Capitol Hill Update: July 24, 2017        

Schedule:

The House and Senate are in session this week.

There are five (5) legislative days remaining for the House before the August recess and 53 legislative days remaining in the year. The Senate will supposedly work through the first two weeks of the August recess.

House:

The FY 2018 budget resolution, dubbed "Building a Better America," was marked up and approved by the Budget Committee on Thursday in a party-line vote. The budget would reduce the budget deficit by $6.5 trillion over the ten-year budget window and eventually come into balance in FY 2027, creating a $9 billion surplus.

Perhaps one of the most important components of the budget is that it begins the reconciliation process for fundamental tax reform. There are also reconciliation instructions for 11 House committees to find roughly $200 billion savings or reforms in mandatory spending.

The FY 2018 budget resolution isn't on the calendar for the week. It's unclear if House Republican leaders will bring it to the floor.

Additionally, the 21st Century Aviation Innovation, Reform, and Reauthorization (AIRR) Act, H.R. 2997, introduced by Transportation and Infrastructure Committee Chairman Bill Shuster (R-Pa.) could come to the floor for a vote this week. The bill reauthorizes the Federal Aviation Administration (FAA) and reforms the United States' out of date air traffic control (ATC) system. FreedomWorks has released a key vote in support of the 21st AIRR Act.

On Monday, the House will consider 17 bills on the suspension calendar. Most of the bills on the suspension calendar related to veterans or active military issues. There are three bills on the suspension calendar that relate to small businesses and investment. The House will also consider the Intelligence Authorization Act, H.R. 3180, sponsored by Intelligence Committee Chairman Devin Nunes (R-Calif.) on suspension.

There are three bills on the suspension calendar for Tuesday, including the Medicare Part B Improvement Act, H.R. 3178, sponsored by Ways and Means Chairman Kevin Brady (R-Texas), and a yet-to-be-numbered resolution that will impose sanctions on Russia, Iran, and North Korea.

The House will also consider H.J.Res. 111, a resolution of disapproval under the Congressional Review Act, to cancel the Consumer Financial Protection Bureau's (CFPB) giveaway to trial lawyers. The rule put restrictions on the use of arbitration to settle disputes over consumer products. This would lead to more class-action lawsuits, benefiting trial lawyers and hurting consumers. FreedomWorks has signed a coalition letter in support of H.J.Res. 111 and will likely include the vote on our 2017 Congressional Scorecard.

For the balance of the week, the House will consider at least four more bills on the suspension calendar. The Make America Secure Appropriations Act, H.R. 3219, will also come to the floor. This is the consolidated appropriations bill, or "minibus," for the Department of Defense, the Legislative Branch, Military Construction and Veterans Affairs, and Energy and Water. Like virtually every other bill to come to the floor this year under "regular order," the Make America Secure Appropriations Act is subject to a rule to limit or prevent amendments from the floor.

On Thursday at 10:00 am, the Judiciary Committee will hold a hearing entitled "The Need for the Balanced Budget Amendment." The witness list for the hearing has not yet been announced. Twelve constitutional amendments have been introduced in the House that would require a balanced budget. Chairman Bob Goodlatte (R-Va.) is the sponsor of two of them, H.J.Res. 1 and H.J.Res. 2. Rep. Justin Amash (R-Mich.), the primary sponsor of H.J.Res. 15, is among the House conservatives who have introduced a balanced budget amendment.

The committee and subcommittee schedule for the week can be found here.

Senate:

Presumably, the Senate will vote this week on the motion to proceed to the House-passed version of H.R. 1628. It's still unclear on what happens next. A vote to proceed to the House-passed version has always been the first step. The next step will be for an amendment to the bill that will substitute the language of either the Better Care Reconciliation Act or language similar to the 2015 ObamaCare repeal bill, now called the ObamaCare Repeal Reconciliation Act. FreedomWorks' key vote on the motion to proceed applies only if the base text that will be substituted is similar to the 2015 ObamaCare repeal bill.

At least a few Senate Republicans have backed away from their votes for the 2015 ObamaCare repeal bill, which was passed in December 2015 with the support of all but two Republicans, including Sen. Susan Collins. Moderate Republicans who refuse to vote for the 2015 ObamaCare repeal bill have demanded $200 billion in Medicaid funding offered by Majority Leader Mitch McConnell (R-Ky.) to get them to support the Better Care Reconciliation Act.

Some parts of the Better Care Reconciliation Act are in limbo, however, as the Senate parliamentarian has apparently ruled that provisions limiting funding for Planned Parenthood and tax credits for plans that cover abortion will require 60 votes. Other provisions that may require 60 votes include the State Innovation Waivers. Many of these provisions can be altered to make them withstand a Byrd rule challenge, as was done in 2015.

The Senate still has several nominees to consider and, on the legislative front, the FDA Reauthorization Act, S. 934; the National Defense Reauthorization Act; and the debt ceiling are among the items awaiting action.

Separately, Senate Democrats are rolling out their "better deal" economic agenda today, which is a rehashing and repackaging of virtually every leftist policy proposal in recent years. The agenda is Democrats' attempt to find a message after a string of special election losses around the country.

The full committee schedule for the week can be found here.


          The Unfinished VA Hospital That's More Than $1 Billion Over Budget        
A decade ago, plans were drawn up for a huge Veterans Affairs hospital near Denver intended to replace old and crowded facilities for nearly 400,000 vets in Colorado and neighboring states.

The original budget was $328 million, but that was totally unrealistic, the VA now acknowledges.

          End Of Life Care Can Be Different For Veterans        
Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

ROBERT SIEGEL, HOST:

Half of the men who die every day in the U.S. are veterans. That's according to the Department of Veterans Affairs, and it's not as shocking as it sounds. Millions of Americans who served in World War II and in Korea are now in their 80s and 90s.

          A Benefit For Rural Vets: Getting Health Care Close To Home        
Army veteran Randy Michaud had to make a 200-mile trip to the Veterans Affairs hospital in Aroostook County, Maine, near the Canadian border, every time he had a medical appointment.

Michaud, who was medically retired after a jeep accident in Germany 25 years ago, moved home to Maine in 1991.

          VA's Inspector General Finds Faked Data At Hospitals Across U.S.        
President Obama addressed the annual convention of the American Legion in North Carolina with a raft of new proposals for vets. The speech comes as the inspector general at the Veterans Affairs Department is releasing a report on the scandal over phony wait times at the Phoenix VA hospital.
Copyright 2014 NPR.
          Obama Taps Former Procter & Gamble Chief To Helm VA        
Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

ROBERT SIEGEL, HOST:

President Obama has decided on his choice to lead the Department of Veterans Affairs. He has nominated Robert McDonald, the former CEO of Procter & Gamble.

          Senate Version Adds Costs To VA Overhaul Measure        
The Senate passed a bipartisan bill to overhaul the Department of Veterans Affairs. The measure is close enough to a version already passed by the House that it could reach the president's desk soon.
          Audit Reveals Vast Scale Of VA Waitlist Issues        
Before former Veterans Affairs Secretary Eric Shinseki stepped down, he ordered an audit of the VA system, hoping to find how many hospitals were lying about wait times. The audit found that approximately 100,000 veterans are waiting too long for care at the VA.
          VA Health Care's Chronic Ailments: Long Waits And Red Tape        
More than 2.5 million veterans served in Iraq and Afghanistan, and they qualify for health care and benefits from the Department of Veterans Affairs.
          Can Civilian Health Care Help Fix The VA? Congress Weighs In        
Veterans across the country are still waiting too long for medical care, a situation that drove the resignation of Veterans Affairs Secretary Eric Shinseki last week.

Now Republicans and Democrats in Congress are competing to pass laws they think will fix the problem of medical wait times and other problems at the VA.

          Shinseki's Apology Punctuates A Long Career Of Service        
Veterans Affairs Secretary Eric Shinseki apologized for lengthy waits at VA facilities, saying he's ousting the leaders of a VA hospital in Phoenix, Ariz., after stories about delays in care there. Shinseki's decision to resign marks a muddy end to an illustrious career, which began when he joined the Army nearly five decades ago.
          Embattled Veterans Affairs Secretary Eric Shinseki Resigns        
Transcript

STEVE INSKEEP, HOST:

Good morning, let's hear more now about the resignation of Eric Shinseki, Secretary of Veterans Affairs. President Obama says he accepted that resignation a short time ago at the White House. He had just finished making a statement after the two men held a short private meeting.

          VA Secretary Apologizes For 'Indefensible' Treatment Delays        
Transcript

DAVID GREENE, HOST:

This is MORNING EDITION from NPR News. I'm David Greene.

STEVE INSKEEP, HOST:

And I'm Steve Inskeep. Good morning. Eric Shinseki, the embattled secretary of Veterans Affairs, meets this hour with President Obama at the White House. Now, earlier today, Shinseki spoke at a conference on homeless veterans, and addressed what he called the elephant in the room.

          Report Finds Systemic Problems With VA Wait Lists        
Transcript

MELISSA BLOCK, HOST:

A systemic problem nationwide - that's how the Inspector General for Veterans Affairs has described the problem of falsified wait times at VA medical centers. At one facility in Phoenix, veterans waited on average 115 days for an appointment.

Today's report confirms some of the allegations that have led many to call for VA Secretary Eric Shinseki to resign. Here to tell us more about this initial report is NPR's Quil Lawrence. And, Quil, 115 days, that's a very long time to wait for an appointment.

          American Legion Calls For VA Secretary's Resignation        
Transcript

MELISSA BLOCK, HOST:

The country's largest veteran's organization wants the secretary of Veterans Affairs to resign. The American Legion hasn't targeted a public official this way since 1941. And in the past, they've supported VA Secretary Eric Shinseki. But now, there are allegations that dozens of veterans died waiting for health care. And VA hospitals are accused of fixing the stats.

          CARF Connection - Marking eight years of collaboration between the VA and CARF - 2005        
At the Veterans Health Administration of the U.S. Department of Veterans Affairs, January 1, 1997, marked the launch of a historic agreement with CARF. For the first time, the VA's rehabilitation programs began preparing for accreditation surveys by applying the same CARF standards to their own programs that were applied to private-sector providers. For the 1.75 million veterans with service-connected disabilities at that time, the agreement marked a renewed commitment of the VA to demonstrate that the care veterans received at the VA met or exceeded national standards for patient satisfaction, access, and quality.
          The U.S. Government Pavilion at the SelectUSA Investment Summit – Federal Investment Resources at Your Fingertips        
Photo from the U.S. Government Pavilion at the 2016 SelectUSA Investment

The following is a cross-post from Tradeology, the official blog of the International Trade Administration (ITA)

By Andrew Owusu, Intern, SelectUSA

The 2017 SelectUSA Investment Summit provides a platform to communicate economic priorities and affirm the United States as the number one destination in the world for foreign direct investment.  Looking for U.S. economic data and analysis? The U.S. Government (USG) Pavilion in the Exhibition Hall at the Summit will feature representatives from federal agencies that can help participants find and understand U.S. economic indicators. They include:

  • The Economics and Statistics Administration (ESA) which performs high-quality economic analysis, disseminates national economic indicators   and fosters the mission of the U.S. Census Bureau (Census), the Bureau of Economic Analysis (BEA) and the Office of the Chief Economist (OCE).  OCE created the Assess Costs Everywhere (ACE) tool for businesses to evaluate locating in the U.S.;
  • The Bureau of Economic Analysis (BEA) is a trusted and impartial source of data and statistics on the U.S. economy. BEA data is comprehensive and available for free to all;
  • The U.S. Census Bureau is the leading source of data about the nation’s people and economy; The U.S. Census Bureau provides a wealth of demographic and economic data that can help potential businesses make informed investment decisions.

Looking for data specifically on FDI?  SelectUSA Stats is a public, free online data visualization tool that allows you to compare data on foreign direct investment into the United States. The tool features interactive dashboards that display graphical data. The data, from sources like BEA, includes useful categories such as greenfield investment by country, stock and flow, impacts on U.S. employment, exports, research and development; FDI trends by industry, country, and state. With a choice of multiple data agencies, attendees have numerous opportunities to pick up practical tools and strategies from expert practitioners in a variety of investment-related fields.

Officials will also be standing by to provide information on workforce and training programs, U.S. exports, supply chain, research and innovation, U.S. visas, and the Global Entry program. Below is a list of all of the federal agencies, along with their booth numbers, that are participating in the USG Pavilion.

GP1: U.S. Department of State

GP2: U.S. Citizenship and Immigration Services

GP3: U.S. Customs and Border Protection

GP6: U.S. Department of Commerce Rural Team

GP7-8: SelectUSA Stats

GP9: International Trade Administration, Industry and Analysis

GP10: Export Assistance Programs

GP11: U.S. Department of Agriculture, Rural Development

GP12: U.S. Department of Agriculture, Foreign Agricultural Service

GP13: U.S. Economic Development Administration 

GP14: Minority Business Development Agency

GP15: Bureau of Industry and Security

GP16: The Office of the U.S. Trade Representative

GP17:  U.S. Environmental Protection Agency

GP18: Export-Import Bank of the United States

GP19: U.S. Department of Transportation

GP20: U.S. Small Business Administration 

GP21: UNICOR

GP22: U.S. Department of Veterans Affairs

GP23-24: U.S. Department of Labor

GP25-26: Bureau of Economic Analysis

GP27:  Economics Statistics Administration

GP28: U.S. Census Bureau

GP29: National Institute of Standards and Technology, Manufacturing Extension Partnership

GP30: National Network for Manufacturing Innovation, Manufacturing USA

GP31-32: The U.S. Patent and Trademark Office

A number of U.S. government representatives will also be participating in the matchmaking system, so interested attendees will be able to request meetings and learn more about the various resources that the agencies offer.

There is still time to register! Head over to the Summit website to apply for registration to the top FDI event in the United States. If you are unable to attend but would like information on SelectUSA and our services, please visit our website or contact us.


          What Ever Happened to Jefferson and Madison?        

