VCS in the News: Guarded Optimism on New VA Secretary, Need to Reach Deeper

As new U.S. Department of Veterans Affairs (VA) Secretary Bob MacDonald passes his two-month mark in office, the news media have begun trying to determine whether or not he is likely to be effective in redirecting VA to a more accountable course.

The Belleville, Illinois News-Democrat published a Sep. 28, 2014 article authored by veteran reporter Mike Fitzgerald, entitled: “Are VA reforms working? Metro-east veterans weigh in“.  The article said, in part:

MAKING A DIFFERENCE?

Nationally, longtime critics of the VA say it’s too early to tell if the reforms that Obama signed into law are making a difference.

After all, the VA, with 731 medical facilities nationwide, is so big and serves so many patients, and handles so many claims, it could take years to assess if the reforms are making a difference.

That’s especially true when it comes to changing the system’s inbred management culture, according to experts.

The VA’s management culture lay at the heart of the latest scandal plaguing the VA. It exploded in late April, when the news media began reporting, based on a whistleblower’s disclosures, that at least 40 veterans had died while waiting for appointments at the Phoenix VA Hospital.

Congress soon jumped into the fray when it was revealed that many of the veterans who died had been placed on secret waiting lists that prevented them from obtaining needed medical care.

The covert list was part of an elaborate scheme which VA managers had devised to hide the fact that up to 1,600 sick veterans had to wait months to see physicians. By hiding these patient lists, the managers reaped millions of dollars in bonuses awarded on the basis of their supposed success in cutting patient wait times.

The scandal over the secret waiting list led to the forced resignation of former Army General Eric Shinseki as the VA secretary and the appointment of Robert McDonald as his replacement.

BIG CHALLENGES

Earlier this month McDonald announced a 90-day plan for fixing the VA’s recent woes.

Anthony Hardie, a board member of Veterans for Common Sense, of Washington, D.C., said he’s hopeful the reform law and McDonald’s 90-day initiative represent a start in the right direction.

But in view of the huge, entrenched problems afflicting the VA — including a culture of deception and a long history of “cooking the books” regarding patient care and research — there is still a long, long way to go, according to Hardie.

“I think a year or two from now we’ll be able to say, ‘Yeah, we’re beginning to see some change,” Hardie said. “And maybe five years from now we’ll be able to look back and say, ‘That was the beginning of major change.’ I hope that’s what we can say.”

A report released by the VA inspector general in August stated that no deaths at the Phoenix VA could be “conclusively” linked to long wait times.

But the main whistleblower in the VA scandal two weeks ago denounced the IG report, calling it a “whitewash.”

A similar article by Claire McNeill in the Oct. 1, 2014 edition of the Tampa Bay Times, VA secretary announces progress, promises more change“, came on the heels of a local Florida visits by MacDonald, who made stops to the Haley VA medical center in Tampa and the much maligned Bay Pines VA Regional Office in St. Petersburg.  

According to the article:

McDonald has appeared at Washington meetings that his predecessor never attended, said Anthony Hardie, a Bradenton resident on the board of directors of Veterans for Common Sense, a nonprofit advocacy group. And McDonald’s presence in the Tampa Bay area is significant, he said.

“He’s clearly making sure that he is hearing what the concerns of veterans are,” Hardie said. “I believe what the secretary is doing are very important first steps. At the same time, I’m still very guarded in my optimism.”

The secretary acknowledged the department’s deep issues.

“Too many of our employees have felt disenfranchised,” he said. “They have not been included. Too many of our veterans have been disenfranchised.”

He said the nearly 9 million veterans under VA care are the top priority, and leaders must work to ensure that veterans and employees are provided for. He called on every employee to be a whistle-blower.

“I want people to feel free to tell me what’s going wrong, and I feel the formality that may have been existing may have gotten in the way of that,” said McDonald, who freely distributes his cellphone number and said he fields calls from veterans at all hours.

Hardie said McDonald must consult all stakeholders to create real change in the department.

“It’s like turning around a battleship, and it will be a long time before we know if the captain of the battleship is successful,” Hardie said. “It feels like he’s doing the right thing in terms of listening, but he needs to reach deeper.”

