American Legion Daily News Clips 4.3.18

Bloomberg: Shulkin’s firing threatens support for VA health-care overhaul

April 2, 2018 | Jack Fitzpatrick

A program that gave veterans more health-care choices following the 2014 Veterans Affairs wait-time scandal is set to run out of money in two months, and the firing of Secretary David Shulkin has thrown a wrench into negotiations to overhaul the program, veterans’ groups say.

Funding and improving the program now appears “monumentally difficult” due to Shulkin’s firing, as veterans’ advocates question the White House’s stance on privatizing the department, said Louis Celli, the national director of veterans affairs and rehabilitation at The American Legion.

Veterans service organizations trusted Shulkin but don’t know much about White House physician Ronny L. Jackson, whom President Donald Trump has tapped as the next secretary, veterans’ groups said.

“You need strong leadership to make legislation go through,” said Garry Augustine, executive director for Disabled American Veterans’ national service and legislative headquarters, in a phone interview yesterday. “Now there seems to be a vacuum in leadership at the VA. We don’t know much about the people coming in.”

The Veterans Choice Program, which gives veterans options to visit non-VA health-care facilities if they face delays or travel burdens, is on track to run out of funding late May, Shulkin told lawmakers in February. The 2014 law (Public Law 113-146) creating it included $10 billion in mandatory funding. Congress provided another $4.2 billion in total last year for the program, and the department spends between $200 million and $400 million per month on the program, Shulkin said.

Some lawmakers sought to attach a bill to the fiscal 2018 spending package (Public Law 115-141) that, in some cases, would give veterans more non-VA options, although the measure was not included in the final package amid opposition from some House Democrats.

The Senate Veterans’ Affairs Committee approved a bill (S. 2193) by a 14-1 vote last November. The House committee advanced a bill (H.R. 4242) by a party-line 14-9 vote in December.

Privatization Concerns

With Shulkin, an Obama administration holdover, publicly accusing political appointees at the VA of pushing the department toward privatization, the only foreseeable path forward might be extending funding for the current Veterans Choice Program, rather than a broader piece of legislation that aims to give veterans more options, Celli told Bloomberg Government.

The American Legion will “not be eager and ready” to back a care package that “isn’t so legislatively tight and nailed down that it would allay any fear whatsoever that we would have on increasing the threat of privatization,” Celli said.

The bill overhauling the program had two provisions in particular that Celli hesitantly supported with Shulkin at the helm, but now says The American Legion may have to oppose over concerns about privatization. One calls on the VA secretary to establish standards for health-care quality and accessibility. If certain VA facilities do not meet them, the department would be required to offer care at non-VA facilities. Another provision allows veterans to seek outside care through an appeals process.

Both could potentially be used as a backdoor to privatizing the department, Celli said, adding that “with a strong leader in place like Secretary Shulkin, who had the trust and faith of employees of the Department of Veterans Affairs and the VSO community, we knew a fair and balanced appellate process would be put in place.”

“Absent that, there could be a policy that any veteran who puts in an appeal gets approved,” Celli said.

Outlook in Congress

Augustine said he is “more confused than anything” about the legislative outlook for the Veterans Choice Program, saying Shulkin’s firing caught him off guard and that there are vaguely worded provisions in the overhaul bill that he still needs to study. The standards for veterans’ access to health-care, which determine who can seek subsidized health-care at non-VA facilities, “were not well-defined,” he said.

Senate Veterans’ Affairs Committee Chairman Johnny Isakson (R-Ga.) still hopes to pass his bill, and has talked to leadership about holding a floor vote “in the coming weeks,” spokeswoman Amanda Maddox said in an email today. Senate Majority Leader Mitch McConnell (R-Ky.) has not announced plans for a vote.

House Democrats are still concerned the bill sponsored by House Veterans’ Affairs Committee Chairman Phil Roe (R-Tenn.) has measures to open the door to privatization, particularly for mental health services, that it removes congressional oversight on VA infrastructure, and that it creates uncertainty with the VA’s budget, a House Democratic aide said.

The Veterans of Foreign Wars still backs Isakson’s bill, legislative director Carlos Fuentes said in a phone interview yesterday. Although he doesn’t know where Jackson stands on privatization, Fuentes said he believes the Trump administration broadly supports VA facilities because of statements Trump made on the campaign trail in 2016.

The bill could be improved by adding language to allow the department to hire employees more quickly, Fuentes said. It also should include funding for the current Veterans Choice Program because it could take about a year to implement the new bill’s measures if it passes, he said.

Jackson an Unknown

Lawmakers and veterans’ groups see Jackson as a mystery nominee. The White House did not ask The American Legion about Shulkin before firing him, Celli said.