The most recent book of Pulitzer Prize-winning historian, Garry Wills, is Head and Heart: American Christianities. The chapters on religion during the Revolutionary Era show how far the USA today has drifted from the plan of our founders (1).
Wills explains that the founders believed that to build an enduring republic they would have to minimize the impact of religion on government. They were keenly aware of the blood that was spilled in the Crusades, the Inquisition, the persecution of the Jews, and the religious wars in Europe in the 16th and 17th centuries, and they saw first hand religious intolerance in the colonies. They also agreed with British philosopher, John Locke, (2) that human beings have a natural right to form their own beliefs on religion based on reason and conscience, that the duly-constituted government must possess a monopoly of power, that churches are subordinate to the State and its laws, and that churches may use only admonitions and exhortations, and never coercion, in dealing with their members or non-members.
Wills tells us that Jefferson and Madison led the battle to build a lasting new republic based on the separation of government and religion. Jefferson's insistence on this is found in his "Bill to Establish Religious Freedom" in Virginia, his Letter to the Danbury Baptists, and his behavior as President. The Virginia statute disestablished the Anglican Church and ended the practice of taxing Virginians to support it (3). In his Letter to the Danbury Baptists, Jefferson characterized the Virginia statute, and the Constitution, as erecting "a wall of separation between Church and state." During his presidency, he refused to issue prayer day proclamations (4). As for Madison, Father of the Constitution, the Constitution, his essay against compulsory taxation to support churches (5), the "Federalist Papers," and his behavior as President show his agreement with Jefferson. Madison insisted on religious liberty for all and required churches to tolerate one another. He also opposed a religious test for public office and government support for a particular church or for religion in general. Like Jefferson, he opposed prayer day proclamations (6). He also opposed paying chaplains with public funds, tax exemptions for churches, government-endorsement of religious charities, and allowing churches to acquire extensive wealth (7).
Thus, our founders were deeply fearful of sectarianism and they aimed to disentangle religion and government (8). Although contemporary political leaders pay lip service to Jefferson and Madison, few follow their lead. Today most politicians pander to religious groups and their leaders. The White House sends hundreds of millions of dollars to religious charities, the Justice Department hires only applicants who pass an evangelical litmus test, atheists or agnostics are unelectable to high office, pastors openly defy IRS rules about partisan political activity, forty states exempt parents who subscribe to faith-healing from prosecution for denying medical care to their sick children, embryonic stem cell research is halted, and Genesis myths trump science in many classrooms. The list goes on and on (9). Today, religion rules. Whatever happened to Jefferson and Madison?


 

  1. See "Part Two: Enlightened Religion," Chapters 7-14, pp. 121-249.
  2. Locke's writings had a powerful influence on our founders. The doctrines of natural rights, limited government, government by consent, majority rule, the separation of powers, the legitimacy of revolution or rebellion against an illegitimate government, the separation of church and state, and others, are found in his First Treatise of Government, Second Treatise of Government, and Letter Concerning Toleration.
  3. Jefferson's "Bill for Establishing Religious Freedom" provides, in part, that "...no man shall be compelled to frequent or support any religious worship, workplace, or ministry whatsoever, nor shall (he) be enforced, restrained, molested, or burthened in his body or goods, nor shall (he) otherwise suffer, on account of his religious opinions or belief; ...all men shall be free to profess, and by argument to maintain, their opinions in matters of religion, and the same shall in no wise diminish, enlarge, or affect their civil capacities." (Quoted in Wills, p. 196)
  4. Wills, p. 237.
  5. "Memorial and Remonstrance." See Wills, pp. 207-222.
  6. Madison reluctantly issued a prayer day proclamation during the War of 1812, a decision he later regretted.
  7. Wills, pp. 242-247. On the issue of church wealth, Madison was fearful that wealthy churches would attempt to exert political influence.
  8. Wills shares two "laments" with readers by individuals who recognized, and apparently regretted, the secular origins of our nation.
  9. a. In 1812 Timothy Wright wrote:
  10. "We formed our Constitution without any acknowledgement of God, without any recognition of His mercies to us as a people, of his government, or even of his existence. The Convention by which it was formed never asked, even once, his direction or his blessing upon their labors. Thus we commenced our national existence, under the present system, without God." (Quoted in Wills, p. 223)
  11. b. In 1813 Chancey Lee wrote:
  12. "Can we pause and reflect for a moment, with the mingled emotions of wonder and regret, that that public instrument which guarantees our political rights and freedom and independence - our Constitution of national government, framed by such an august, learned and able body of men, formally adopted by the solemn resolution of each state, and justly admired and celebrated for its consummate political wisdom - has not the impress of religion upon it, not the smallest recognition of the government or the being of God, or the dependence and accountability of men - be astonished, O Earth! - nothing by which a foreigner might certainly decide whether we believe in the one true God, or in any God." (Quoted in Wills, p. 223-224)
  13. Other examples include vouchers and other forms of government support of religious schools, displays of nativity scenes on public property, allowance of Christian proselytizing in the military academies, support of proselytizing by Christian ministries in jails and prisons, prayer breakfasts sponsored by public officials, legislative prayers, office holders and candidates closing speeches with "God bless you and God bless America" or a variation, newly-elected presidents utilizing a Bible during their oath and adding "So help me God" to the presidential oath provided in the Constitution, highly publicized efforts by office-holders to block the disconnection of life support systems from individuals in persistent vegetative states, such as Terri Schiavo, stacking boards of education with evangelicals, evangelical opposition to bills promoting children's rights, state referenda defining marriage as the bond between one man and one women, "In God We Trust" on currency, "One Nation Under God" in the Pledge of Allegiance, government "sex education" programs promoting abstinence only and ignoring condoms and the pill, the White House and others promoting the teaching of intelligent design alongside evolution, opposition to casino gambling by evangelicals and their political patrons in some states, the placing by the State of Utah of 12-feet crosses at the sites of state highway patrol officers who died in the line of duty, a 36-year old "Free Day Away" program at Fort Leonard Wood in Missouri where trainees may leave base provided that they participate in a religious program conducted by the Tabernacle Baptist Church of Lebanon, Missouri, incorporation of religion into the health care programs of the U.S. Department of Veterans Affairs, etc.

© 2008 Tom Shipka


          (USA-CA-Merced) Licensed Vocational Nurse (Telehealth)        
Job Overview ## Job Overview ### Summary **Vacancy Identification Number (VIN):** 1991434 **OUR MISSION:** To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? The **Department of Veterans Affairs** (VA) needs employees who possess the energy, compassion, and commitment to serve those who served our Country. Whatever the job title, every position in VA will give you a chance to make a meaningful and personal contribution to the lives of truly special and deserving people - our Veterans. VA professionals feel good about their careers and their ability to balance work and home life. VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities. Working for VA is one of the most emotionally satisfying and professionally rewarding ways to dedicate the best within you to your Country's service. If you are transitioning from the military or a Veteran already, we invite you to explore the benefits of continuing your career at the VA. **The VA is committed to hiring Veterans.** The VA is much more than just another employer. It is an honorable, open and welcoming community of those who care. Gratitude is our motivation and service is our mission. The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define "who we are," our culture, and how we care for Veterans, their families and other beneficiaries. The Values are** I**ntegrity, **C**ommitment, **A**dvocacy, **R**espect and **E**xcellence ("**I CARE**"). **America's Veterans need you!** To find out more, go to http://www.va.gov/jobs/. VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. **NOTE:** Current permanent VA Central CA Health Care System (VACCHCS) employee or current, permanent VA nationwide employee, you must apply under internal announcement number NP-17-AGC-1991438-BU. 1st Area of Consideration - Current permanent VA Central California Health Care System (VACCHCS)/CBOC employees; 2nd Area of Consideration - Current permanent VA Nationwide employees. This position does not require the filing of a financial disclosure report. A Recruitment/Relocation Incentive is not authorized. PCS/Relocation Allowances are not authorized. ### Duties This Licensed Vocational Nurse (LVN) position is located in our Community Based Outpatient Clinic (CBOC) with the VA Central California Healthcare System (VACCHCS), in Merced, CA. The Veterans Health Administration (VHA) expands the provision of patient care to various institutional and non-institutional settings, such as the Department of Veterans Affairs Medical Centers (VAMCs), Community-Based Outpatient Clinics (CBOCs), State Veteran Homes, Vet Centers, homeless shelters, Indian Health Services (IHS), Department of Defense (DOD) and other affiliated organizations by utilizing innovative telecommunication technologies to enhance care coordination, access to care, and to routinely and proactively manage diseases to prevent healthcare crises. These programs may include, but are not limited to, Video Conferencing, Learning Management System, My Health E Vet, Care Coordination Home Technology (CCHT), Clinical Video Telehealth (CVT) and Store and Forward (CCSF) technologies. The Telehealth Clinical LVN serves in a generalist role to support (but not limited to): *video conferencing and staff training *learning management systems *telehealth clinical encounters from the patient and provider locations and *the site Telehealth Clinical LVN for telehealth store and forward applications *CCHT technology support *clinical presenter/facilitator for real time telehealth events, including patient education activities, technical support, training, help desk, business processes, and scheduling support *other program duties as needed **Designated Drug Testing Position:** Applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Applicants will not be appointed to the position if a verified positive drug test result is received. **Work Schedule:** Monday through Friday, 8:00 am to 4:30 pm **Functional Statement Title:** GS-06 LVN (Telehealth Clinical) FS-023080 This position is not eligible for telework. ### Supervisory Status No ### Promotion Potential 06 ### Travel Required * Not Required ### Relocation Authorized * No ### Who May Apply #### This job is open to… U.S. Citizens and current permanent Federal employees of other Agencies Questions? This job is open to 2 groups. Job Requirements ## Job Requirements ### Key Requirements * Must pass pre-employment examination * Must be proficient in written and spoken English * Designated and-or Random Drug Testing required * Background and-or Security Investigation required * Selective Service Registration is required for males born after 12/31/1959. ### Qualifications **Basic Requirements:** **Citizenship:** Citizen of the United States. Non-Citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. **Education:** Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. **Licensure:** Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. **English Language Proficiency:** Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in both spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). **Preferred Experience:** * Experience in Outpatient Clinic Care * Experience with Telehealth technology Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. **Note:** A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. **Grade Determinations:** **GS-6:** * Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN. * Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. * Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. * Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors. * Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. * Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. * Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff. * Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers. * Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures. * Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice. **References:** VA Handbook 5005, Part II, Appendix G13. This can be found in the local Human Resources Office. **Note:** Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **PLEASE NOTE:** Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html. All education claimed by applicants will be verified by the appointing agency accordingly. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **Physical Requirements:** Heavy Lifting (45 lbs and over); Heavy Carrying (45 lbs and over); Straight Pulling (7 to 8 hours); Pushing (7 to 8 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (7 to 8 hours); Standing (1 hour); kneeling (1 hour); Repeated bending (7 to 8 hours); both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; far vision correctable in one eye to 20/20 and to 20/40 in the other; Hearing (aid permitted); emotional/ mental stability. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/qualifications. ### Security Clearance Other Additional Information ## Additional Information ### What To Expect Next After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. During our review, if your résumé and application package do not support your questionnaire answers, we will adjust your rating accordingly. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email (if provided); otherwise, applicants will receive a notification letter via the U.S. Postal Service. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made. You may check the status of your application at any time by logging into your USAJOBS account and clicking on "Application Status." For a more detailed update of your status, click on "more information." Information regarding applicant notification points can be found in the USAJobs Resource Center. #### BENEFITS **Receiving Service Credit for Earning Annual (Vacation) Leave:**Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employees credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. ### Other Information * It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. * This job opportunity announcement may be used to fill additional vacancies. * This position is in the Excepted Service and does not confer competitive status. This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/475310200. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered. *Open & closing dates:* 2017-07-26 to 2017-08-15 *Salary:* $52,820 to $68,671 / per year *Pay scale & grade:* GS 06 *Series:* 0620 Practical Nurse *Appointment type:* Excepted Service Permanent *Work schedule:* Full Time *Job announcement number:* NP-17-AGC-1991434-BU *Control number:* 475310200
          (USA-CA-Merced) Licensed Vocational Nurse (Telehealth)        
Job Overview ## Job Overview ### Summary **Vacancy Identification Number (VIN):** 1991438 **OUR MISSION:** To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? The **Department of Veterans Affairs** (VA) needs employees who possess the energy, compassion, and commitment to serve those who served our Country. Whatever the job title, every position in VA will give you a chance to make a meaningful and personal contribution to the lives of truly special and deserving people - our Veterans. VA professionals feel good about their careers and their ability to balance work and home life. VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities. Working for VA is one of the most emotionally satisfying and professionally rewarding ways to dedicate the best within you to your Country's service. If you are transitioning from the military or a Veteran already, we invite you to explore the benefits of continuing your career at the VA. **The VA is committed to hiring Veterans.** The VA is much more than just another employer. It is an honorable, open and welcoming community of those who care. Gratitude is our motivation and service is our mission. The VA has adopted Core Values and Characteristics that apply universally across the Department. The five Core Values define "who we are," our culture, and how we care for Veterans, their families and other beneficiaries. The Values are** I**ntegrity, **C**ommitment, **A**dvocacy, **R**espect and **E**xcellence ("**I CARE**"). **America's Veterans need you!** To find out more, go to http://www.va.gov/jobs/. VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. **NOTE:** If you are not a current, permanent VA Central CA Health Care System (VACCHCS) employee or current, permanent VA nationwide employee, you must apply under external announcement NP-17-AGC-1991434-BU. **NOTE:** Fee Basis, WOC, Contract, Volunteer, Resident/Trainee, and Temporary personnel must apply to the external announcement in order to receive consideration.* This position does not require the filing of a financial disclosure report. A Recruitment/Relocation Incentive is not authorized. PCS/Relocation Allowances are not authorized. ### Duties This Licensed Vocational Nurse (LVN) position is located in our Community Based Outpatient Clinic (CBOC) with the VA Central California Healthcare System (VACCHCS), in Merced, CA. The Veterans Health Administration (VHA) expands the provision of patient care to various institutional and non-institutional settings, such as the Department of Veterans Affairs Medical Centers (VAMCs), Community-Based Outpatient Clinics (CBOCs), State Veteran Homes, Vet Centers, homeless shelters, Indian Health Services (IHS), Department of Defense (DOD) and other affiliated organizations by utilizing innovative telecommunication technologies to enhance care coordination, access to care, and to routinely and proactively manage diseases to prevent healthcare crises. These programs may include, but are not limited to, Video Conferencing, Learning Management System, My Health E Vet, Care Coordination Home Technology (CCHT), Clinical Video Telehealth (CVT) and Store and Forward (CCSF) technologies. The Telehealth Clinical LVN serves in a generalist role to support (but not limited to): *video conferencing and staff training *learning management systems *telehealth clinical encounters from the patient and provider locations and *the site Telehealth Clinical LVN for telehealth store and forward applications *CCHT technology support *clinical presenter/facilitator for real time telehealth events, including patient education activities, technical support, training, help desk, business processes, and scheduling support *other program duties as needed **Designated Drug Testing Position:** Applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Applicants will not be appointed to the position if a verified positive drug test result is received. **Work Schedule:** Monday through Friday, 8:00 am to 4:30 pm **Functional Statement Title:** GS-03 LVN (Telehealth Clinical) FS-023080 GS-04 LVN (Telehealth Clinical) FS-023270 GS-05 LVN (Telehealth Clinical) FS-023280 GS-06 LVN (Telehealth Clinical) FS-023080 ### Supervisory Status No ### Promotion Potential 06 ### Travel Required * Not Required ### Relocation Authorized * No ### Who May Apply #### This job is open to… 1st Area of Consideration - Current permanent VA Central California Health Care System (VACCHCS)/CBOC employees; 2nd Area of Consideration - Current permanent VA Nationwide employees. Questions? This job is open to 3 groups. Job Requirements ## Job Requirements ### Key Requirements * Must pass pre-employment examination. * Must be proficient in written and spoken English. * Designated and-or Random Drug Testing required. * Background and-or Security Investigation required. * Selective Service Registration is required for males born after 12/31/1959. ### Qualifications **Basic Requirements:** **Citizenship:** Citizen of the United States. Noncitizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. **Education:** Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC) at the time the program was completed by the applicant. **Licensure:** Full, active, current and unrestricted licensure as a licensed practical or vocational nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or District of Columbia. **English Language Proficiency:** Licensed practical or vocational nurses appointed to direct patient care positions must be proficient in both spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d). **Preferred Experience:** * Experience in Outpatient Clinic Care * Experience with Telehealth technology Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. **Note:** A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. **Grade Determinations:** **GS-3:** * None beyond the basic requirements **GS-4:** * Six months of qualifying experience as an LPN or LVN; **OR** * Graduation from an approved school and one year of experience that involved nursing care work in a hospital, outpatient clinic, nursing home, or other supervised medical, nursing, or patient care facility that provided a practical knowledge of human body structure and sterile techniques and procedures; **OR** * Graduation from an approved school of at least 24 months duration. **GS-5:** * Completion of at least 1 year of qualifying experience at the GS-4 level or equivalent. * Demonstrated knowledge and ability to provide a full range of practical nursing care to patients with a variety of physical and/or behavioral problems. * Demonstrated ability to serve as a responsible member of the nursing team and interact in an appropriate manner with patients, family members, professional and other supportive personnel involved in the delivery of patient care, incorporating acceptable, established customer service standards into practice. * Knowledge and skill sufficient to prepare, administer, and appropriately document actions taken specific to commonly prescribed oral, topical, subcutaneous, intramuscular, and/or intravenous medications as permitted by approved local facility policies and procedures. Observation and documentation will include patient's response to medication administered and the reporting of any noted change in patient's condition to RN or MD/DO. * Knowledge and ability to recognize the need for and to institute emergency measures when indicated, promptly seek the assistance of the RN or MD/DO, and assist in resuscitation procedures in cardiac and/or pulmonary arrest. * Recognizes and appropriately responds to breakage/malfunction or loss of equipment, safety hazards, and supply deficiencies, promptly reporting to appropriate personnel for corrective action. * Completed work is under the general supervision of an RN or MD/DO. Individuals at this grade level are expected to have a broad working knowledge of practical nursing procedures. However, completion of more complex practices or procedures may be subject to closer higher-level review. **GS-6:** * Completion of at least one (1) year of additional qualifying experience at the GS-5 level or equivalent, fully meeting all performance requirements for the GS-5 LPN/LVN. * Technically proficient in initiating, performing and completing assigned duties in providing care to variable patient populations. * Knowledge and ability to appropriately carry out assigned patient care based on the patients' conditions; to use judgment in selecting the appropriate order and sequence of procedures and treatments; and to accurately recognize, report and record relevant] patient information. Completed work should need only a general review by a registered nurse (RN) or physician (MD/DO) for appropriateness and conformity with established policies/procedures. * Ability to observe, identify and respond to the patient's needs for care, including medication, equipment-assisted care and patient/family education. In organizing and delivering care, the LPN/LVN recognizes and considers emotional, cultural, spiritual, socio-economic, and age-related factors. * Prepares and administers prescribed medications (oral, topical, subcutaneous, intramuscular and/or intravenous) and performs treatments according to established policies/procedures. Observes for physical and/or emotional changes in patient's condition from prescribed medications/treatments, promptly and accurately documenting noted changes, and reporting any deviations from normal to RN or MD/DO. * Knowledge and ability to recognize urgent or emergent patient care situations, seek assistance of the RN and/or MD/DO, and initiate appropriate emergency interventions as directed. * Knowledge and understanding of human behavior, patient motivations and reactions to situations, and ability to appropriately utilize this knowledge in working effectively with patients, family members, and other staff. * Establishes constructive relationships with individual patients and their families to elicit feelings and attitudes, and to promote positive relationships, communication and socialization skills. Fosters an environment of respect for individual patient and family rights to privacy and dignity in all aspects of care delivery. Effectively incorporates knowledge and understanding of established customer service standards in all interactions with patients, family members, and/or other internal/external customers. * Knowledge and skill in performing support duties for complex diagnostic tests and/or specialized practices or procedures, which include preparing the patient, assisting in the diagnostic examination, preparing and handling specialized instruments or other specialized equipment, and monitoring the patient's condition before, during, and following the procedure. Serves as a preceptor in orienting, educating, and training less experienced LPNs/LVNs or NAs/HTs related to support duties for these more complex, specialized tests/procedures. * Actively seeks out educational opportunities to enhance nursing knowledge and skills, sharing new knowledge gained with other staff to improve and advance nursing practice. **References:** VA Handbook 5005, Part II, Appendix G13. This can be found in the local Human Resources Office. **Note:** Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **PLEASE NOTE:** Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications (particularly positions with a positive education requirement.) Therefore, applicants must report only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education. Applicants can verify accreditation at the following website: http://www.ed.gov/admins/finaid/accred/index.html. All education claimed by applicants will be verified by the appointing agency accordingly. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **Physical Requirements:** Heavy Lifting (45 lbs and over); Heavy Carrying (45 lbs and over); Straight Pulling (7 to 8 hours); Pushing (7 to 8 hours); Reaching above shoulder; Use of fingers; Both hands required; Walking (7 to 8 hours); Standing (1 hour); kneeling (1 hour); Repeated bending (7 to 8 hours); both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; far vision correctable in one eye to 20/20 and to 20/40 in the other; Hearing (aid permitted); emotional/ mental stability. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at http://www.opm.gov/qualifications. ### Security Clearance Other Additional Information ## Additional Information ### What To Expect Next After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. During our review, if your résumé and application package do not support your questionnaire answers, we will adjust your rating accordingly. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email (if provided); otherwise, applicants will receive a notification letter via the U.S. Postal Service. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made. You may check the status of your application at any time by logging into your USAJOBS account and clicking on "Application Status." For a more detailed update of your status, click on "more information." Information regarding applicant notification points can be found in the USAJobs Resource Center. #### BENEFITS **Receiving Service Credit for Earning Annual (Vacation) Leave:**Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employees credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. ### Other Information * It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. * This job opportunity announcement may be used to fill additional vacancies. * This position is in the Excepted Service and does not confer competitive status. This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/475305200. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered. *Open & closing dates:* 2017-07-26 to 2017-08-15 *Salary:* $37,727 to $68,671 / per year *Pay scale & grade:* GS 00 *Series:* 0620 Practical Nurse *Appointment type:* Agency Employees Only *Work schedule:* Full Time *Job announcement number:* NP-17-AGC-1991438-BU *Control number:* 475305200
          Re: Headstone for British soldier        
Good day,