That “deeper” included reaching out to former VA employees-turned-whistleblowers, many of whom were forced out of VA employment.  One of them would be former top VA epidemiologist Dr. Stephen Coughlin, whose testimony at a March 2013 Congressional hearing rocked Capitol Hill with his insider revelations of VA cooking the books on post-deployment health research to cover-up or otherwise minimize acknowledgement of post-deployment health issues.  Those allegations were later substantiated in a very quiet internal VA investigation.

Coughlin was honored last week at an evening affair in Washington, DC hosted by the Sgt. Sullivan Center, which focuses on complex post-deployment health issues like that suffered by the center’s namesake before his untimely death.  Veterans for Common Sense was represented at the event by Anthony Hardie, VCS Board Member and one of the event’s featured speakers.

If MacDonald were to consult whistleblowers like — and including — Coughlin, collectively they could provide a great deal of insight to MacDonald in righting and reforming the VA ship.

***

Read the full cited articles here:

http://www.bnd.com/2014/09/27/3424662/metro-east-veterans-report-mixed.html?sp=/99/166/

http://www.tampabay.com/news/military/veterans/new-va-secretary-says-he-is-trying-to-put-veterans-at-the-center/2200336

 

Belleville News Democrat-Sep 28, 2014
Posted in Menu of Pages, VA Healthcare Crisis, Veterans Articles & News | 2 Comments

Gulf War Advisory Committee Letter Expresses Grave Concerns to New VA Secretary

The following is reposted from 91outcomes.com with permission.

***

I ask you to please post … this letter RAC members sent to Secretary McDonald after the RAC meeting this week.  VA staff now controls what is posted to the RAC website, so this may never see the light of day otherwise.  The new Secretary should be cleaning house with the staff, not the committee.   So much for promises to fix VA’s lack of integrity.  — Joel Graves, Gulf War veteran member of the Research Advisory Committee, being replaced.

****

SOURCE:  Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC), September 23, 2014
http://www.scribd.com/doc/241187447/RAC-Recommendation-Letter-Sep-23-2014

LETTER TEXT:

Research Advisory Committee on Gulf War Veterans’ Illnesses

 

September 23, 2014

 

The Honorable Robert A. McDonald

Secretary of Veterans Affairs

United States Department of Veterans Affairs

Washington, DC

 

Dear Mr. Secretary,

We greatly appreciate your meeting with us yesterday and asking our views. We look forward to working with you to advance research to improve the health of Gulf War veterans.

Yesterday’s meeting showed the need for this advisory committee to provide you the full story on Gulf War veterans’ health. Despite twelve years of work, the committee just yesterday, through its independent review process, noted:

1. VBA staff said that VA recognizes that chronic multisymptom illness and undiagnosed illnesses are presumed to be service-connected for Gulf War veterans. But their data show that eighty percent of these claims are denied.

2. OPH staff reported on a new review of diagnoses received by Gulf War veterans who use VA facilities, which appears to show their health problems are no different from veterans of the same period who did not deploy, but the review does not include 75,000 Gulf War veterans who served after March 1, 1991, the most toxic period, when oil well fires burned and the demolition of the Khamisiyah nerve agent depot occurred, and does not state that VA doctors were not trained to consider the illness a serious physical illness. The non-deployed also include veterans who were deployed later in other operations in the same theater and have received many of the same exposures.

3. OPH staff reported on a new survey of Gulf War veterans that shows higher rates of stress and depression than previous surveys, without mentioning that the survey was overweighted with questions on mental health and that people suffering from chronic health problems often become depressed due to their illness after 23 years, but it is not the cause  of their illness.

4. The VA press release issued after the meeting stated that “nearly 800,000 Gulf War era Veterans are currently receiving compensation benefits for service-connected issues”, without clarifying that for benefits purposes, the “Gulf War era” extends from 1990 to the present, taking in all recent Iraq and Afghanistan veterans.

This underscores the need for a continued independent ongoing review process. We recommend that, for the new members you plan to appoint to the committee, you choose scientists and veterans who are independent of VA staff and who understand that Gulf War illness is not a mental illness, that you continue to provide for the committee to have its own independent staff, and that you continue to welcome the committee’s comments on all aspects of VA’s Gulf War research program.