“Nobody knows Jackson,” Celli said.

Fuentes said Jackson’s lack of experience leading a large organization is “certainly a concern.”

Military Times: White House doctor could face the most contentious VA confirmation process ever

By: Leo Shane III   16 hours ago

WASHINGTON — Ronny Jackson’s nomination to become the next Veterans Affairs secretary could become the most contentious confirmation process since the department was founded 30 years ago.

But that’s also a fairly low bar.

Since the department was elevated to a Cabinet-level post back in 1988, no senator has ever voted against a VA secretary pick. All of the confirmations have been unanimous or near-unanimous votes (with a handful of lawmakers absent), or procedural votes where no opposition was formally recorded.

That includes former VA Secretary David Shulkin, confirmed by a 100-0 vote in February 2017. His total support from the Senate was frequently touted by President Donald Trump in public appearances, including one just a few weeks before Shulkin was fired by the president over social media on March 28.

In fact, no nominee for a confirmable department post over the last 30 years — totaling more than 150 individuals — has ever received a vote of opposition from the Senate, underscoring the non-partisan nature of VA work.

That means even a single vote against Jackson’s confirmation could send a message of irreversible political division on the once seemingly untouchable approach to the department issues.

Jackson, who retired from the Navy last week as a rear admiral with 23 years of service, was a surprise nominee for the post. He’s an Iraq War veteran who served under three presidents as the top White House medical officer, and is best known for giving Trump a clear bill of health in January.

But little is known about his familiarity with the department, which boasts a budget this fiscal year of more than $186 billion and a staff of more than 370,000 employees. Senate Democrats have openly questioned the pick, and hinted he may not receive the same support as past nominees.

“I admire Dr. Jackson’s service to the nation, but I don’t know if he is the right person to lead the VA,” Sen. Jack Reed, D-R.I., and ranking member on the Senate Armed Services Committee, said in a statement last week. “The VA is a large and intricate agency that requires steadfast leadership and an understanding of how to run a complex organization.”

Sen. Tammy Duckworth, D-Ill., is a combat-wounded Iraq War veteran and a frequent critic of the Trump administration. Like Reed, she promised to “carefully review Dr. Jackson’s qualifications to determine whether he has the best interests of our veterans at heart.”

But she also accused Trump of wanting “to push VA down the dangerous path of privatization” and warned that “the next VA secretary must be able to protect the department from becoming consumed by partisan politics.”

Former Senate Veterans’ Affairs Committee Chairman Bernie Sanders, I-Vt., similarly said the Senate “should not approve any nominee for secretary who supports the privatization of the VA,” a charge which he has also leveled at Trump. The current top Democrat on the committee, Montana Sen. Jon Tester, said simply that he is “looking forward to meeting Admiral Jackson soon and seeing if he is up to the job.”

Few Republicans in the chamber have offered strong praise for Jackson thus far, though none have offered serious public concerns, either.

No timetable has been set for the confirmation hearings. Senate officials still have not received the formal nominating paperwork from the White House, which will start the background check and confirmation process.

That work typically takes between one and two months. Senate leaders have said they hope to move quickly on the work to ensure a vote on Jackson’s nomination before the summer.

Des Moines Register: National American Legion commander and native Iowan returns to her home state

Paige Godden, pgodden | Published 11:50 a.m. CT April 2, 2018

The first female National American Legion commander, Denise Rohan, spent a few days in her home state of Iowa this week, preaching her message of "family first."

"When you go off to basic training you get a new family," Rohan said. "From there, every military base you go to you start building those new relationships and you have everyone’s back. That’s what we’re trying to do."

Rohan was elected as the commander of the 2 million-member American Legion in August at the 99th national convention in Reno, Nevada. She was elected to the group’s top position for a one-year term.

During that time, she will visit Legion posts all 50 states, the U.S. territories and several European countries. During the week of March 23, she visited eight Legion posts in Iowa.

Her last stop was at a county-wide meeting of the Warren County Legion members at Southeast Warren High School in Liberty Center on March 26.

There, she reminded the 50 people in attendance that it’s not just the person in uniform who serves, she said. Rather, it’s the whole family.

"If a military person is transferred to another military base, the whole family has to go," Rohan said. "When a person in the National Guard or military is deployed their whole family is affected by that."

Rohan told the veterans she was always so homesick as a child she couldn’t even stay at friends’ houses for sleepovers.

When she signed up for basic training, she knew it was going to be hard.

"The first time I got to call home and I heard my mom’s voice I cried really hard," Rohan said. "Somehow my mother kept talking to me throughout that whole process. Of course, she wanted to make sure I was OK, and I was physically OK.