I would contact representatives from the below website as they should be able to provide proper guidance. They are affiliated with the Veterans Affairs Canada.

http://www.lastpostfund.ca/EN/UGP.php

Regards,
Jeff
http://frasers78th.blogspot.com




          VA Announces New Grants to Help End Veteran Homelessness – $6 Million Award Headed to Northwest Montana        
On Tuesday, Secretary of Veterans Affairs Robert McDonald awarded nearly $93 million  in Supportive Services for Veteran Families three-year grants that will help approximately 45,000 homeless and at-risk veterans and their families. Six million dollars of that was awarded right here in the Treasure State. Continue reading…
          Blog Post: Watchdog Says VHA Improperly Bills For Service Conditions        
The Veterans Health Administration improperly issued close to 1.7 million bills to veterans and third-party payers for treatments for service-connected conditions, the U.S. Department of Veterans Affairs Office of Inspector General said in a report Wednesday.
           House Passes $81.6 Billion Veterans Affairs Bill: Includes Allowing Medical Marijuana         

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law On May 19, 2016, a new bill was passed that would allow US Department of Veterans Affairs (VA) doctors to prescribe medical marijuana to patients. As part of the $81.6 billion budget and policy bill for military construction and the department of Veterans Affairs, this new measure would allow VA doctors to prescribe medical marijuana to their patients in states where medical marijuana is currently legal. Treatment For Veterans. Rep. Earl Blumenauer, first brought about this new measure citing heightened rates of depression, suicide, and opioid use and abuse among veterans....


          Predictors of Satisfaction With Life in Veterans After Traumatic Brain Injury: A VA TBI Model Systems Study        
imageObjective: To identify predictors of satisfaction with life in Veterans 1 year after traumatic brain injury (TBI). Setting: The VA TBI Model Systems (TBIMS) project includes 5 Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Participants: Veterans enrolled in the VA TBIMS study who completed the Satisfaction With Life Scale at year 1 follow-up. The sample is largely male (96%) and Caucasian (72%), with a median age of 27 years upon enrollment. Design: Prospective observational cohort study measuring including demographics (eg, education), preinjury variables (eg, mental health history and employment), and military variables (eg, injury during deployment and injury during active duty status). Main Outcome Measure: Satisfaction With Life Scale. Results: Multivariate regression analyses revealed that age, marital status, preinjury employment status, preinjury mental health history, and active duty status at the time of injury were significant predictors of life satisfaction at year 1 follow-up. Conclusions: Results of this study suggest that satisfaction with life in Veterans with TBI is mediated by several factors that might inform rehabilitation interventions and discharge recommendations. Preinjury variables and active duty status (a unique aspect of the Veteran population) influence life satisfaction at 1 year postinjury. Limitations and future clinical implications will be discussed.
          Relationship Stability After Traumatic Brain Injury Among Veterans and Service Members: A VA TBI Model Systems Study        
imageObjective: To explore stability of relationships and predictors of change in relationship status 2 years following TBI/polytrauma. Setting: Five Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRCs). Participants: A total of 357 active duty service members and Veterans enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers Traumatic Brain Injury Model Systems database with complete marital status information at 2 years postinjury. Design: Prospective, longitudinal, multisite. Main Measures: Relationship status change was defined as change in marital status (single/never married; married; divorced/separated) at 2-year follow-up, compared with status at enrollment. Results: At the time of enrollment, 134 participants (38%) were single/never married; 151 (42%) were married, and 72 (20%) were divorced/separated. Of those married at enrollment, 78% remained married at year 2 while 22% underwent negative change. Multivariable analyses revealed that age and education at the time of injury and mental health utilization prior to injury were significant predictors of relationship change. Among those who were single/divorced/separated at the time of enrollment, 87% remained so at year 2 while 13% underwent positive change. Injury during deployment significantly predicted positive relationship change. Conclusions: The unmalleable, preinjury characteristics identified may be used as potential triggers for education, prevention, surveillance, and couples therapy, if needed.
          Stability and Validity of the Veterans Health Administration's Traumatic Brain Injury Clinical Reminder Screen        
imageObjective: Determine the test-retest stability and validity of the Veterans Health Administration's Traumatic Brain Injury Clinical Reminder (VHA-TBI-CR) screen. Design: Criterion-standard. Setting: Veterans Health Administration. Participants: Ninety-five Operations Enduring Freedom and Iraqi Freedom veterans who had previously completed the VHA-TBI-CR screen were recruited from the Tampa Veterans Affairs Medical Center. Participants were primarily male (89.5%), with a mean age of 41.6 (SD = 11.14) years; 86% completed at least some college and over half were employed (56.8%). The majority of the participants were enlisted (83.2%). Main Outcome Measures: Phi coefficients of stability were calculated comparing the original clinically administered VHA-TBI-CR screen, with a paper-and-pencil version of the screen completed as part of the current study. Validity analyses were conducted by comparing the results from both screens to the study's TBI Identification Clinical Interview findings regarding a history of deployment-related traumatic brain injury (TBI). Sensitivity, specificity, positive predictive value, and negative predictive value of the screen were computed. Kappas were also calculated to examine agreement between screens and the study's “criterion standard” TBI diagnosis. Interventions: None. Results: The VHA-TBI-CR screen had poor test-retest stability (ϕ = 0.34). The clinically administered VHA-TBI-CR screen had only moderate sensitivity (0.61) but relatively good specificity (0.88). Historical drift was present in the data. Clinical VHA-TBI-CR screens completed within the past 24 months were less accurate (κ = 0.27) than screens completed between 25 and 38 months earlier (κ = 0.63) or those completed between 38 and 57 months earlier (κ = 0.53). Conclusion: The VHA-TBI-CR screen has poor test-retest stability and poor validity when compared with a semistructured TBI identification interview. In this sample, sensitivity was unacceptably low such that the screen failed to identify 39% of veterans who were determined to have had a deployment-related TBI.
          Human-Centered Therapy . . . with Robots        

Now that the U.S. Department of Veterans Affairs recognizes post-traumatic stress disorder as a significant issue among veterans, they’ve uncovered another problem—there aren’t enough therapists to go around. Virtual reality experts at the University of Southern California have a solution: robots. Reporter Anna Stitt explains how advocates see these “therapy bots” as enhancing the field of therapy; they don’t tire out, they don’t need a salary, and patients are often more honest with them than human therapists. The only problem? Some people are worried that these therapy bots will one day replace humans.

Fears of artificial intelligence aren’t new, but they do seem increasingly common. Elon Musk declared that creating artificial intelligence is akin to "summoning the demon.” And Hollywood has done a solid job of convincing us that we’re approaching an age of artificial superintelligence—when machines’ capabilities will greatly exceed those of humans. We turned to philosopher and University of California, Berkeley professor John Searle to get his take on how realistic these concerns are. He says he takes the threat just as seriously as if someone said “shoes have been walked on for centuries. Any day now, they might come out of the closet and walk all over us."

Show Clock

00:04 Intro
02:06 Human-Centered Therapy....with Robots
19:56 John Searle interview

Credits

Hosts: Michal Meyer and Bob Kenworthy
Guest: John Searle
Reporter: Anna Stitt
Producer: Mariel Carr
Associate Producer: Rigoberto Hernandez

Music

Music courtesy of the Audio Network.


          Re:Politics - USA        
A little history of Trump believing, or saying, crazy things:

- Hillary was involved in Vince Foster's suicide
- Obama was born in Kenya
- vaccines cause autism
- thousands of Muslims celebrating 9/11
- Ted Cruz father was involved in JFK's assassination



Automatically Appended Next Post:
To go back to the VA wait time problem.

