Category Archives: DoD

Barack Obama: Veterans/Poverty Headlines and Video

Barack and Veterans Issues

Ok, I’m not trying to influence any votes here, nor run off any readers.  It’s just that I’m impressed with what I’ve heard said by Senator Obama regarding homelessness and veterans and what the press and veterans advocates have said.  I don’t know if you have seen them.   He does have the advantage of being a member of the Senate Veterans’ Affairs Committe.   I acknowledge that there are other important issues than veterans and homelessness to consider in a campaign, but that is what we are about here, so that is my focus.

I do have an couple of links to the Clinton side.  There is an equal-time segment at the bottom that will give you a look see between the top two Democratic candidates on veterans issues.   I may come back with more of this and feature a Republican or two later.  We will see how this plays out with my readers first.  Are you interested in politics?

BarackObamadotcom  (Video) Dinner with Barack Obama:  Four grassroots donors talk to Barack Obama about veterans and poverty during dinner.

I’ve mentioned Obama and Veterans in a previous post where he discusses his plan to improve veterans care and help get the homeless veterans off the streets as reported by a wire service.

Here are a few more headlines and links on this subject:

SEN. OBAMA: VETERANS ADMINISTRATION DENIED HEALTH CARE SERVICES TO NEARLY 9,000 ILLINOIS VETERANS IN 2005

Sen. Barack Obama (D-IL) today announced that the Department of Veterans Affairs (VA) denied health care to 8,944 Illinois veterans last year as part of a Bush Administration cost-cutting policy begun in 2003. Nationally, more than 260,000 veterans were denied access to VA hospitals, clinics and medications in Fiscal
Year 2005

Clinton v. Obama, Veterans Version

The tit-for-tat between Sens. Hillary Rodham Clinton and Barack Obama has expanded to new territory:   veterans benefits.

This week, the “Commission on Care of America’s Wounded Warriors” issued recommendations for improving treatment for veterans who return injured from the front. Clinton and Obama responded the way members of Congress often do to government reports – with legislative language.  

(…)  explains different positions

Obama, McCaskill sponsor bill on care for veterans

Sens. Barack Obama (D-Ill.) and Claire McCaskill (D-Mo.) are sponsoring legislation to improve the lives of recovering veterans at Walter Reed, while Sen. John Kerry (D-Mass.), a cosponsor of the Obama-McCaskill legislation, said that he would explore ways to direct new funds to Walter Reed and make immediate improvements to its veteran housing.

Barack Obama Honors Sacrifice of America’s Veterans

Barack Obama has a record of helping the heroes who defend our nation today and the veterans who fought in years past. As a grandson of a World War II veteran who went to college on the G.I. Bill and a member of the Senate Committee on Veterans Affairs, Obama has successfully reached out to Republicans and Democrats to pass laws to combat homelessness among veterans, improve care for troops recovering from injuries, ease the transition of new veterans into society, and make the disability benefits process more equitable.

Veterans Issues  From Obama’s website

Homeless Veterans

Every year, 400,000 veterans across the country, including an estimated 38,000 in Chicago, spend some time living on the streets. Senator Obama has been a leader in fighting homelessness among veterans. He authored the Sheltering All Veterans Everywhere Act (SAVE Act) to strengthen and expand federal homeless veteran programs that serve over 100,000 homeless veterans annually. During the debate on the Fiscal Year 2007 budget, Senator Obama passed an amendment to increase funding for homeless veterans programs by $40 million. These funds would benefit programs that provide food, clothing, mental health and substance abuse counseling, and employment and housing assistance to homeless veterans.

Working with Senators Akaka and Craig, Senator Obama passed legislation in December 2006 to provide comprehensive services and affordable housing options to veterans through the Department of Veterans Affairs, Department of Housing and Urban Development and nonprofit organizations. This legislation was signed into law and is modeled on parts of the SAVE Act and the Homes for Heroes Act, a measure that Senator Obama had previously authored.

Benefits Disparities

The Bush Administration’s approach to handling veterans’ health care ignores the reality of increasing demands on the VA, and the additional burden placed on veterans. The Administration has established a means test for VA health care eligibility, and it has banned hundreds of thousands of veterans – some who make as little as $30,000 a year – from enrolling in the system. These changes affect both older and younger veterans, and Senator Obama has opposed them, fighting instead for greater funding for veterans’ health care.

Greater Funding for Veterans Health Care

In January 2007, Senator Obama reintroduced the Lane Evans Veterans Health and Benefits Improvement Act to improve the VA’s planning process to avoid budget shortfalls in the future. The bill requires the VA and the Department of Defense to work together and share data so that we know precisely how many troops will be returning home and entering the VA system.

Food for Recovering Soldiers

Senator Obama introduced an amendment that became law providing food services to wounded veterans receiving physical therapy or rehabilitation services at military hospitals. Previously, service members receiving physical therapy or rehabilitation services in a medical hospital for more than 90 days were required to pay for their meals.

Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI)
 

Senator Obama fought a VA proposal that would have required a reexamination of all Post Traumatic Stress Disorder (PTSD) cases in which full benefits were granted. He and Senator Durbin passed an amendment that became law preventing the VA from conducting a review of cases, without first providing Congress with a complete report regarding the implementation of such review. In November 2005, the VA announced that it was abandoning its planned review.