"It was that my heart was broken," she said.

Her mother helped her understand that the other women who were going through basic training with her at Fort McLellan, Alabama, were her new sisters.

When it came time to graduate from basic training Rohan said it was like losing her family all over again. But, she found a whole new family once she arrived at Fort Lee, Virginia.

She found her husband there. Even after they were married, Rohan said the military couldn’t guarantee they’d be assigned to the same places in the future so Rohan left the military to become a military wife.

Eventually, her husband left the military too and they found themselves in a town neither of them grew up in. They were able to connect to their new community through The American Legion.

"We had that new family. We had that connection," Rohan said. "That’s what the American Legion family is all about."

The Legion members in Liberty Center were excited to meet Rohan. State Commander Mike Etzel, from Marion, said getting a national commander to a post meeting is like "winning the lottery."

"Many members don’t even see a state officer except when they go to convention," Etzel said. "It’s a very rare occurrence to bring a national commander around to a post and we’ve visited probably eight out of 570 posts in Iowa this week."

Donald Swan, the Iowa membership chair, said getting to meet the national commander reminds local members what the group stands for.

"It helps to re-energize the local people that sometimes have a tendency to think they’re out there alone," Swan said. "When they see someone coming from national saying the same things, doing the same things, talking about the things happening in other states that are very similar to what we are doing, this reinforces them and makes them feel better."

Swan also said it’s nice to see a female national commander. He said women now make up nearly 20 percent of the armed forces so the Legion needs to keep changing and moving forward as well.

"I was a second lieutenant back in ’73 and ’74 when they shut down the Women’s Army Corps and integrated it into the Army," Swan said. "We have progressed significantly from that."

It doesn’t matter "what we are," Swan said, "because we’re all veterans."

Military.com: Some vets still can’t apply for new veteran ID card

Military.com | 2 Apr 2018 | By Amy Bushatz

Some veterans have been told their military service cannot be verified while attempting to apply for the Department of Veterans Affairs’ new ID card. But sources disagree on what’s causing the problem.

The ID card, mandated by Congress in 2015 and rolled out last year, is free for all honorably discharged veterans of any era. It is designed to function as proof of service at private businesses and save veterans the trouble of carrying around their DD-214s to show they served.

It is not considered an official federal ID and does not qualify veterans for federal benefits.

But the application process and card printing program have encountered a parade of glitches, including website problems and a delay in printing and shipping the cards.

The online application uses the ID.me authorization system, which is meant to allow veterans to easily verify their identity and service before uploading a photo and other details for the card.

But some veterans complain that they receive an error message saying their military service cannot be authenticated when they attempt to apply for the card.

Officials with ID.me said the problem can be blamed on a glitch between their system and the Defense Enrollment Eligibility Reporting System (DEERS), causing users who created ID.me accounts in the past to receive an error message that their records were not found, according to information provided to veterans who contacted the ID.me help desk.

"This issue is unfortunately not something that ID.me can address from our end and will require that the VA addresses this communication problem between the DoD’s DEERS database and the VA application," the help desk email response said.

The ID.me system is used by hundreds of online businesses and many federal websites to verify identity. Although exact data on how many users are enrolled in ID.me was not immediately available, VA officials said last year that the program was selected for the new ID card system in part because it is already broadly used.

VA officials, however, disagreed with ID.me’s explanation of the cause of the problem. They said the records failure is instead an issue created by bad data.

"The issue is not between ID.me and DEERS, but rather that VA and DoD systems (including DEERS) have inaccurate data in some cases," Curt Cashour, a VA spokesman, said in an email. "For example, if a Veteran’s Social Security number is inaccurate in DEERS or in a VA backend system, then VA may not be able to automatically verify the Veteran’s eligibility for the ID card."

Cashour said the VA’s fix for this problem is to ask veterans to manually upload their DD-214 forms, which show proof of service. Those who continue to face problems can email VIC for help, he said.

But veterans attempting to apply for the ID said the DD-214 upload system has also given them problems.

"When you go into ID.me and fill out the information and then go through the process of trying to send a copy of your DD-214 to them, [it] fails," one veteran told Military.com via email. "This has happened to me every time I have tried it."

"I tried to apply for a Veteran ID Card in February. I got to a point where the message said, ‘We need more information to process your request,’ " another veteran wrote in an email to Military.com last month. "The VA help line … told me, after a 4-hour wait on hold, that there was a glitch and that they would fix it soon. It is a month later and the message is still there on my file."

About 74,500 veterans have successfully applied for the ID card, Cashour said. Although cards can be printed at home from the VA website, hard copies are scheduled to be mailed to veterans starting this month.