This seems like a good approach, and I'm hoping it works out and spreads:

Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain to offer urgent care services to more than 65,000 veterans.

The experiment began Tuesday at the VA's operations in Palo Alto, Calif.

Veterans can visit 14 CVS MinuteClinics in the San Francisco Bay Area and Sacramento, where the staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications that can be filled at CVS pharmacies.

The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications. Whether the partnership will spread to other VA locales isn't yet clear.

The collaboration comes amid renewed scrutiny of the nation's troubled VA health system, which has tried without much success to improve long wait times for veterans needing health care.
...
(More at the link)



          VA Answers Governor Christie's Call on Opioid, Launches S.T.O.P. P.A.I.N Advices and Guidelines        
When it comes to treating pain and substance abuse, the Department of Veterans Affairs is recognized by many as a leader in the pain management field and the responsible use of opioids across the VA healthcare system.
          Veterans Affairs Secretary David J. Shulkin Statement on House Passage of S. 114, the VA Choice and Quality Employment Act        
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          Statement From Secretary Shulkin on Agreement Reached on Funding to Increase Veterans Access to Health Care and Strengthen VA Workforce        
WASHINGTON - On behalf of the Department of Veterans Affairs (VA) and the nation's Veterans, I want to commend the leadership of the House and Senate Veterans' Affairs Committees on their agreement on legislation that will greatly benefit Veterans.
          VA Announces Immediate Actions at Manchester VA Medical Center        
WASHINGTON - Today, U.S. Secretary of Veterans Affairs David J. Shulkin, M.D., announced actions the department is taking immediately to respond to whistleblower concerns at the Manchester, New Hampshire, VA Medical Center (VAMC) detailed in an article in today's Boston Globe.
          VA Honors Outstanding Achievements in Support of Homeless Veterans Programs        
WASHINGTON - During several award ceremonies across the country in July, the U.S. Department of Veterans Affairs (VA) will honor exemplary facilities, employees and civilian providers working to address Veteran homelessness.
          Despite Claims To Contrary, Trump Has Signed No Major Laws 5 Months In        
Updated 12:30 p.m. ET President Trump kept one of his campaign promises, signing a bill Friday to make it easier for the secretary of veterans affairs to fire and discipline employees. It came in response to the 2014 VA scandal in which employees covered up long wait times while collecting bonuses. The bill, which passed earlier this month with strong bipartisan support, also gives the secretary authority to revoke bonuses and protects whistleblowers who report wrongdoing. "What happened was a national disgrace and yet some of the employees involved in these scandals remained on the payrolls," Trump said just before signing the bill. "Outdated laws kept the government from holding those who failed our veterans accountable. Today we are finally changing those laws." The Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 marks Trump's 40th law signed. Sounds like a lot. And in recent days, Trump has boasted about all the legislation he has signed. "We
          White House Touts 'Historic' 28 Laws Signed By Trump, But What Are They?        
Even though President Trump calls the 100-days measure "ridiculous," the White House is still touting what one press release called the president's " historic accomplishments " — including 28 laws he has signed since taking office. But when it comes to legislation, political scientists say it is better to measure significance than to simply add up the number of bills. It is better, they argue, to ask whether a law changes the status quo or introduces a new policy idea. By that measure, there is not as much to show legislation-wise for Trump's first 100 days. Of the 28 new laws signed by Trump, two name Veterans Affairs clinics in honor of people, one adds National Vietnam War Veterans Day to the list of days people and businesses are encouraged to fly American flags, five are related to personnel matters (including the waiver allowing James Mattis to become secretary of defense), and one extends an Obama-era policy allowing veterans in some circumstances to get health care outside of
          GI Bill will pay for military vets to learn commercial RE        
A CCIM program offered in partnership with the Department of Veterans Affairs will cover the CCIM Institute's cost of tuition and fees as a GI Bill benefit.

          'Point Of Order' - 01/11/07        
itunes pic
NEWS IN BRIEF: LONDON, ENGLAND - If ringing in the New Year feels like a gong banging in your head, chances are you drank too much alcohol celebrating New Year's Eve, and you're not alone. Scientists have studied few of the common treatments for hangovers found at your local drugstore. However, you can avoid headaches this holiday by learning the facts about alcohol: a cup of coffee won't sober you up, popping Tylenol can be bad for your liver, and the hair of the dog will only prolong your pain. "The severity of a hangover is related to the blood alcohol level you reach, how rapidly you drink, and the amount you drink," said Dennis Twombly, program director of the Division of Neuroscience and Behavior at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). "After the alcohol has been cleared from the system, a hangover can last for 8 to 24 hours, depending on how much you've consumed." Hangovers cost the United States more than $148 billion annually in worker absenteeism and poor job performance, according to a study by researchers at the Veterans Affairs Medical Center in San Francisco Calif. But sleeping off a hangover is the best way for your body to cope during those painful hours. TOKYO, JAPAN – Brain scans have given scientists a clue about how we create a mental image of our own future. Researchers say that specific areas of the brain are active when thinking about upcoming events. The Proceedings of the Academy of Sciences study could help doctors trying to understand damage inflicted by strokes, injuries or diseases. The findings tally with damage spotted in the brains of patients who have lost the ability to 'think ahead'. Much of our everyday thought depends on our ability to see ourselves partaking in future events. The brain remains the most poorly understood organ of the body, but the use of MRI scans to examine the way they work has taken off in recent years. When patients or volunteers are placed in the functional MRI scanner and asked to think or move in a particular way, specific areas of the brain 'light up' on the scan image, corresponding with increased electrical activity in those regions. The technique has developed to the extent that scientists can almost know what patients are thinking about simply by looking at the brain areas they are using. The latest project looked at one of the qualities thought to be unique to humans - the ability to create a mental picture of events that have not yet happened. RURAL RETREAT, USA - One of the newest arrivals at Kirk Heldreth's dairy farm is drawing crowds. A calf with two faces was born Dec. 27 at Heldreth Dairy Farm, and word has spread in southwest Virginia as residents flock to his farm. The animal is normal from its tail until its unusually large head. The calf breathes out of two noses and has two tongues, which move independently, according to Heldreth. There appears to be a single socket containing two eyes where the heads split. "It's the craziest thing I've ever seen," the dairyman said. During the calf's birth, Heldreth said he first thought there were two calves. The calf has two lower jaws, but only one mouth. Heldreth feeds her through a tube, and acknowledges he probably can't maintain that feeding schedule for long. The calf was the product of artificial insemination, which was supposed to create a genetically superior specimen. "Genetically, this is one of my better calves," he said. Bob James, a professor in the dairy science department at Virginia Tech and Heldreth's former teacher, said such births are unusual. "In my 25 years, I've seen it maybe two or three times, but it's pretty rare," he said. James said the abnormality could be caused by a developmental problem or a genetic quirk. Heldreth said the calf doesn't appear to have any other physical ailments or complications. "It's as healthy as can be," he said. Heldreth expects many more people will be curious enough to stop by. "I'll just have to tie the dogs extra tight," he said. ________________________________________________________
          A Splash of July in Paris         
In honor of the heatwave Paris is struggling through right now, as well as the fact that it's the first day of July, today's post is dedicated to the secrets of spending July in Paris. It's a unique experience to get to be in the city during the summer, not just because of special additions like beaches in the middle of the city, but also because the area will empty out as many Parisians leave for vacation.

Many tourists probably don't know that for one month in the middle of the summer, over 5000 tons of sand are dumped in Paris and "Paris Plages" are born. This year's 13th-annual edition of the event will transform the Bassin de la Villette and the Voie Georges Pompidou into areas of mini river-side beaches for people to come and relax, hang out with friends, and enjoy the best of both worlds in the middle of the city. It's unexpected and unique, but it's definitely worthwhile to be able to say you spent a day at the beach in the middle of Paris. Paris Plages 2015 runs from July 20 until August 23.
Another fun summer activity can be enjoyed at the open air cinema at La Villette, perhaps after a leisurely day at the beach! Wednesdays through Sundays you can settle in on the lawn and watch a film as the sun sets. Their program of films contains a little bit of everything, including many films in English. You can even make a picnic out of the experience to make the most out of an evening in one of Paris' finest parks. This year's festival runs from July 22 until August 23.
Last but not least, July in Paris means Bastille Day, though here it's known as the Fête Nationale or le quatorze juillet.  The day commemorates the beginning of the French Revolution and the unity of the French people, and it means big celebrations across Paris and across France. First off, there's the military parade on the Champs-Élysées beginning at 10 in the morning and featuring the French president, the prime minister, the minister of defense, the secretary of state for veterans affairs, and the parade of troops down the Champs-Élysées. Next, there are the famous Bals de Pompiers, the balls held in fire stations across Paris the nights of the 13 and the 14. They're full of music and dancing and are widely-known as a part of celebrating Bastille Day in Paris. Lastly, there's the fireworks display from the Eiffel Tower and Trocadero. Grab a spot on the Champs de Mars and enjoy over 30 minutes of fireworks beginning at 11pm!
From relaxing on the beach to watching a movie in the park to dancing the night away in a firehouse, you can literally do anything when it's July in Paris.

Contact info@parisaav.com for custom-made itineraries that make the most of special events around Paris during your vacation. 

          Elevator Control Switch        
Chip and Dan Heath, professors, researchers, authors, entrepreneurs, and contributors to Fast Company magazine, have recently released a second book called Switch that claims to help folks manage or initiate change in their lives, businesses, etc. Dan recorded a video about the book for a group of VA Senior Executives to be played during last year’s Senior Management Conference, and his speech is available via VA’s Training Management System (TMS), but no one can find it there because the system’s search engine is about as useful as the following procedure:
1. Set up a manual typewriter next to a cactus in the desert

2. Type the question “what is Switch”

3. Swing the carriage return

4. Stare at the cactus

(but that’s another post)
Dan’s video boils down the message in the book which is essentially: people don’t actually resist change, they resist ambiguity, vagary, lack of direction. Dan points out that folks regularly go willingly toward some of the most massive changes a person can experience by simply breaking them down into manageable next steps. We voluntarily join the military, get married, have kids. Those are some pretty massive changes and humans seem to embrace them, not run from them.

He tells that story to explain this one: we like to think change is hard because we’re all schizophrenic. We have a rational side that fully understands why we shouldn’t spend so much time blogging or Facebooking, why we should drop 10 pounds, or why we should get up early tomorrow. Humans also have an emotional side that ignores the rational side and tells us things like one more drink before last call won’t hurt, or we deserve that donut, or hitting snooze one more time is the right decision. The Heath brothers describe this situation (actually they cite the psychologist who described it) as a rational human rider on the back of an emotional elephant. In a battle, the elephant will obviously win. So, the Heath brothers explain, any call for, or attempt to change anything must come with a rational appeal for the rider and an emotional appeal for the elephant. The rider must break down what it wants the elephant to do into easily manageable key steps and then provide the motivation to make those steps appealing to the elephant. Read the book, or, if by some miracle you can find it in TMS, watch the videos. They’re way better at explaining it than I am.

I told you that story to tell you this one: I was in New Orleans last week for the program in which I played that Switch video for a small group of VHA employees in a leadership training program. The hotel where I stayed, gorgeous though it was, had the strangest elevator control system I’ve ever encountered. Before I go on to describe it I should emphasize that I’m one of the folks who don’t need to read Switch in order to be convinced that humans embrace change. I’ve always enjoyed change. I get bored easily. I’d much rather be involved with creating or implementing or revising the new than with maintaining old. It’s just the way I’m wired. I tell you this so you’ll better understand, and perhaps better be able to help with my dilemma.

Back to the elevator control system. I vaguely recall as I checked in to this hotel, the clerk mentioning that I had to go up two floors (via escalators) to the main elevators in order to get to the guest rooms. Like most big city hotels, the first few floors were conference space, public areas, bars, restaurants, Starbucks, and FedEx store. The clerk also said something about swiping my room keycard in order to use the elevator. That seemed odd from a main floor. As a regular traveler, I belong to several of the major chain’s “preferred customer” groups and so I assumed she referred to those floors or areas reserved for card carrying preferred customers, like a top floor lounge, or the floor with just suites or something like that. I was too busy trying to remember her directions for how to even get up to the elevators to think much more about how my key card might be necessary to operate them. It was a good concern to have cuz it turns out I could have walked to another hotel (with my luggage) in less time than it took to get to these damned elevators.

As I approached them, I realized I should have paid more attention to what she said about how to operate them. Unlike every elevator I’ve ever been in, this bank of four cars had a touch screen on the wall between each pair of cars right where you normally find the simple “up/down” buttons you usually associate with elevator operation. I watched as another guest swiped a key card under the touch screen and walked into the car that opened behind us. My past experience with elevators told me to just follow her rather than fish through pockets for my keycard, and so I dragged my roller suitcase into her car, smiled politely, and then turned to press the button for the 7th floor.

“First day here?” she said from behind me as I began to realize the mistake I’d made. This elevator had no buttons inside it save for the alarm bell, and door open/close buttons.
“You’ll have to ride with me to 15, get out, and swipe your card again to get to your floor. Watch the touchscreen to see which car will take you to 7.”

Her instructions seemed about as clear as the ones I’d already ignored at the front desk – they in no way meshed with my four decades of elevator riding experience - but I smiled and thanked her and then rode quietly to 15 with her. I was silently debating whether I would actually get off at 15 until it dawned on me that staying in an elevator with no buttons on the inside was not a useful activity, so when we arrived at 15, I followed her out. I dug my keycard out of my pocket and swiped it under the touch screen. A keypad similar to the one on my iPhone appeared with the “3” and the “7” “keys” highlighted and flashing. I was a tad confused, but I intuitively tapped the “7” and the screen changed to instructions that said something like “take car A to the 7th floor.” And right about then, the door I’d just exited – car A as it turned out – opened. I stepped in and was whisked back down to the 7th floor.

I felt fairly confident with my success. I had passed the first lesson even if, you might argue, I had failed on my first try ending up on the 15th floor. I was now on floor 7 and could now go back to a more familiar process: searching for an indication of which of the four hallways I should follow to find room 725. I pulled my suitcase along while scanning the walls ahead of me and had far less difficulty finding my room than I had controlling the elevators. But the entire time I walked to my room, entered it, hung up my clothes, drank a glass of water, and headed back out to meet with our conference hosts in the building next door, my thoughts were on that elevator control experience.