 

Respectfully,

James Binns, chairman

James A. Bunker

Fiona Crawford, PhD

Beatrice Golomb, MD, PhD

Nancy Klimas, MD

James O’Callaghan, PhD

Lea Steele, PhD

Roberta White, PhD

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MEDIA REPORTS: The Beginning of Finally Some Truth about the VA

After a great deal of covering up, retaliation against and intimidation of whistleblowers, media reporting, Congressional hearing and inquiries, and VA delays, denial, and more covering up, finally this week it appears as though the first elements of truth are creeping out in the healthcare access scandal that has consumed VA.

A great deal more needs to be done in holding VA healthcare officials accountable.  A great deal more needs to be done to hold VA benefits officials accountable, including for inappropriate VA denial of service-disabled veterans’ disability claims, efforts to roll back the clock on Gulf War veterans’ and possibly other “presumptive” access to disability benefits, inappropriate VA benefits official’s meddling in healthcare and medical research matters, and shifting the claims wait lines from one excessively long waiting line (initial claims) to another even longer waiting line (appeals).

And, a great deal more needs to be done in holding VA’s research officials to account for confirmed whistleblower accounts that VA research officials routinely cover-up research finding that might show links between deployment health exposures and negative health consequences of those exposures, inappropriately shape VA research projects so as not to uncover links between deployment and negative health outcomes, misappropriation of funds, lying to Congress and top VA officials, and an utter inability to focus research efforts on tangible research outcomes such as improved prosthetic limbs or to develop effective treatments for post-deployment health conditions.

However, the following articles represent a new breakthrough in the armor in which VA bureaucrats have surrounded themselves.  As one Arizona Republic editorial notes below, it is the beginning of finally some truth about the VA.

Read on… and help hold VA managers and executives accountable for VA’s failures and cooking the books in nearly every aspect of VA operations.

-Team VCS

***

Associated Press: Ex-VA Doctor: Phoenix Report a ‘Whitewash’

Arizona Republic: Auditor ties VA waits to deaths

Arizona Republic Editorial: Finally, some truth about the VA.  Our View: Lengthy delays didn’t do veterans any good. Why didn’t the inspector general recognize that?

CNN:  VA inspector general admits wait times contributed to vets’ deaths

New York Times:  V.A. Official Acknowledges Link Between Delays and Patient Deaths

Washington Examiner:  Veterans Affairs IG couldn’t see records that didn’t exist for dead vets

Washington Examiner:  Delays contributed to patient deaths at veterans’ hospital, IG concedes

Washington Times:  VA official admits not every wait-list death reviewed by investigators

 

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VCS to Participate in Sgt. Sullivan Center’s Event: Rebuilding Trust, Renewing Our Dedication to Transparency in Deployment Health Science

 

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Sergeant Sullivan Center Reception: Honoring Excellence in Post-Deployment Health

Rebuilding Trust, Renewing Our Dedication to Transparency in Deployment Health Science:            Awards Ceremony 2014

“If you blow the whistle on higher ups because you have identified a legitimate problem, you should not be punished. You should be protected … problems [at the VA] require us to regain the trust of our veterans and live up to our vision of a VA that is more effective and more efficient.”   President Barack Obama, August 2014
When
Tuesday, September 23rd
6:30 PM – 8:30 PM
Where

Pew Charitable Trusts Conference Center
Washington, DC

Driving Directions

Presenters Include

(a complete speaker list will be sent prior to the event)

Robert F. Miller, MD

Associate Professor of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center

Honoree, Excellence in Deployment Health Science 2012

Mark Lyles

Captain, US Navy, DMD, PhD, MA, MS, EdS – VADM Joel T. Boone Chair of Health and Security Studies, Naval War College

Honoree, Excellence in Deployment Health Science 2011

Jim Binns

Chairman, Research Advisory Committee on Gulf War Veterans’ Illnesses

Anthony Hardie

Veterans for Common Sense Board of Directors, 91outcomes.com Author, Federal Advisory Committee Member on Gulf War Illness Research

2014 Honoree
Dr. Steven S. Coughlin
The Sergeant Sullivan Center Annual Awards Reception supports community building to improve diagnosis, treatment and prevention of chronic, multi-symptom, currently unexplained post-deployment health concerns. The Sergeant Sullivan Center is the only 501(c)(3) nonprofit organization exclusively dedicated to confronting and eradicating post-deployment illnesses through awareness, research, and connection. Speakers appear in their individual capacity.
Join us for cocktails and light fare, presentations, and the Award for Excellence in Post-Deployment Health Science on Tuesday September 23rd, 2014 at the Pew Charitable Trusts Conference Center in Washington, DC.