Military Times: US air defense artillery brigade begins new European mission for first time since Cold War

By: Kyle Rempfer   18 hours ago

In an echo of the Cold War, a U.S. Army air defense artillery unit is once again deployed to Europe.

Soldiers from the 678th Air Defense Artillery Brigade, South Carolina National Guard, officially uncased their unit’s flag and colors in a ceremony at the U.S. Army garrison based in Ansbach, Germany, on March 27.

The brigade’s commander, Col. Richard Wholey, said the deployment marked the first time an American air defense artillery brigade had deployed to Europe since the end of the Cold War.

"Today is a historic day for U.S. Army Europe, the [10th Army Air and Missile Defense Command], [U.S. Army Garrison] Ansbach and the local Ansbach community," Wholey said during the ceremony. "Here we are in Ansbach uncasing the 678th Air Defense Artillery Brigade colors — the first uncased since the Cold War drawdown in Europe.”

The 678th ADA works to command and coordinate the operations of subordinate air defense artillery battalions.

In addition to the unit being the first ADA to return to the European theater since the end of the Cold War, it is the only integrated fires brigade in the Army’s inventory, according to an Army press release.

The unit will provide pivotal short-range air defense (SHORAD) coordination for U.S. forces in Europe, a capability found lacking when compared to the Russian military’s assets on display in the Ukraine conflict.

“Back in the 1990s, decisions were made to downsize and there was not much of a need for SHORAD,” said Col. David Shank, commander of the 10th AAMDC. “It all started in 2004 when the first SHORAD battalion was inactivated and it snowballed from there.”

“Fast forward to today and what does that mean? We have Stinger teams, Avenger batteries … and why we are here today, the 678th Air Defense Artillery Brigade,” Shank added.

The ceremony marked the beginning of the 678th ADA’s nine-month forward deployment in support of Operation Atlantic Resolve.

The brigade will be tasked with coordinating air defense missions in Europe as part of the operation.

Atlantic Resolve is an ongoing effort by NATO allies to respond to Russian aggression in Ukraine that began in 2014, according to U.S. Army Europe.

Soldiers with the 678th will take part in joint and multinational exercises with allies across the continent.

Since April 2014, multinational training and security cooperation missions have taken place in Estonia, Latvia, Lithuania, Poland, Romania, Bulgaria and Hungary. The Army says these training missions are intended to “strengthen relationships and trust among allied armies, contribute to regional stability, and demonstrate U.S. commitment to NATO.”

KXLH: Helena veteran receives the 2018 American Legion Patriot Award

By MTN News

Diane Carlson Evans of Helena, a U.S. Army veteran, received The American Legion’s Patriot Award recently at the organization’s 58th annual conference in Washington D.C.

Evans led the movement to place a memorial on the National Mall in D.C., honoring women who served in the Armed Forces during the Vietnam War.

Evans was a combat nurse in 1968 and 1969 and later served in stateside military medical facilities.

She later spent eight years raising money and clearing bureaucratic hurdles to get the Vietnam Women’s Memorial dedicated on Veterans Day 1993.

She has since been a leading voice for women veterans and all who served during the Vietnam War.

“Diane Carlson Evans is, first and foremost, a wartime veteran,” American Legion National Commander Denise Rohan said before presenting the award. “She volunteered to serve deep in the combat theater of Vietnam. She put her life on the line – often in terrible conditions and under deadly enemy fire – to save others. When others in our country were looking for ways to get out of the war, she was asking for ways to get into it.”

“My vision needed a champion,” Carlson Evans told hundreds of American Legion Family members gathered for the conference. “I knew I couldn’t do this alone. The American Legion never hesitated.”

“It is wholly within her character…how she single-handedly led a difficult movement that continues today to honor the wartime service of women in the military, to reverse stereotypes and inspire future generations,” Honorary Committee Chairman Ted Roosevelt IV said at the presentation.

“I humbly accept your Patriot Award – on behalf of the women veterans I sought to honor and on behalf of all those on a team – that’s you – who made this dream come true,” Carlson Evans said.