Was this touchscreen thing that automatically offered me options a better system than the ones I was used to? It didn’t seem like it. It seemed overly complicated, but did I only think that because it was so new and different from well-established prior experience? More importantly, would I be able to work the system to get myself to the second floor – a floor I previously only set foot on between escalators on my way to the guest room elevators on the third floor – in order to meet with my host? I was about to find out. The elevator bank on the 7th floor was rapidly approaching. I had my keycard out and was ready to scan, but I paused to observe for a moment before I jumped right back into this new game. There were two sets of four elevators. Cars A-D were on the far end of the crossing hallway, and cars E-H; on the end nearest the hallway to my room. I had stopped at the E-H touch pad.

I swiped my card and a message on the touchscreen offered the iPhone-looking keypad again, this time with the “3” highlighted, but right below the keypad grid was another box that said, “lower floors.” I tapped it. At that point a new, less complicated grid popped up that offered “2,” “lobby,” and ”upper floors.” I tapped “2.” The screen then flashed “take car A to the 2nd floor.” I headed over from the E-F bank to the A-D bank, and as you can probably guess by now, got to car A just as the doors were closing. I swiped my keycard again, calling up the increasingly familiar iPhone keypad with the “3” highlighted again and the “lower floors” box below the grid. (Apparently, everyone from every upper floor rides to three and then hikes or escalates to 1 or 2??) I tapped the “lower floors” button again, selected “2” again and read “take car B to the 2nd floor.” I glanced up at the two cars I was facing: A & C. I turned around in time to see the doors to car B closing. (did I mention I had an ear infection, and couldn’t hear the doors opening - or jets taking off, or small arms fire - since my plane landed at Louis Armstrong Airport?) I swiped my card again. Tapped “lower floors” again. Tapped “2” again, and braced myself to launch at the first open door. The screen read “take car B to the 2nd floor.”

I tried that once! I thought, loudly.

This time I was ready though, and I managed to enter car B as the doors were closing. Out of habit, I still looked for buttons to push as the car descended to the 2nd floor. I got out, located the skybridge to the connected federal building next door, and made my way over to my host’s office building’s second floor lobby. I passed a bank of elevators marked “Levels 1-4,” a security desk where a friendly guard told me to have a good afternoon, another bank of elevators marked “Levels 5-9,” and finally, just as I was beginning to wonder what problems folks in New Orleans must have had with just plain old elevators in the past, a bank of elevators marked “Levels 9-15.” To my great relief, the elevators to floors 9-15 were operated by the old standard “up arrow/down arrow” buttons. I pushed the up arrow button and climbed on the first car that opened up. Inside, I found the standard panel of buttons (and in answer to the newly forming question in my head, I could actually choose any floor from 1 through 15 in spite of the signage that forced me to walk all the way past two other banks of perfectly good elevators to get to this one. I guessed that the others would have provided the same selection of floors no matter what the signs said!)

I arrived at floor 10, and in typical government fashion, saw absolutely no signage that would confirm nor deny that I was in the right place. To my left was an opening to a hallway. To my right was a set of decorative glass doors with an empty reception desk behind them bearing a Department of Veterans Affairs seal, but no further hierarchical identification indicating it was in the fact the Human Resources and Recruiting Office headquarters. (there are actually a LOT of Department of Veterans Affairs offices)
I walked through the glass doors until I found someone who instantly recognized me as someone who didn’t really belong. I introduced myself, explained why I was intruding, who I was looking for, and discovered I was in fact in the right place. The meeting (and the entire trip) went well from that point on (except for the cabin pressurization/depressurization effects on my ears on the flight home) but the issue of the hotel elevator controls either nagged or intrigued me, and continues to do so.

Each trip I made to and from my room reminded me that I had yet to decide whether or not this change was an improvement. The elevator touch pad was definitely a cool, Star Trek-like, high tech, futuristic kind of toy, and its inconspicuous, brushed stainless steel frame surrounding the glowing blue screen fit nicely with the newly redecorated hotel interior. There was no doubt that the hardware involved was sexy. These touchpads were sleek, slim, cool looking.
There is also no doubt that they worked, once a new user got the hang of them. No doubt that the inside of the elevator was “cleaner,” sleeker looking without all those buttons cluttering it up. No doubt there are fewer moving parts without a button for each floor plus the buttons outside, etc. I can certainly come up with a list of positive things to say about this new elevator GUI, if I may. But the question remains, is it better. If I could become used to it, does it make my elevator experience better than it was in the past?
I’m not sure I’m ready to make that Switch.

So, my dilemma: Do I suspect this new system is not better only because it is so new? Will I grow to love it once it becomes second nature? Or is it sufficiently overly complex and just the latest failure in a line of attempts to replace what is actually a solid existing system that will require more time and effort (and something WAY better than this) to replace it? And how do you ever know?
          VA News Highlights        
Several headlines from the Department of Veterans Affairs in recent days.  Click the links to read the full stories. Statement from Veterans Affairs Secretary Eric K. Shinseki on the American Jobs Act – Shinseki comments on the proposed Act which … Continue reading
          Former GSA Official and Husband Sentenced for Nepotism Scheme        

United States Attorney's Office
Eastern District of Virginia
July 28, 2017

Former GSA Official and Husband Sentenced for Nepotism Scheme

ALEXANDRIA, Va. – A former senior official with the General Services Administration and her husband were sentenced today to 18 months and 1 year in prison, respectively, for engaging in a nepotism hiring scheme.

Helen Renee Ballard (aka Renee Ballard), 52, and Robert S. Ballard (aka Steve Ballard), 56, both of Brandywine, Maryland, pleaded guilty to conspiracy to make false statements on March 23. Renee Ballard was the Director of the Central Office Contracting Division of the U.S. General Services Administration (GSA) from May 2006 to May 2011 and worked for GSA until 2016. From 2010 through July 2014, Renee Ballard and her husband, Steve Ballard, engaged in a scheme to enrich themselves by obtaining employment with federal contractors and the U.S. government through false and misleading statements concerning Steve Ballard’s relation, education, and qualifications. As part of the more than $200,000 scheme, Renee and Steve Ballard fraudulently induced a federal contractor to hire Steve Ballard. The Arlington based contractor then placed Steve Ballard on a federal contract awarded by GSA and supervised by Renee Ballard. Later, Renee Ballard attempted to hire Steve Ballard for a federal civil service position within GSA under her supervision.

In addition, Renee and Steve Ballard caused over 139 false employment applications to be submitted to federal agencies, including the FBI, Office of the Director of National Intelligence, U.S. State Department, U.S. Transportation and Security Administration, Department of Veterans Affairs, Department of Education, Federal Communications Commission, Federal Emergency Management Agency, Department of Labor, U.S. Office of Personnel Management, and the Internal Revenue Service. These applications falsely misrepresented Steve Ballard’s education and qualifications, including that he had earned or taken classes toward a master’s degree and was certified in government contracting at Levels I, II, and III. In order to corroborate these false representations, Renee and Steve Ballard obtained and submitted fake certification documents. Furthermore, the Ballards sent Steve Ballard’s false resume to the Executive Office of the President in an attempt to obtain employment there. Subsequently, Steve Ballard submitted false applications to at least six different private contractors who worked, at times on-site, with the federal agencies, including GSA and U.S. Customs and Border Protection.

Co-conspirator Donna C. Hughes, 32, of Lanham, Maryland, who served as a contracting officer at GSA and reported directly to Renee Ballard, pleaded guilty on April 21 in case 1:17-cr-66. Hughes was sentenced today to 1 year of probation for her role in the conspiracy.

Dana J. Boente, U.S. Attorney for the Eastern District of Virginia; and Carol Fortine Ochoa, Inspector General, GSA, made the announcement after sentencing by U.S. District Judge Claude Hilton. Assistant U.S. Attorneys Uzo Asonye and Katherine Wong prosecuted the case.

A copy of this press release is located on the website of the U.S. Attorney’s Office for the Eastern District of Virginia. Related court documents and information are located on the website of the District Court for the Eastern District of Virginia or on PACER by searching for Case No. 1:16-cr-136.


Source:  U.S. Attorney's Office press release


          Snoqualmie Washington Man Sentenced to Three Years in Prison for Defrauding Government Programs of More than $646,000        

United States Attorney's Office
Western District of Washington
June 1, 2017

Snoqualmie Washington Man Sentenced to Three Years in Prison for Defrauding Government Programs of More than $646,000

Invented Injuries from Rocket Attack to Falsely Claim Medals, Disability Payments and Other Benefits

          A former Captain of the Idaho and Washington National Guard was sentenced today in U.S. District Court in Tacoma to three years in prison, three years of supervised release, and $646,300 in restitution for his lengthy scheme to defraud multiple government programs, announced U.S. Attorney Annette L. Hayes. DARRYL LEE WRIGHT, 48, who served as Chairman of the City of Snoqualmie Planning Commission, pleaded guilty to two counts of wire fraud in February 2016, admitting he defrauded the Veterans Administration, Social Security Disability, Washington State Employment Security, the Department of Commerce and others with his claims of being injured while serving in Iraq with the Army National Guard. In fact, WRIGHT lied about being injured in a rocket attack and submitted pictures of destruction which had no connection to his service in Iraq. At today’s sentencing hearing U.S. District Judge Benjamin H. Settle said Wright dragged “many people into a web of deceit . . . this was a complex and nefarious scam implemented over a long period of time . . . it was a continuous fraud. . . a very lucrative scheme.”

          “This defendant brazenly lied about his combat history to get more than $600,000 in benefits he did not deserve,” said U. S. Attorney Annette L. Hayes. “His willingness to steal from a system meant to take care of those who have bravely served our country, or are otherwise in need, is an outrage. There is no question that the defendant earned the significant sentence he will now serve for his crimes.”

          As early as 2006, WRIGHT began his scheme to defraud by submitting phony statements to the Army and to the Veterans Administration to create the false narrative that he had been injured in a rocket attack. As the scheme progressed over the years, WRIGHT made false and conflicting claims to various agencies in an effort to fraudulently obtain benefits. Government investigators estimate that WRIGHT’s frauds cost government programs some $737,539. The Army has stripped WRIGHT of his Purple Heart Medal and Combat Action Badge.

          In an evidentiary hearing lasting six days, the government presented evidence that WRIGHT defrauded Veteran’s Benefit Administration of $261,719 in claiming he was disabled by a rocket attack that did not occur as he described. WRIGHT then defrauded a Veteran’s Caregiver program of $83,967 claiming he was so disabled he needed a full time caregiver even as he was traveling, playing basketball, caring for his child and serving on the Snoqualmie Planning Commission. He defrauded Social Security Disability of $181,438 claiming he was too injured to work even though at the time he was employed full time by the U.S. Department of Commerce. Later in the scheme, WRIGHT defrauded the Office of Personnel Management of some $48,226 by claiming disability from his job at the Department of Commerce. WRIGHT defrauded Washington State Employment Security by collecting $29,860 in unemployment benefits claiming he was able and willing to work while simultaneously claiming to the Social Security Administration that he was fully disabled and unable to be employed. WRIGHT further used his disability status to avoid repayment of more than $41,068 in student loans to the Department of Education. Finally, WRIGHT defrauded his employer, the Department of Commerce, by submitting fake orders claiming he was on military leave.

          In all, pleadings indicate that Wright victimized 16 different federal, state, local, and private entities, including agencies, programs, organizations, individuals and benevolent institutions such as Disabled American Veterans.

          “This conviction demonstrates the VA Office of Inspector General’s unwavering commitment to protect the programs intended to assist veterans that have served this nation and rightfully earned their benefits,” said Special Agent in Charge James Wahleithner, VA Office of Inspector General, Criminal Investigations Division.

          “The primary mission of the Office of the Inspector General for the Social Security Administration is to investigate allegations of fraud, waste, and abuse in Social Security programs. In this charge, we are incredibly grateful for our law enforcement partnerships and for the collaborative approach to crime fighting demonstrated by the Wright investigative and prosecutorial team. The results of this powerful force-multiplier are quite evident given today’s sentencing, and will undoubtedly send a message to those who would otherwise attempt to defraud Social Security,” said Steuart G. Markley, Jr., Special Agent in Charge, SSA OIG, Seattle Field Division.

          “Mr. Wright not only betrayed the trust of the American people and his fellow veterans by fraudulently accepting these military honors, he bilked Washingtonians who actually deserve this help out of nearly $30,000 in unemployment insurance benefit funds,” said Dale Peinecke, Commissioner of the state’s Employment Security Department, which administers the unemployment insurance system and serves veterans through the WorkSource system. “We are proud to help veterans with disabilities find employment and we’re pleased to be part of the team that brought this case to justice.”

          “The Department of Commerce Office of Inspector General is dedicated to stopping fraudulent activities like this in programs designed to support America's deserving veterans,” said Inspector General Peg Gustafson. “I want to thank the U.S. Attorney’s Office and our law enforcement partners for their leadership and dedication to serving Justice.”

          “We will continue to work with our law enforcement partners to hold accountable brazen fraudsters such as Mr. Wright,” said U.S. General Services Administration Inspector General Carol Fortine Ochoa.

          “PTSD is a serious medical condition and it is unconscionable that Mr. Wright would fake such an injury for financial gain,” said Scott Rezendes, Special Agent in Charge of Office of the Inspector General, U.S. Office of Personnel Management. “I would like to thank the OPM OIG agents who worked on this case and our law enforcement partners for their diligent efforts to safeguard OPM’s retirement programs from fraud and abuse. Our office remains committed to ensuring that OPM’s disability payments are made only to those Federal annuitants who have a right to them.”

          The case was investigated by multiple agencies led by the Social Security Office of Inspector General (SSA-OIG). The Office of Inspector General of these agencies were involved in the investigation: Veterans Affairs (VA-OIG), Department of Commerce (DOC-OIG), Office of Personnel Management (OPM-OIG), and General Services Administration (GSA-OIG). Also contributing to the investigation was the FBI, U.S. Army Criminal Investigation Division, the Washington National Guard, the Washington Employment Security Department and the Washington State Department of Social and Health Services.

          The case is being prosecuted by Assistant United States Attorneys David Reese Jennings and Gregory A. Gruber.

 

Source:  U.S. Attorney's Office press release


          Former GSA Official and Husband Plead Guilty in Nepotism Scheme        

United States Attorney's Office
Eastern District of Virginia
March 23, 2017

Former GSA Official and Husband Plead Guilty in Nepotism Scheme

ALEXANDRIA, Va. – A former senior official with the General Services Administration and her husband pleaded guilty today to engaging in a nepotism scheme in which they conspired to fraudulently obtain employment from the U.S. government and private federal contractors.

According to the statement of facts filed with their plea agreements, Helen Renee Ballard, 51, and Robert S. Ballard, 56, both of Brandywine, Maryland, pleaded guilty to conspiracy to make false statements to the United States.