Thank your for your response, and I look forward to seeing you at the event!

Sincerely,

William Wisner / Veteran Fellowship for Mission Leadership

202-261-6562 Office
On Tuesday, September 23, The Sergeant Thomas Joseph Sullivan Center will honor former senior VA epidemiologist Dr. Steven S. Coughlin with its annual Award for Excellence in Post Deployment Health Science at the Pew Charitable Trusts Conference Center located at 901 E Street, NW Washington, DC.
Dr. Coughlin resigned his position at the VA over ethical concerns and since then through testimony and media interviews has furthered a dialogue among those dedicated to helping the VA/DoD become more effective, efficient, compassionate, and transparent in the delivery of healthcare to those who have served us in war and are recovering from toxic wounds.
 
There is no charge for this event but space is limited. Please register by September 17, 2014.
 
We encourage veterans, veteran advocates, lawmakers, active duty personnel, physicians, researchers and our friends at the VA/DoD to join us in the spirit of the President’s call to honor those who have bravely told the truth in order to bring about reform on behalf of those who have served the nation and were injured by war related environmental exposures.
Click on the link below to register or RSVP.
(PLEASE LET US KNOW ALSO IF YOU CAN’T MAKE IT)
Register Now!
I can’t make it

 

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VA Officials Spun Inspector General Report to Make VA Appear Not at Fault for 40+ Veteran Deaths in Phoenix

A new investigative report by the Arizona Republic newspaper has found that officials in the U.S. Department of Veterans Affairs (VA) whitewashed a report by the VA’s Inspector General regarding the depth, breadth, and scope of the healthcare access scandal that resulted in the deaths of at least 40 veterans in Phoenix alone.

According to the news article:

During a Senate Committee on Veterans’ Affairs hearing Tuesday, Sen. Dean Heller, R-Nev., challenged the language in the OIG report, suggesting it downplayed the effects of long-standing VA delays in delivering care to ailing veterans.

“I don’t want to give the VA a pass on this, and that’s exactly what this line does,” Heller said to Dr. John Daigh, assistant inspector general for health-care inspections. “It exonerates the VA of any responsibility in past manipulation of these … wait times.”

….

Based on the OIG’s cause-of-death conclusion, many media outlets cast the investigative report as vindication for the VA and as refutation of Arizona whistle-blower claims.

A Washington Post article was headlined, “Overblown claims of death and waiting times at the VA.” The Associated Press report, which appeared in publications nationwide, was titled, “IG: Shoddy care by VA didn’t cause Phoenix deaths.”

That spin on the story first circulated a day earlier when a copy of the VA’s response to the OIG investigation was leaked before release of the report. The key talking point: “It is important to note that OIG was unable to conclusively assert that the absence of timely quality care caused the death of these veterans.”

Inspector general reports are typically circulated to agency bosses prior to publication, providing an opportunity to correct errors and suggest changes.

More than a week before the Phoenix investigation was released, TheRepublic learned that a dispute had arisen over standard-of-proof language that was being pushed by VA administrators to downplay deaths in Phoenix.

….

OIG investigators corroborated virtually every major allegation of wrongdoing submitted by the two whistle-blowers. Nevertheless, the report and congressional briefing papers contain passages that appear to criticize Foote and his credibility, emphasizing that “the whistle-blower did not provide us with a list of 40 patient names.” The passage referred to VA patients Foote said died while awaiting care in Phoenix.

….

In interviews and a written rebuttal, Foote said the portion of the report about him is “false and misleading” because he and other whistle-blowers provided 24 names to inspectors and explained where in VA records to identify 16 more.

Another part of the VA report acknowledged that Foote had supplied at least 17 names and that others could not be traced because documentation had been destroyed by VA employees.

Read the full Arizona Republic news report here:

http://www.azcentral.com/story/news/politics/investigations/2014/09/10/report-phoenix-va-deaths-raises-questions/15375005/

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VA’s Medical Research Failures Continue to Grow

A new example of VA’s failures on medical research — an often overlooked area where VA remains badly broken — has emerged near Fort Hood.