Senator Obama passed an amendment to ensure that all service members returning from Iraq are properly screened for Traumatic Brain Injury (TBI). TBI is being called the signature injury of the Iraq war. The blast from improvised explosive devices can jar the brain, causing bruising or permanent damage. Concussions can have huge health effects including slowed thinking, headaches, memory loss, sleep disturbance, attention and concentration deficits, and irritability.

Easing the Transition to the VA

Senator Obama passed an amendment that became law requiring the Department of Defense (DOD) to report to Congress on the delayed development of an electronic medical records system compatible with the VA’s electronic medical records system. DOD’s delay in developing such a system has created obstacles for service members transitioning into the VA health care system.

Part of the Lane Evans Veterans Health and Benefits Improvement Act, which Senator Obama reintroduced in January 2007, would help veterans transition from the DOD health system to the VA system by extending the window in which new veterans can get mental health care from two years to five years. The Lane Evans bill also would improve transition services for members of the National Guard and Reserves.

For Equal Time’s sake:

Compare Senator Obama’s site with Senator Clinton’s site, both on Veterans Issues.

Oldtimer

GAO Testimony – DOD and VA

Transition Field Unit staffingGAO Testimony – DOD and VA

This is a troubling situation.  We have our kids off at war and they become severely injured, physically and mentally.   Our country has pulled out all stops to provide the best possible care for them and still we have problems.  Due to the protective gear and terrific and speedy medical care, thankfully more and more are surviving.  This shift in the severity and long term recovery needs requires major adjustments in our programs for treatment and rehabitation, for our benefits and compensation programs.  The cause and effect has driven the case loads and delays out of sight at the expense of our wounded heroes.

The good news is that that there is a scramble going on to correct these problems as soon as possible. There are people in high places capable of fixing the problem that have a heart for our heroes and are working very hard to fix the problems.  There are people in our VA and in militray trauma centers that are just as frustrated as we are.  There is a continuum of care mentality for our soldiers starting at the battlefield and continuing through our VA system. There are programs under development to reduce the time required to make determinations before our heroes get the treatment and benefits they need.

The bad news is there are still more than 150,000 cases more than 6 months old among the pending 600,000 cases in the VBA system, and we have no idea how old these cases really are.  The GAO found that new programs designed to correct the problems are not yet fully off the ground and there are severe staffing problems in key places, both on the active duty side and the veteran side of the picture. It appears to me that some of it is due to needing to move physicians from one program to staff another, leaving both under staffed. 

(Download Here)

What the GAO found

Warrior Transition Unit

Challenges have emerged for staffing the Warrior Transition Unit in which servicemembers are assigned to three key staff – a physician care manager, a nurse care manager, and a squad leader. For example, as of mid-September 2007, over half the U.S. Warrior Transition Units had significant shortfalls in one or more of these critical positions. In addition the number of recovery coordinators and how many servicemembers each would serve have yet to be determined.

Transition Field Unit staffing

This table shows that in actuality we have only 35% perminent staffing for these teams.  More than 450 of the existing staff (19%) have been borrowed from elsewhere, likely reducing the staff, already short, in othere facilities.   The table below shows where those with less than 50% staffing are located. 

 Staffing problem locations

PTSD and TBI 

Three independent review groups examining the deficiencies found at Walter Reed identified a range of complex problems associated with DOD and VA’s screening, diagnosis, and treatment of TBI (Traumatic Brain Injury) and PTSD, signature injuries of recent conflicts. Both conditions are sometimes referred to as “invisible injuries” because outwardly the individual’s appearance is just as it was before the injury or onset of symptoms. In terms of mild TBI, there may be no observable head injury and symptoms may overlap with those associated with PTSD. With respect to PTSD, there is no objective diagnostic test and its symptoms can sometimes be associated with other psychological conditions (e.g., depression).

TBI and PTSD chart
 
This table outlines what is being implimented (or planned) for handling TBI and PTSD better.   However, according to Army officials and the Independent Review Group report, obtaining qualified health professionals, such as clinical psychologists, is a challenge, which is due to competition with private sector salaries and difficulty recruiting for certain geographical locations. 

Data Sharing

In addition, the Dole-Shalala Commission noted that while VA is considered a leader in PTSD research and treatment, knowledge generated through research and clinical experience is not systematically disseminated to all DOD and VA providers of care.

Data Sharing

This table shows the efforts being taken to improve the data sharing between organizations. 

Disability Evaluations

As GAO and others have previously reported, providing timely and consistent disability decisions is a challenge for both DOD and VA. To address identified concerns, the Army has taken steps to streamline its disability evaluation process and reduce bottlenecks.   To address identified concerns, the Army has taken steps to streamline its disability evaluation process and reduce bottlenecks. The Army has also developed and conducted the first certification training for evaluation board liaisons who help servicemembers navigate the system. To address more systemic concerns, the Senior Oversight Committee is planning to pilot a joint disability evaluation system. Pilot options may incorporate variations of three key elements:

(1) a single, comprehensive medical examination;

(2) a single disability rating done by VA; and

(3) a DOD-level evaluation board for adjudicating servicemembers’ fitness for duty.

DOD and VA officials hoped to begin the pilot in August 2007, but postponed implementation in order to further review options and address open questions, including those related to proposed legislation.

Fixing these long-standing and complex problems as expeditiously as possible is critical to ensuring high-quality care for returning servicemembers, and success will ultimately depend on sustained attention, systematic oversight by DOD and VA, and sufficient resources.

You are invited to download and read the entire report here:  GAO Report (pdf – 32 pages)

Oldtimer