Helen Renee Ballard (aka Renee Ballard) was the Director of the Central Office Contracting Division of the U.S. General Services Administration (GSA) from May 2006 to May 2011 and worked for GSA until 2016. From 2010 through July 2014, Renee Ballard and her husband, Robert S. Ballard (aka Steve Ballard), engaged in a scheme to enrich themselves by obtaining employment with federal contractors and the U.S. government through false and misleading statements concerning Steve Ballard’s relation, education, and qualifications. As part of the more than $200,000 scheme, Renee and Steve Ballard fraudulently induced a federal contractor located in Arlington to hire Steve Ballard. The Arlington based contractor then placed Steve Ballard on a federal contract awarded by GSA and supervised by Renee Ballard. Later, Renee Ballard attempted to hire Steve Ballard for a position within GSA under her supervision.

According to the statement of facts, Renee and Steve Ballard caused over 139 false employment applications to be submitted to federal agencies, including the FBI, Office of the Director of National Intelligence, U.S. State Department, U.S. Transportation and Security Administration, Department of Veterans Affairs, Department of Education, Federal Communications Commission, Federal Emergency Management Agency, Department of Labor, U.S. Office of Personnel Management, and the Internal Revenue Service. These applications falsely misrepresented Steve Ballard’s education and qualifications, including that he had earned or taken classes toward a master’s degree and was certified in government contracting at Levels I, II, and III. In order to corroborate these false representations, Renee and Steve Ballard obtained and submitted fake certification documents. In addition to these fraudulent applications, the Ballards sent Steve Ballard’s false resume to the Executive Office of the President in an attempt to obtain employment there. Subsequently, Steve Ballard submitted false applications to at least six different private contractors who worked, at times on-site, with the federal agencies, including GSA and U.S. Customs and Border Protection.

The Ballards each face a maximum penalty of five years in prison sentenced on July 28. The maximum statutory sentence is prescribed by Congress and is provided here for informational purposes, as the sentencing of the defendant will be determined by the court based on the advisory Sentencing Guidelines and other statutory factors.

Dana J. Boente, U.S. Attorney for the Eastern District of Virginia; and Carol Fortine Ochoa, Inspector General, GSA, made the announcement after the plea was accepted by Senior U.S. District Judge Claude M. Hilton. Assistant U.S. Attorneys Uzo Asonye and Katherine Wong are prosecuting the case.

A copy of this press release is located on the website of the U.S. Attorney’s Office for the Eastern District of Virginia. Related court documents and information are located on the website of the District Court for the Eastern District of Virginia or on PACER by searching for Case No. 1:16-cr-136.

 

Source:  U.S. Attorney's Office press release.  


          Construction Company Owner, KC Veteran Indicted in $13.8 Million 'Rent-A-Vet' Scheme        

United States Attorney's Office
Western District of Missouri
January 13, 2017

Construction Company Owner, KC Veteran Indicted in $13.8 Million 'Rent-A-Vet' Scheme

KANSAS CITY, Mo. – Tammy Dickinson, United States Attorney for the Western District of Missouri, announced that the former owner of a local construction company and a Kansas City, Mo., veteran were indicted by a federal grand jury today for their roles in a “rent-a-vet” scheme to fraudulently obtain more than $13.8 million in federal contracts.

Jeffrey K. Wilson, 51, of the Village of Loch Lloyd in Belton, Mo., Paul R. Salavitch, 56, of Kansas City, Mo., and Patriot Company, Inc., a business located in Kansas City, Mo., were charged in an eight-count indictment returned by a federal grand jury in Kansas City, Mo.

Today’s indictment alleges that Wilson, Salavitch and the Patriot Company participated in a conspiracy to defraud the government by falsely representing Patriot Company as a veteran-owned or service-disabled veteran-owned small business in order to fraudulently obtain approximately $13.8 million in federal government construction contracts for work in nine states.

According to the indictment, Patriot Company was a pass-through or front company for a Greenwood, Mo., construction company owned by Wilson during the scheme. Conspirators allegedly used Salavitch’s veteran and service-disabled veteran status in a “rent-a-vet” scheme to bid on at least 20 government contracts and receive approximately $13.8 million to which Patriot Company would not have otherwise been entitled to receive because those contracts were set-aside exclusively for legitimate veteran-owned or service-disabled veteran-owned small businesses. As a result of the fraud scheme, legitimate veteran owned and run businesses were not awarded these contracts.

Today’s indictments cites 20 contracts with the U.S. Department of Veterans Affairs and the U.S. Army, totaling $13,819,522, which allegedly were fraudulently obtained by Wilson, Salavitch and Patriot Company. The contracts, which ranged as high as $4.3 million, included construction projects in Missouri, South Dakota, Texas, Nebraska Oklahoma, Michigan, Indiana, Tennessee, Iowa, Illinois and North Dakota.

According to the indictment, Salavitch, a service-disabled veteran, worked full-time as a federal employee with the Department of Defense in Leavenworth, Kan., and did not work full time for Patriot Company. Salavitch nominally served as president of Patriot Company from July 14, 2005, to April 1, 2014. Salavitch did not actively control the day-to-day management, daily operation or long-term decision making of Patriot Company. Salavitch never managed a construction company prior to his involvement with Patriot Company, the indictment says, and he had limited government contracting experience.

For example, the indictment cites an e-mail exchange in which Wilson discusses leasing an office for Patriot Company and writes, “I would like for you to get a thing or two from Paul (Salavitch) to put in that office that is personal. Anything from his military. Any plaques, or US ARMY stuff or anything that if one stepped into it, it would look and feel like Patriot …” The indictment also refers to a series of e-mails in which Salavitch was still contemplating the start date of his work with Patriot Company after the firm had already obtained 10 of the government contracts.

During the fraud scheme, the indictment says, Wilson wired $449,321 as down payment for his Village of Loch Lloyd home purchase, of which $250,000 originated from Patriot Company’s bank account. Wilson financed the balance of the purchase price with funds from the sale of his previous home and a $240,000 mortgage. Wilson used $225,000 in Patriot Company funds, the indictment says, to pay off the mortgage.

Wilson used $175,000 in Patriot Company funds for the purchase of a residence in Mesa, Ariz., the indictment says. Wilson allegedly also used $400,000 of Patriot Company funds to pay two annual premiums for life insurance policies.

In addition to the conspiracy, Wilson, Salavitch and Patriot Company are charged with four counts of major government program fraud. Wilson is also charged with one count of wire fraud and two counts of money laundering.

Today’s indictment also contains forfeiture allegations, which would require Wilson and Salavitch to forfeit to the government any property derived from the proceeds of the fraud scheme, including $2,152,189 that has been seized by law enforcement from various financial accounts, Wilson’s residences in Village of Loch Lloyd and Mesa as part of the money judgment of $13,819,522.

Dickinson cautioned that the charges contained in this indictment are simply accusations, and not evidence of guilt. Evidence supporting the charges must be presented to a federal trial jury, whose duty is to determine guilt or innocence.

This case is being prosecuted by Assistant U.S. Attorneys Jane Pansing Brown and Stacey Perkins Rock. It was investigated by the Department of Veterans Affairs – Office of Inspector General – Criminal Investigation Division and the General Services Administration – Office of Inspector General.

 

Source:  U.S. Attorney's Office press release. 


          McCain’s Brain Cancer Draws Renewed Attention to Possible Agent Orange Connection        

This story was co-published with the Houston Chronicle.

When Amy Jones’ dad, Paul, was diagnosed with glioblastoma last month, she wondered whether it might be tied to his time in Vietnam.

Then, last week, when Sen. John McCain, R-Ariz., also a Vietnam veteran, was diagnosed with the same aggressive brain cancer, Jones searched online for glioblastoma and Vietnam vets.

She soon learned the disease is one of a growing list of ailments that some Vietnam veterans and their relatives believe is caused by exposure to Agent Orange, the toxic herbicide sprayed during the war.

“Honestly, it’s not easy to even admit that this is happening, let alone to even talk about it,” said Jones, whose 68-year-old father has had surgery to remove a brain tumor and now is receiving radiation treatments. “It’s only been six weeks. It’s such a devastating diagnosis.”

McCain’s diagnosis comes as the U.S. Department of Veterans Affairs is under increased pressure to broaden who’s eligible for Agent Orange-related compensation. During the war, the military sprayed millions of gallons of the herbicide in Vietnam to kill enemy-covering jungle brush, and in the process, may have exposed as many as 2.6 million U.S. service members — including McCain.

News of his illness has prompted Amy Jones and others to call on the VA to study a possible connection between their loved ones’ Agent Orange exposure and glioblastoma.

Under current policy, the agency makes disability payments to veterans who develop one of 14 health conditions, but only if they can prove they served on the ground in Vietnam, where the chemicals were sprayed. Veterans who served off the coast in the Navy and those with other diseases not on the list — such as brain cancer — are left to fight the agency for compensation on a case-by-case basis.

Those with glioblastoma — or widows seeking survivor benefits — must prove the disease was “at least as likely as not” caused by Agent Orange, a cumbersome process that often takes years and more times than not results in denial.

Although McCain primarily served at sea from the deck of an aircraft carrier — and survived more than five years in a prison camp after his plane was shot down over North Vietnam — the VA would presume he was exposed to Agent Orange because he also spent time on the ground in Saigon.

Still, McCain never has sought to connect any of his health troubles, including prior bouts with skin cancer, with Agent Orange exposure and has a mixed record when it comes to compensating fellow veterans for wartime exposures. His office did not respond to emailed questions about a possible link between glioblastoma and the chemical.

As a senator, McCain voted to approve the original 1991 law that directed the VA to presume every veteran who served in Vietnam was exposed and to begin compensating those with illnesses scientifically linked to it.

Are You a Vietnam Veteran?

Help us investigate the impact of Agent Orange. Share your story.

In 2011, however, as many Vietnam veterans aged into their 60s and 70s and annual disability payments to them swelled to more than $17 billion, McCain spoke in favor of an amendment that would have required a higher standard of scientific proof before any new illnesses would be covered.

The goal, McCain said in a floor speech, was to ensure that veterans who actually deserved compensation received it, “but at the same time not have a situation where it is an open-ended expenditure of taxpayers’ dollars.” The amendment was defeated — and since then, Vietnam vet disability payments have grown to $24 billion a year — and the episode damaged McCain’s reputation with veterans groups.

In a statement, a VA spokesman said the agency currently does not recognize a connection between Agent Orange exposure and brain cancer but is examining the topic anew in light of the questions that have been raised. In March, the VA asked a National Academy of Medicine panel studying the effects of Agent Orange to focus special attention on glioblastoma. (Previous reports by the group have not found a connection.) The VA also is asking about brain cancer in a sweeping survey of Vietnam veterans now underway.

VA data provided to ProPublica last fall shows that more than 500 Vietnam-era veterans have been diagnosed with glioblastoma at VA health facilities since 2000. That doesn’t include the unknown number diagnosed at private facilities.

ProPublica and The Virginian-Pilot reported last year how widows of Vietnam vets were banding together to push the VA to add glioblastoma to its list of diseases linked to Agent Orange. Through a Facebook group, they support one another and offer advice on navigating the VA’s labyrinthian process for seeking disability and survivor benefits.

Since news of McCain’s illness broke last week, dozens like Jones have joined the group, whose members mostly include widows and surviving relatives, but also some veterans living with the disease. “Every one of us, our phones were blowing up the day it came out” that McCain had glioblastoma, said Kathy Carroll-Josenhans, one of the group’s leaders.

The group now has some 450 members, about double its size in December.

One of their challenges is that the VA’s handling of claims related to glioblastoma has been somewhat inconsistent. Between 2009 and last fall, the Board of Veterans’ Appeals, the VA’s in-house tribunal for adjudicating benefit denials, issued more than 100 decisions in cases in which widows have appealed benefits denials related to their husbands’ brain cancer, according to a ProPublica analysis of board decisions. About two dozen won. (Here are two additional approvals from this year.)

Brad Riddell, a 35-year-old communications specialist living in Austin, Texas, is not a member of the Facebook group but immediately thought of his father when he heard about McCain’s illness. His dad, Jerry Riddell, served in a Navy construction battalion in Da Nang during the war and routinely came in contact with Agent Orange, which was used to clear brush before paving roads and runways.

Jerry Riddell, a Vietnam vet, was diagnosed with glioblastoma when his son, Brad, was in high school. He died 14 months after his diagnosis. (Courtesy of Brad Riddell)

Riddell was in high school when his father had a seizure while driving from work one day. A brain scan later that day revealed a tumor the size of a grapefruit and a medical term that still makes Riddell shudder: glioblastoma.

His father endured three surgeries — including two at MD Anderson Cancer Center in Houston — before doctors told him there was nothing more they could do. He entered hospice and died in February 1999, just 14 months after the diagnosis.

“I absolutely thought about dad when I heard about McCain,” Riddell said. “Anytime I hear that diagnosis, it just feels like, ‘Man, that person is a goner.’ It’s terrible.”

After his father’s death, Riddell’s mother gave him a bag of his military records and told him to hold onto them: “She said, ‘You need to have all these records in case there‘s ever a connection made between your dad’s cancer and Agent Orange.’”

In the wake of the McCain news, Riddell wonders if it’s time to pull the records out.

Heidi Spencer had a similar revelation a year ago. Her father, Jack Niedermeyer, died of glioblastoma at age 58 in June 2004. Her mother didn’t think to apply for benefits until last year when someone at the local Veterans of Foreign Wars post where she works suggested it. Spencer helped her mom fill out the application and the VA approved it in March.

“He never knew his cancer came from Agent Orange. He never talked about his service,” she said of her dad, who worked in a steel mill in Pittsburgh and had six kids.

Spencer, 42, found her dad’s commanding officer in the Marine Corps, who wrote a letter saying her dad had been sprayed by Agent Orange.

“The more you research it, the more it comes into light,” she said. “The VA needs to look at this, they need to link it and they need to look at his [McCain’s] diagnosis and whether or not the Vietnam War played a role in him getting his disease.”

In approving her mom’s claim, the VA wrote that glioblastoma was not recognized as a disease that automatically warranted benefits linked to Agent Orange but that “current medical research has shown a causal relationship between herbicide exposure and glioblastoma multiforme.” This is contrary to the VA’s official policy.

Regardless of McCain’s position on the matter, advocates hope his diagnosis will spark a conversation.

In a statement last week, John Rowan, the president of Vietnam Veterans of America, said he was saddened to learn “yet another Vietnam veteran” had been diagnosed with glioblastoma.

“Unfortunately, brain cancer is not on the presumptive list for exposure to Agent Orange,” Rowan said in a statement, “despite the efforts of our fellow veterans and their family members.”

Read prior articles on the effects of Agent Orange on veterans and their children. Share your story.