An Austin, Texas newspaper reports that a $3.8 million mobile MRI machine, widely touted by VA at the time of its 2008 inauguration, has been sitting empty and unused.  While VA announced in 2008 in detail the life changing brain research it was going to conduct using the equipment, VA never conducted that research and the equipment sits empty.   (“Lost Opportunity: With wars winding down, VA’s brain research failed to launch,” Austin Austin American Statesman-Staff, Sep. 7, 2014, Jeremy Schwartz reporting).

Among VA’s known, systemic medical research failures:

  • Cooking the books on medical research.  In March 2013, top VA epidemiologist-turned-whistleblower Dr. Stephen Coughlin testified to Congress about concerted efforts in the VA’s Office of Public Health to deliberately cover-up research findings that might show connections between military deployment and health risks.  Just like there were real consequences of VA’s cooking the books in the healthcare access scandal rippling outwards nationwide from the Phoenix VA medical center, veterans who were found by VA during some VA medical research to be suicidal were never aided and ultimately did commit suicide.  Coughlin’s array of assertions were found to be valid.
  • Denying scientific truth.  Over the past decade, the mainstream media has covered a myriad of stories on how VA research and benefits officials have downplayed, fought against, and outright denied the consensus findings by the penultimate National Academy of Sciences’ Institute of Medicine and the VA’s own Research Advisory Committee on Gulf War Veterans’ Illnesses that Gulf War Illness is a real,  debilitating, and enduring medical condition, that it is not psychiatric or psychological in nature, that it was likely caused by environmental exposures, that it afflicts roughly one-third of the veterans of the 1991 Gulf War, and that treatments can likely be found.
  • No Confidence.  After more than two decades and hundreds of millions of dollars expended, the VA’s own Research Advisory Committee on Gulf War Veterans’ Illnesses blasted VA research officials with a unanimous finding of “no confidence in the ability or demonstrated intention of VA staff to formulate and execute an effective VA Gulf War illness research program,” and a, “failure to acknowledge that the central health problem of this war even exists.”  
  • Retaliation.  True to form in retaliation against VA whistleblowers and those who speak up and out about problems in VA, VA’s leaders swiftly moved against the Gulf War Illness panel, gutting its leadership, membership, charter, and independence.
  • Making medical decisions for budgetary reasons.  In April 2014, widely reviled VA Undersecretary of Benefits Allison Hickey was revealed in a Military Times expose to have secretly weighed in with the Institute of Medicine in an effort to quash the IOM’s broad recommendation to the world’s medical community of calling “Gulf War Illness” by that name.  Her apparent goal was to prevent VA from being burdened with more disability claims from veterans suffering from Gulf War Illness, a covert roll-back of existing federal benefits law.
  • “Lost” database.  VA acknowledged that a critical research registry database containing medical data on hundreds of spouses and children of 1991 Gulf War veterans has been irretreivably “lost”.
  • Footdragging.  VA officials dragged their feet for years in implementing a registry of veterans with potential lung and other effects resulting from exposure to massive overseas burn pits.  There is no announced research related to veterans on the registry that might help provide a pathway to treatments and improving ill veterans’ health and lives.
  • Inability to Lead Research to Targeted Outcomes.  An array of important veteran-related medical research aimed at targeted outcomes has had to be directed by Congress to be conducted more effectively outside VA, from prosthetic limbs development by the Department of Defense Advanced Research Projects Agency (DARPA) to research on traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) in DoD’s Congressionally Directed Medical Research Program.

From foot-dragging to outright attempting to roll back the clock on Gulf War Illness research, VA’s systemic medical research issues remain largely on the back burner of Congressional, media, and public attention — if they are being addressed at all.

Read the full Austin article here:

http://projects.statesman.com/news/va-center-of-excellence/

Posted in Veterans Articles & News | 3 Comments

Ill Gulf War Veterans Protest VA Failures on Gulf War Illness

The following article appears courtesy of 91outcomes.com.  It is reprinted in full with the permission of 91outcomes.

 (91outcomes.com) – In VA medical centers across the country, Gulf War veterans suffering from Gulf War Illness are speaking up and out.   

