for his service and sacrifice, including the Army Commendation Medal, NATO Medal, Afghanistan Campaign Medal and Global War on Terrorism Service Medal. He was in his third overseas deployment, having previously served in Iraq in 2005 and 2009.

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THE IMPEDIMENTS STANDING IN THE WAY OF TIMELY DELIVERY OF BENEFITS

Posted on May 14, 2012 by Patrick

Editorial Prepared by Gordon Erspammer JD lead Attorney for VCS-VUFT vs Eric K. Shinseki

I frequently am asked the fundamental question of why the benefit and health care delivery systems for veterans administered by the Department of Veterans Affairs are so dysfunctional. Like many things, there is no simple answer. In many ways, the VA is like a battleship, with powerful forces of inertia and mass frustrating the ability of administrators to make any meaningful changes. The unfortunate result is that all too often, the well-being of veterans and their families is compromised, and many never receive the benefits that Congress intended.

First, a major underlying factor in the present state of affairs is the structural impediments that insulate the VA from accountability. These include: (1) a statutory prohibition dating back to the Civil War that forbids veterans from paying counsel any money to represent them in any claims for benefits, which effectively eliminates access to counsel for most veterans; (2) the long history of a statutory bar to judicial review of VA claims decisions, which was finally changed in part in 1990 by the creation and opening of the Court of Appeals for Veterans Claims, a specialty court with very circumscribed powers and authority; and (3) the Feres doctrine, emanating from a Supreme Court decision during the Cold War, which in effect immunized the government from any liability to active-duty military personnel.

These provisions have combined to give the VA extraordinary latitude to do what it pleases, and to restrict veterans’ access to justice. The VA supports and clings to these restrictions on veterans’ civil rights, relying on outdated and inaccurate characterizations of its processes as nonadversarial. For far too long, the VA has resisted the rule of law and compliance and enforcement procedure, and required each veteran to repeat the same struggle for justice.

Second, the VA has never grappled with or solved the major problems that have plagued it for decades, such as the glaring lack of internal controls, the ever-expanding backlogs of claims and appeals, and the long waiting lists for health care. Instead, the VA simply resets its “goals” to account for further deterioration in timeliness, and the lines just get longer. From the management perspective, the VA hops from crisis to crisis, sometimes on multiple, simultaneous fronts, acting much like a player in a multipanel game of “Whack a Mole.”

And most recently, we have seen stories about Inspector General audits of how the VA “cooks the books” regarding statistical measures, such as patient wait times. And even last week I learned that, after extensive litigation and investigations into the VA’s manipulation of its electronic waiting lists for health care, the VA in June 2009 quietly redefined what the standard for being placed on a waiting list by requiring that patients have to wait for at least 120 days (rather than 30) before even being placed on the electronic waiting list. For suicidal veterans, we need to acknowledge that a delay in providing care may turn out to be a death sentence. If the VA’s eye were on the ball of its mission of serving veterans, it would not need to resort to applying the principles of “how to lie with statistics.” And the backlogs of claims and appeals and remands in the VA adjudications system for death and disability compensation have continued markedly to deteriorate. For example, how can anyone defend a system that requires five to 10 years to resolve a veteran’s appeal? This is a cardinal example of how justice delayed is justice denied.

Read more…http://www.utsandiego.com/news/2012/may/13/tp-the-impediments-standing-in-the-way-of-timely/

Posted in VCS Lawsuit Against VA | 1 Comment