          Is this Story Real? 248,000 Veterans Die Waiting for Health Care from VA        
There’s a Huffington Post story that is suggesting that 248,000 soldiers have died waiting for Veterans Affairs health care. The whistleblower, Scott Davis, provided the Huffington Post with a Veterans Affairs report that includes this statistic. While there’s little doubt that the VA could be better, this statistic alone doesn’t really tell us much. For... Read more »
          Trump’s 2018 Budget Blueprint (link)        
President Trump’s White House released today his budget proposal for 2018. Scroll down for winners and losers. The budget is called “America First – A Budget Blueprint to Make America Great Again.” Here is the link to the budget (PDF): #https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/budget/fy2018/2018_blueprint.pdf WINNERS – Defense Department: INCREASE: $52.3 billion, 10% – Veterans Affairs: INCREASE: $4.4 billion, […]
          Different kind of transfer        
10/25/2013
Liz Beaulieu

CARSON, Calif. – Shoprider has diversified its product portfolio with an exclusive agreement to distribute Barton Medical’s transfer chair to the Veterans Affairs and homecare markets.

Driving Shoprider’s decision: Unlike power wheelchairs and scooters, where the company does the bulk of its business, transfer chairs have not been included in competitive bidding, says John Wright, senior vice president of sales and marketing.

“With all the issues surrounding the program, we’re diversifying,” he said. “This is a departure from what we’ve done in the past.”

The transfer chairs recline to a prone position, allowing for easy lateral transfers from chair to bed or bed to chair. Medicare covers the chairs under codes E1035 or E1036 (heavy duty) for bed-bound patients who require assistance to transfer. Reimbursement varies, but on average, it’s about $6,800 over 13 months.

While the transfer chairs are a “departure,” they’re a good fit for Shoprider and its provider customers, Wright says.

“It’s kind of linear to what we do,” he said. “A patient may progress from a walker to a rollator to a wheelchair to a bed. Once they’re in a bed, how do you get them mobile again?”

Shoprider hopes to put enough sales muscle behind the transfer chairs to give competing sling-type lifts a run for their money. 

“There are just a lot of things going on with (a sling-type of lift)—you’re getting them into the sling, you’re cranking them up, you’re steadying them and, at the same time, trying to position them into a wheelchair,” Wright said. “Also, there are bariatric patients who can’t use them.”


          A Senate still in the balance         

After all the dust stirred up by Vermont Sen. Jim Jeffords abandoning the Republican Party and thereby putting Democrats in control of the Senate for the first time since 1994, what effect will his decision have on policymaking in Washington?

Not all that much.

Mr. Jeffords's action puts more short-term pressure on the new Senate majority leader, Tom Daschle to deviate from the wishes of his party's core constituencies as much as it does on President Bush to be less mindful to his.

In philosophy as well as tone, the Democratic Senate that Mr. Daschle will lead much resembles the one voters turned out six years ago. Nearly all committee chairmen will be decidedly more liberal, not only compared with Republicans they replace, but with Daschle himself.

Of the expected lineup - Sens. Ted Kennedy of Massachusetts (Health and Labor); Patrick Leahy of Vermont (Judiciary); Paul Sarbanes of Maryland (Banking); Carl Levin of Michigan (Agriculture); Chris Dodd of Connecticut (Rules); Tom Harkin of Iowa (Agriculture); Robert Byrd of West Virginia (Appropriations); Fritz Hollings of South Carolina (Commerce); Joseph Biden of Delaware (Foreign Relations); Jeff Bingaman of New Mexico (Energy and Natural Resources); Kent Conrad of North Dakota (Budget); John Kerry of Massachusetts (Small Business); Joseph Lieberman of Connecticut (Government Affairs); Max Baucus of Montana (Finance); and Jay Rockefeller of West Virginia (Veterans Affairs) - only Mr. Lieberman and Mr. Bingaman could be accurately described as "new Democrats." (Mr. Bachus, up for reelection next year, has supported Mr. Bush's tax cuts.)

As a group and as individuals, all the others have been more hostile to tax cuts, friendlier to heavy regulations, and opposed to increased defense expenditures. They more resemble the kind of Democrats that Bill Clinton displaced as he became the second Democratic president elected since Lyndon Johnson and only the first reelected since Franklin Roosevelt.

If Daschle articulates the sentiments of these chairmen - or his caucus - he risks casting his party outside the national "mainstream." That would yield the center to Bush. Another risk inherent in that strategy is the likelihood that one of the 12 Democrats who supported Bush's budget will rebel. It will only take a switch of one senator to hand power back to the Republicans. If Daschle tries to blur the lines, those on his far left may abandon him. That would weaken the Democrats' ability to push an agenda.

As the most visible and, now, most powerful Democrat, Daschle joins the ranks of potential presidential hopefuls. That should bring competition from at least five other Democratic Senators who fancy themselves as their party's next standard-bearer - in addition to his other challenges.

While adjusting his strategy and outreach efforts slightly, Bush can be expected to argue that it is he who is more in sync with public opinion when it comes to tax cuts, military preparedness, partial privatization of Social Security, and education. The easy passage of his budget plan - along with 12 Democratic senators voting for his tax cuts - strengthens his case. And he will still enjoy support from the Republican-controlled House of Representatives. Its members will have a say both on the floor and in critical bicameral negotiations.

Daschle, meanwhile, will be facing a second set of problems. As his predecessor, soon-to-be former majority leader Trent Lott discovered, unlike the House of Representatives, Senate rules allow the minority party and individual senators ample opportunities to thwart the will of the majority of the chamber. Sixty votes are needed to curtail filibusters. (Jefford's action leaves 50 Democrats, 49 Republicans, and 1 independent.)

Even in the one area where majority control conveys increased power, that of control of the floor, Democrats may have a harder time than expected. History and tradition holds that the entire Senate considers Supreme Court nominees. With the president in command of the "bully pulpit," public pressure and expectations may compel the most reluctant of majorities to grant "up" or "down" votes on other nominees and measures.

Then there is the matter of Bush's veto. In the unlikely event the president's ranks in the House fail to hold, neither Daschle nor his House counterpart, minority leader Dick Gephardt, are likely to muster the two-thirds necessary to override him. And, Vice President Cheney will still be on hand in the Senate to break ties in Bush's favor.

Finally, Daschle will have to contend with the circumstances surrounding Jeffords's defection. The public dangling of a major committee chairmanship before him undercuts the justification the senator supplied for his action: principle. By accepting a change in party control of the Senate, without a vote from the people (whether through special election in Vermont or in upcoming off-year special elections in 2002), Daschle and his colleagues leave themselves open to charges that they took power through a backroom deal or "coup." That leaves their adherents in less of a position to question the "legitimacy" of Bush's election.

When all is said and done, politics in the nation's capital will proceed much as before.

Alvin S. Felzenberg directs the Mandate for Leadership Program at the Heritage Foundation. He writes and lectures on the presidency and other American political institutions.

(c) Copyright 2001. The Christian Science Monitor

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          July 2016 Highlights        
Editor-in-chief Shawn Kennedy and Clinical Editor Betsy Todd present the highlights of the July issue of the American Journal of Nursing. On this month’s cover is Moonrise Over the Sandias (2015) by Charles Kaiman, a painter and a psychiatric nurse at the New Mexico Veterans Affairs Health Care System in Albuquerque. Our first CE, “Appropriate Use of Opioids in Managing Chronic Pain,” discusses current best practices for prescribing opioids for chronic pain, emphasizing patient assessment and essential patient teaching points regarding safe medication use, storage, and disposal. In our second CE, “Moral Distress: A Catalyst in Building Moral Resilience,” the authors outline the concept and prevalence of moral distress, describe its impact and precipitating factors, and discuss promising practices and interventions. Our next article, “Diabetes Under Control: Prediabetes: What Nurses Need to Know,” provides an overview of prediabetes criteria and reviews the evidence showing that interventions targeting modifiable risk factors—such as diet and physical activity level—can prevent or delay progression to type 2 diabetes. In “Teaching for Practice: Strategies for Successful Clinical Teaching,” the authors offer strategies for clinical teaching with an emphasis on the importance of creating a positive learning environment. In addition, there’s News, Reflections, Drug Watch, Art of Nursing, and more.
          Does Trump Want to Put Generals in Charge of Everything?        

This is getting to be a bit much. After President-elect Donald Trump chose retired generals to be his national security adviser and his secretary of defense (the latter requiring a special waiver from Congress, granted only once before, in 1950), I figured that David Petraeus was probably out of the running for secretary of state; even Trump might not want to stack his Cabinet with too many stars and bars. But now that he’s picked John Kelly—another retired general, this one, like James Mattis, a marine—to be secretary of homeland security, I’m thinking maybe he wants to put generals in charge of everything.*

A big question about these appointments—besides the larger one concerning civilian control not just of our military but of our government—is whether these generals have what it takes to run a large federal bureaucracy. The Department of Homeland Security isn’t just a large bureaucracy, with 240,000 employees and a $41.2 billion budget (the third-largest federal department, after Defense and Veterans Affairs)—it’s a hodgepodge of entities, slammed together in one of the most thoughtless reorganizations in recent history.

The department was the brainchild of Joseph Lieberman, then a Democratic senator from Connecticut, who, after the 9/11 attacks, put forth the view that every federal agency having anything to do with securing the homeland—22 agencies, once under the rubric of eight separate Cabinet departments—should be corralled into one big tent. You’ve got immigration, Customs and Border Protection, the Federal Emergency Management Agency, the Coast Guard, the Transportation Security Administration, the Secret Service, and national cybersecurity, among others. The problem, as it’s turned out, is that the secretary of this omnibus department can focus on just two or three of its two-dozen functions, meaning that the other functions are relegated to assistant or deputy assistant (or assistant to the deputy assistant) secretaries, meaning that they get lost in the shuffle and never get any face time with the president.

It’s probably impossible for any one person to run the Department of Homeland Security.

That said, Trump could have done worse than to appoint John Kelly. As senior military assistant to Secretaries of Defense Robert Gates and Leon Panetta, Kelly struck several who worked with him as intelligent, disciplined, and an all-around good guy. His letters of condolence to Gold Star families, especially after he lost his own son to a landmine in Afghanistan, have been passed around by their recipients as testimonials to his own deep and eloquent compassion. More pertinent, his service as commander of Southern Command—which controls U.S. military operations in Latin America and the Caribbean—gave him expertise in issues of border control.

But there’s another commander of Southern Command who can lend military advice on border control—and a commander of Northern Command who can do the same on broader issues of homeland security. Does Kelly have the staff experience to run a gigantic bureaucracy such as DHS, or is Trump just going to get two sources of military advice? One might argue that Kelly’s military sensibility might knock some discipline and rigor into this ramshackle department, and maybe it will—but the department might be too ramshackle, too resistant to rigor, for it to matter.

If Trump really wants to “drain the swamp,” DHS might be one plug to pull. Split it up into three or four coherent departments, each with a Cabinet secretary (or deputy secretary) who could give their missions the attention they require. John Kelly might be just the right guy to do that.

*Correction, Dec. 7, 2016: This piece originally misidentified John Kelly as John Allen. (Return.)


          Well, That Was a Waste of Time        

What an ill-focused forum, a senseless not-quite-debate, another wasted hour in an election season that’s been more wasteful and dispiriting than anyone could have imagined possible, until it gets more dispiriting still.

The Iraq and Afghanistan Veterans of America, which sponsored Wednesday’s “commander-in-chief forum,” as they called it, is a laudable organization, and the tragedy of our wounded warriors and the mess of the Veterans Affairs system warrants more attention. But a back-to-back Q-and-A with the two main presidential candidates might not be the best place. A veteran in the audience asks what they think of the high rate of suicides among his comrades-in-arms, and what answer can anyone expect but “It’s terrible, I plan to do something about this, go read the position paper on my website.”

The moderator, NBC’s Matt Lauer (who proved himself unready from Moment 1), grilled Hillary Clinton on her emails—entirely appropriate, but then two of the veterans in the audience also grilled her on the emails. (Were the questions screened?) By the time Lauer got around to asking her about the Iran nuclear deal and she started to explain the deal’s context, he interrupted and urged her to make her answer quick. He did that a couple of times.

Lauer put some challenging questions to Donald Trump as well, asking, for instance, what in his experience made him qualified to be commander-in-chief. He replied, “I built a great company, I’ve been all over the world, I’ve dealt with foreign countries. … I have great judgment, I know what’s going on”—saying (and being asked) nothing about his company’s four bankruptcies, the fleecing of vendors, or the fundamental difference between running a business (where there’s a clear profit-loss tally) and running a country (where there are competing views of what the goals should be).

Asked how he’s been preparing for the awesome job of commander-in-chief, should he be elected, Trump referred to the 88 generals and admirals who recently endorsed him without noting that he’s consulted, or even talked with, very few of them. He then said, as he’s said before, “I think also I really feel I have a common sense on the issues”—proving yet again that Trump is that most dangerous man: a prospective national leader who doesn’t know just how much he doesn’t know.

Lauer then recalled Trump’s statement, a few weeks ago, that in the heat of a campaign, he sometimes says things that he regrets, and asked if this is a quality one should seek in a president. Trump replied, “I regret, but in the meantime, I beat 16 people”—referring to his primary opponents—“and here I am.” To Trump, it’s all about the popularity. Similarly, when asked about his admiration of Russian President Vladimir Putin, he noted Putin’s 82 percent popularity rating among his people, making him, Trump said, a better leader than President Obama.

Trump disputed Clinton’s remark in the first half of the forum that he, too, had initially supported the invasion of Iraq, saying that he opposed the war in a 2004 issue of Esquire. But the invasion took place in 2003, and he told Howard Stern a few months before its launching that he favored the war—just as he also, in fact, favored U.S. military intervention in Libya, for which he lambasted Clinton, blaming her for the chaos that ensued.

The most jaw-dropping moment may have come when he said that we could have preempted the rise of ISIS if only we’d taken Iraq’s oil. “It used to be ‘To the victors belong the spoils,’ ” he said—thus confirming every anti-American’s deep belief that our foreign policy is driven by rapacious imperialism. How would you take the oil? Lauer asked. “We’d leave a group behind, we would take sections that have the oil,” Trump replied, as if that were the easiest thing in the world.

Trump used to say that he had a plan to defeat ISIS “very fast,” but recently he said he would ask his generals to give him a plan within 30 days on how to do so. Is that his plan, Lauer asked: to get others to come up with a plan? “No,” Trump replied, “but when I do come up with a plan that I like—I may love what the generals come up with … I have a plan … maybe a combination of my plan and the generals’ plan”—without once hinting, even broadly, what his plan entailed.