Faced by VA’s failure to try to find effective treatments and further afflicted by VA’s expanded efforts  to deny their disability claims, ill veterans of the 1991 Gulf War are facing a new wave of denial by the U.S. Department of Veterans Affairs.

In various corners of the country the media is also paying attention.

In Missouri, the Columbia Daily published a feature article that included Gulf War veteran Marsha Young’s poor treatment by VA.   “We may have missed the boat with your group back in the ’90s,”  Truman Memorial VA Medical Center Chief of Staff Lana Zerrer told her.  

And in Central Florida, The Tampa Tribune’s Highlands Today published an extended article detailing the experiences of ill Gulf War veterans Larry Roberts and Randy Livingstone.

As VA continues its series of public Town Hall meetings at every VA medical centers across the country, VA leaders will continue to hear from ill Gulf War veterans who continue to suffer, not just from their debilitating Gulf War Illness, but more tragically from VA’s continuing failure to cook the books on Gulf War research and failure to try to develop effective treatments to help improve their health and lives.

Read the latest full articles here:

http://highlandstoday.com/hi/local-news/local-veteran-fights-for-gulf-war-illness-help-20140905/

http://www.columbiatribune.com/news/local/veterans-voice-concerns-compliments-at-truman-town-hall/article_6b60ca5f-a6a7-5f98-9b71-fd5f6ca1bd44.html






 

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Chairman Miller Responds to OIG Report, What’s Still Needed

The following statements were released by the office of Rep. Jeff Miller (R-FL-01), Chairman of the U.S House Committee on Veterans’ Affairs.

On August 7, a statement by Rep. Miller on the signing into law of the VA Reform Bill included this sage insight and advice:

VA’s problems festered because administration officials ignored or denied the department’s challenges at every turn. In order to prevent history from repeating itself, President Obama must become personally involved in solving VA’s many problems.”

*****

Miller Statement on VA OIG Review of Phoenix VA Health Care System

WASHINGTON – Aug. 26, 2014 — Following the release of the VA Inspector General’s review of the Phoenix VA Health Care System, Chairman Jeff Miller released the below statement.

“The inspector general’s report paints a very disturbing picture. Delays in care that VA officials tried to hide caused harm to veterans. Even though the IG says it can’t conclusively assert that deaths were caused by VA negligence, the report does link 20 deaths to substandard care.

Almost as troubling as the report itself is the fact that VA officials sought to downplay it by selectively leaking portions of the department’s response to the review prior to its release. The VA scandal was caused by bureaucrats who chose to whitewash or conceal the department’s problems.

The fact that some department officials are still engaging in similar practices underscores the dire need for real accountability throughout the organization. So far, despite repeated requests from our committee, we have seen no evidence that the corrupt bureaucrats who created the VA scandal will be purged from the department’s payroll anytime soon. Until that happens, VA will never be fixed.” –

-Rep. Jeff Miller, Chairman, House Committee on Veterans’ Affairs

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Miller Statement on President Obama’s Speech to American Legion National Convention

WASHINGTON – Aug. 26, 2014 — After President Obama’s speech to the American Legion National convention, Chairman Jeff Miller released the following statement.

“President Obama’s actions today fall far short of what’s needed to regain the trust of America’s veterans. VA’s problems festered because administration officials ignored or denied the department’s challenges at every turn.

In fact, I wrote to the president more than a year ago about a string of serious VA health care problems, lapses in employee integrity and failures in accountability, but the president didn’t bother to respond. Instead, I received a boilerplate letter from then-Sec. Eric Shinseki that assured me everything was OK at the department – an assertion that couldn’t have been further from the truth.

Additionally, White House claims that VA is improving when it comes to accountability, transparency and protecting whistleblowers don’t add up, especially when no one has been fired as a result of the VA scandal, the department is still sitting on 113 outstanding information requests from the House Committee on Veterans’ Affairs and VA whistleblowers who tried to expose problems are still enduring retaliation.

What we need from the president right now is more follow-through and less flash when it comes to helping veterans. A good place for him to start would be to meet with family members and veterans who have been struck by the VA scandal, order the department to cooperate with the congressional committees investigating VA, and force DoD and VA to work together to establish a joint electronic health record integrated across all DoD and VA components.”

– Rep. Jeff Miller, Chairman, House Committee on Veterans’ Affairs

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