HistoryNet.com has more on Evans, including this overview:

Inspired by her aunt who served in World War II, Diane Carlson Evans volunteered for the military and at the age of 21 served as head nurse in a major surgical evacuation unit at Pleiku in 1968-69. Fifteen years later, she would unwittingly head into another form of combat. In 1982 she attended the dedication of the Vietnam Veterans Memorial, which left her sleepless and uneasy. The ensuing controversy about adding a figurative statue depicting men stirred up even more pain. Eventually, she decided she could not rest until the contributions of women in Vietnam had been recognized. Facing a tidal wave of opposition during a decade of struggle, Evans and her supporters—ranging from veterans organizations to civic organizations, veterans and their families and friends—turned the tide, making history with the placement of a statue honoring all the women who served in Vietnam. The statue of three uniformed women with a wounded soldier, erected near The Wall in 1993, stands as the first national monument honoring women in the military. A celebration of the Vietnam Women’s Memorial’s 20th anniversary will take place over Veterans Day weekend, November 9-11, 2013.

NPR: To Treat Pain, PTSD And Other Ills, Some Vets Try Tai Chi

April 2, 2018 3:45 PM ET | Heard on All Things Considered

Every week in Murfreesboro, Tenn., Zibin Guo guides veterans in wheelchairs through slow-motion tai chi poses as a Bluetooth speaker plays soothing instrumental music.

"Cloudy hands to the right, cloudy hands to the left," he tells them. "Now we’re going to open your arms, grab the wheels and 180-degree turn."

The participants swivel about-face and continue to the next pose. Guo, a medical anthropologist at the University of Tennessee at Chattanooga, has modified his tai chi to work from a seated position. Even though many of the participants are not wheelchair-bound, using the mobile chairs makes it easier for them to get through a half-hour of movement.

The U.S. Department of Veterans Affairs has given $120,000 in grant money to Guo to spread his special wheelchair tai chi curriculum. He started in Chattanooga, and has expanded his class offerings to Murfreesboro.

This idea of going beyond prescriptions — and especially beyond opioids — in dealing with different sorts of pain and trauma has become a focus of the VA nationally.

In Tennessee, nearly a quarter of all VA patients with an active medical prescription were on opioids in 2012. That number is now down to 15 percent, but that’s still higher than in most other parts of the country.

According to a national survey from 2015, nearly every VA hospital now offers some kind of alternative health treatment — like yoga, mindfulness and art therapy.

Guo is teaching people in a half dozen VA hospitals in Florida, Texas, Utah and Arizona to use his version of tai chi. He believes the focus on breathing and mindfulness — paired with manageable physical activity — can help ease a variety of ailments.

"When you have a good amount of body harmony, people tend to engage in proactive life," he says, "so that helps with all kinds of symptoms."

In addition to making a vet feel better physically, the VA also hopes these alternative therapies might help ease symptoms of conditions like post-traumatic stress disorder.

Thomas Sales, of Nashville, Tenn., says his latest panic attack caught him by surprise. "Night before last, when we had the thunderstorm," he says. "The thunder is a big trigger for some people."

It’s been 25 years after Sales fought in the first Gulf War with the Navy Special Warfare Command, and he still has panic attacks regularly.

"You’ll find yourself flashing back to being out there with the fellas, and you’ll just kind of snap," he says. "And I found myself, for some reason, thinking about doing the breathing techniques [from tai chi], and doing the ‘heaven and earth,’ and then breathing deep and slow."

Sales says he knows it must look crazy to some people when he reaches to the sky and then sweeps his arms to the ground. There was a time when he would have agreed. Most of the patients in this class had some skepticism going into the tai chi program. But Vietnam veteran Jim Berry of Spring Hill, Tenn., says he’s now convinced of its value.

"My daughter sent me a t-shirt that sums it up," he says. "Tai chi is more than old folks chasing trees."

Berry credits meditation and tai chi with helping him quit smoking. "No cigarettes for three months now," he says.

Zarita Croney, a veteran with the National Guard, says tai chi has helped her with chemical dependency. She now makes the nearly two-hour drive from Hopkinsville, Ky., to Murfreesboro each week, and has reduced her use of pills for pain.

"My whole life … revolved around, ‘Oh shoot, when can I take my next pill?’ " Croney recalls. "I’ve gone from about 90 percent of my day being on my bed to being able to come out and be social."

The VA has been aggressively trying to wean vets off high-powered opioids — using prescription data as a key measurement to judge how its hospitals across the country are doing with that goal.

The VA acknowledges that there’s little evidence at this point that tai chi or mindfulness therapy or acupuncture will ease PTSD or addiction, though recently there has been research into the quality of life benefits of tai chi among the elderly.

But physicians say they suspect many of the opioisa aren’t always helping veterans either, and the drugs carry more risks.

Aaron Grobengieser, who oversees alternative medicine at the VA hospital in Murfreesboro, says tai chi won’t replace medication. But it might help reduce prescriptions, and the agency plans to start measuring that.

"I believe this is going to be an avenue," he says, "to really help address that group of folks [who are] looking for ways to manage those types of conditions without popping another pill."