Then again, Hillary Clinton didn’t do so well at this forum either. She started strong. Asked to list the most important character traits of a commander-in-chief, she replied, “Steadiness … mixed with strength … someone who listens, who evaluates … who is able to sort out the very difficult options and make the decision,” like the one that she helped make to raid Osama Bin Laden’s lair. She was listing the traits that she most clearly possesses and Trump most clearly lacks.

Then came the onslaught of questions about emails, the Iraq vote, and Libya—for which she’d prepared answers that were coherent (if not quite convincing to viewers who hold those issues against her). She mounted a good defense of the Iran nuclear deal, summarizing her stance on Iran in general as “distrust but verify.” She rattled off the many things she’s done and bills she’s helped pass to assist veterans—more than Trump has done.

But she took a strange route when it came to the war against ISIS. She said she supported airstrikes, special-ops forces, and enablers to help Arab and Kurdish ground fighters—but, she added, no U.S. ground troops. “We are not putting ground troops into Iraq ever again” or in Syria either. Well, we have put a few thousand ground troops in Iraq and Syria: That’s what those special-ops forces and enablers are. She might have been more precise had she pledged not to escalate beyond the levels or types of troops in place now—but it’s hard to say what precisely she thinks.

Then again, she clearly thinks something, she thinks about these issues, she’s thought about them a lot, though sometimes, as she now admits, to mistaken conclusions—whereas Trump has never thought about them at all yet believes he’s a sage.

This was the choice laid out before us: on the one hand, a flawed, sometimes slippery, but capable, intelligent, tough woman well-versed in all levels of politics and diplomacy—on the other hand, a man who thinks he’s all those things but isn’t any of them. But there was one moment that may have stood out in the minds of the undecided—when Trump said of Clinton, “She’s been there for 30 years. We need change.”

It was the same tack he took when he tried to appeal to black Americans by saying, “What have you got to lose?” It didn’t work with black Americans. For one thing, he made the remark to an all-white audience. For another, black life in America isn’t the unrelieved hellhole that he depicted. Trump spent his time Wednesday night—and in a speech earlier in the day—painting America’s military as “depleted,” its foreign policy as “disastrous,” and its generals (except for those supporting him) as “reduced to rubble” under the leadership of Barack Obama and Hillary Clinton. His speech was jammed with mendacity, comparing the number of U.S. warships and jet fighters with those of decades ago (without noting the enormous difference in quality) and claiming that Obama has shrunk the military budget (when in fact it’s larger than it has been for the last 30 years).

Hillary Clinton wasn’t asked about any of these matters. But if Trump’s big lies are believed, if people (most of whom don’t experience foreign policy in their everyday lives) are convinced that we’re getting weak, growing limp, and so “we need change,” even from someone who seems so improbably cast for the job, he might sway votes his way, even on this issue, where the contrast between the two candidates is so enormous—vaster than the contrast between any two candidates in modern times—that the contest should be tipping effortlessly the other way.

Read more from Slate on the 2016 campaign.


          LM Statement on Ryan McCarthy and Jim Byrne Appointments to US Government Roles        
Two Lockheed Martin leaders have left their positions at the company following appointments by the U.S. Senate to new roles in the Department of Defense and Department of Veterans Affairs. Ryan McCarthy, formerly vice president of F-35 Sustainment, was confirmed as undersecretary of the Army and appointed as acting secretary of the Army. Jim Byrne, formerly Lockheed Martin's chief privacy officer and associate general counsel, was confirmed as general counsel for the Department of Veterans Af...
          Re: Laura Troquille Vercher        
Hi,

1900 Natchitoches Par.
Frank Troquille, b. LA May 1828, farmer
Mary A., b. LA Dec 1866, 9/7 ch
Elizabeth, b. LA Oct 1881, farm laborer
Albert, b. LA, Dec 1882, farm lab
Adam, b. LA Oct 1884, farm lab
Lizzie, b. LA May 1887, farm lab
Josephine, b. LA May 1890
Lisa, b. LA Dec 1893
Mary, b. LA aug 1894

1910 Natchitoches Par.
Albert Troquille, b. LA, 26, M1-7yrs, general farmer
Lizzie, b. LA, 21, 3/3 ch
Azelie, dau, b. LA, 5
Louanna, b. LA, 3
Mitchell, b. LA, 1

1920 Natchitoches Par.
Albert Troquille, b. LA, 37, farmre
Lizzie, b. LA, 32
Azelie, b. LA, 14
Lavonna, b. LA, 12
Michael, b. LA, 10
Laura, b. LA, 8
Louise, b. LA, 6
Frances, dau, b. LA, 4
Lucie, b. LA, 2

1930 Natchitoches Par.
Albert Troquette, b. LA, abt. 1882, general farmer
Elizabeth, b. LA, 42
Laura, b. LA, 18
Louise, b. LA, 16
Florence, b. LA, 14
Lucille, b. LA, 12
T. C., son, b. LA, 10
Gertrude, b. LA, 8
Ellis, b. LA, 5
Albert Jr., b. LA 3 6/12ths

1940 Natchitoches Par.
Albert Troquille, b. LA, 58, fcotton farmer, education=1st grade
Lizzie, b. LA, 46, educ=5th grade
Florence, b. LA, 22, lab cotton farm, educ=5th grade
Lucille, b. LA, 21, housekeeper private family, educ=7th grade
T. C., b. LA, 19, laborer cotton farm, educ=5th grade
Ellis, b. LA, 17, laborer cotton farm
Albert, b. LA, 14
Kay, son, b. LA, 10
Frank, father, b. LA, 73, widower, educ=none

Albert Troquille
Born: 28 Dec 1881, Gorum, Natchitoches, LA
Father: Frank Troquille
Mother: Marian Martin
Notes: Nov 1941, name listed as Albert Troquille
Source: U. S. Social Security Applications & Claims Index 1936-2007

Albert Troquille
Born: Dec 28, 1881
Died: Oct 9, 1946
Buried: Gorum Cemetery, Gorum, Natchitoches, LA
Source: www.findagrave.com

I'd contact the following and ask about Albert's obituary.

Central Louisiana Genealogical Society, www.rootsweb.ancestry.com/~laclgs/

Natchitoches Genealogical & Historical Association, www.rootsweb.ancestry.com/~langha/

now back to Laura

1940 Natcitoches Par
Millard Vercher, b. LA, 29, farmer, educ=4th grade
Laura, b. LA, 27, educ=5th grade
Millard, b. LA, 7
Charles, b. LA, 5
Rabon Lee, son, b. LA, 2?

Laura T. Vercher
Born: 5 Oct 1911
Last Res: Pineville, Rapides, LA
Died: 13 Dec 2000
Source: U. S. Social Security Death Index 1935-2014

Laura Troquille Vercher
Born: Oct 5, 1911
Died: Dec 13, 2000
Buried: Emmanuel Cemetery, Chopin, Natchitoches, LA
Source: www.findagrave.com

I'd contact the Rapides Parish Library, http://innopac.rpl.org:81/search/ and ask about a copy of her obit.

Paul Vercher
Born: 19 Dec 1909
Military Enlistment: 23 march 1944
Release Date: 10 Dec 1945
Died: 18 Sept 2006
Source: U. S. Dept. Veterans Affairs BIRLS Death File 1850-2010

Paul Millard "Millard" Vercher
Born: Dec 19, 1909
Died: Sept 18, 2006
Buried: Emmanuel Cemetery
Source: www.findagrave.com

Paul Millard Vercher
Born: 1910
Died: 18 Sept 2006
Obit Date: 19 Sept 2006, Alexander Daily Town Talk, Alexandria, VA
Source: U. S. Obituary Collection 1930-2017
Successful Searching!
          Appropriations outlook for housing, FY 2017 and 2018        
by Kaitlyn Snyder

As NHC's Ethan Handelman predicted in an earlier appropriations discussion, appropriations for both Fiscal Year (FY) 2017 and 2018 are indeed messy, again. Funding for the federal government for FY 2017 is set to expire on April 28. Senators return from a two-week recess on Monday, April 24 and representatives return on Tuesday, April 25, leaving just a few days to pass a bill. Of the 12 spending bills, 1 (military construction and veterans affairs) has already passed both chambers of Congress and become law, another (defense) was passed by the House and now awaits passage by the Senate. We expect to see the remaining 10 bills attached to the defense bill, pass the Senate, and then go back over to the House for a final vote. To achieve this, we expect Congress to pass a short-term Continuing Resolution that will fund the federal government for a week or so, and then pass a larger bill that will fund the government for the remainder of the fiscal year, till September 30th, 2017.

However, complicating matters is President Trump’s request to cut $18 billion from discretionary spending programs for the remainder of FY 2017. Cutting $18 billion over the remaining 5 months of the fiscal year would amount to zeroing out entire programs. HUD alone would face about $1.7 billion in cuts coming from the Choice Neighborhoods Initiative (-$125 million), the Community Development Block Grant (CDBG) (-$1,494 million), and the Self-Help Homeownership Opportunity Program (SHOP) ($56 million). Congressional leaders from both parties have largely dismissed the cuts and are hoping to stick to the agreed upon funding in the Bipartisan Budget Act of 2015 which raised the sequester caps. Should Congress pass a spending bill that largely ignores the president's proposed cuts, President Trump could decide to veto the bill. It is unlikely that the bill will have a veto-proof majority, leaving an alternative path uncertain. With the uncertainty around FY 2017 funding, public housing agencies have been administering fewer vouchers in case the program does get cut when Congress addresses FY 2017 spending. No cuts to housing programs have gone into effect yet. However, a full-term continuing resolution for FY 2017 would essentially be a cut to housing programs, discussed below.

Once the federal government is funded for the remainder of FY 2017, appropriators will immediately focus on funding for FY 2018. President Trump released his skinny budget in March and we expect to see a full budget in mid-May.  The skinny budget would keep the overall FY 2018 spending cap of $1.065 trillion set in place by the Budget Control Act of 2011, but increase the defense side of the budget by $54 billion and decrease the non-defense side by $54 billion. Under President Trump’s skinny budget, HUD faces a $6.2 billion or 13% cut for FY 2018. While the skinny budget did not provide much detail, it did propose eliminating CDBG, the HOME Investment Partnerships Program, SHOP, Choice Neighborhoods and Section 4. Altogether, eliminating those 5 programs would cut about $4.45 billion, meaning an additional $1.75 billion needs to be cut from the HUD budget to reach $6.2 billion. And that’s just within HUD; many housing programs that aren’t based within HUD would face similar cuts.

Appropriations for FY 2018 were already going to be messy because sequestration would take full effect in FY 2018. Notably, the full impact of the sequestration law has never taken place because Congress has found alternatives. The caps only applied to 6 of 12 months in FY 2013. FY 2014 and FY 2015 caps were raised by the Bipartisan Budget Act of 2013, otherwise known as the Murray-Ryan deal. FY 2016 and FY 2017 caps were raised by the Bipartisan Budget Act of 2015. Absent another bipartisan deal to raise the caps, non-defense discretionary funding would be cut by $3 billion from sequestration alone, only to be cut by an additional $54 billion from President Trump’s budget.

While congressional appropriators may not fully support President Trump’s request for $54 billion in cuts, the request alone has changed the discussion and made smaller, but still harmful, cuts seem reasonable. The HUD budget requires a 3-4% increase every year just to keep up with inflation and rising housing costs. So even keeping funding levels at current levels effectively amounts to a cut for HUD. The housing community must come together to stave off these proposed cuts. This is why the National Housing Conference has teamed up with groups like NDD United and the Campaign for Housing and Community Development Funding to support efforts for robust federal funding of affordable housing and other domestic programs that help lift families out of poverty and enable them to reach better outcomes.


          Supersize Rx: the impact of specialty drug spending and Hep C in 2014        

The number of people in the U.S. spending over $100,000 a year on prescription drugs tripled in 2014, according to Super Spending: U.S. Trends in High-Cost Medication Use, from The Express Scripts Lab. Express Scripts is a pharmacy benefits management company that manages over one billion prescriptions a year. The company analyzed prescription drug claims for 31.5 million health plan members for this study, in commercially insured, Medicare, and Medicaid plans. The big-dollar story in 2014 was Hepatitis C, with a relatively small patient population but a super-sized drug spend as the first chart shows: a very tall blue bar (Rx costs for patients exceeding $100,000 a year) and an almost imperceptible red bar (patient population). Compare this with the #1 drug spend for high blood pressure, or high cholesterol, with big spends and big populations. An important part of the spending story involves depression, which is quite often a co-morbidity with other diagnoses. Nearly 1 in 3 patients had at least one prescription for an antidepressant among patients with annual drug spending over $50,000. And, 2x as many patients taking a high-cost specialty medication also had at least one prescription for an antidepressant versus the overall patient population. Anti-depressant use was found quite likely among people with diabetes, cancer, Hep C, HIV, and Multiple Sclerosis. Treating the “whole patient” will help mitigate and rationalize wasteful and ineffective drug spending, Express Scripts believes, recommending a pharmacy providing integrated, coordinated care including specialist pharmacists, doctors, nurses, nutritionists and other professionals relevant for the particular patient — to personalize care. Health Populi’s Hot Points:  Earlier this week, Sen. Bernie Sanders (I-Vt.), who announced his candidacy to run for U.S. President in 2016, asked the Department of Veterans Affairs (the VA) to “invoke emergency powers) to make Hep C drugs available to veterans. This was prompted by the VA’s recent blockage of access to the drugs for veterans because the department had burned through the $400 mm earmarked for the drugs. The VA has about 20,000 patients on the Hep C drugs, but believes there are an additional 200,000 patients who have Hep C and do not have access to these specialty drugs. Sanders is quoted on his website from a letter he wrote to the Secretary of the VA: “Our nation’s veterans cannot and should not be denied treatment while drug companies rake in billions of dollars in profits….We must not allow corporate greed to stand in the way of this potential.” That’s the politics of the situation. About the time Sanders sent his letter to Secretary McDonald of the VA (link to PDF found on the page), this week Pharmaceutical Executive magazine named the Hepatitis C drugs Sovaldi and Harvoni the 2015 Brand of the Year. The 31-member editorial board of the magazine voted unanimously for this decision, which never happened before in the 9 years that the publication has crowned a Brand of the Year (previous products have included Copaxone (2014), Januvia (2013), Humira (2012), Gilenya (2011), Avastin (2010), Crestor (2009), Chantix (2008) and Merck’s Gardasil vaccine was the first award). Sovaldi’s first-year sales in 2014 were $10.3 bn in the U.S., a record for the launch of any new grand name drug. (Harvoni sales were $2 bn). Express Scripts forecasts that by 2016, spending on hepatitis C medications will exceed that of medications for high blood pressure and high cholesterol. “The explosive drug trend is led by new therapies that cost $1,000 a day, sometimes more than $100,000 per patient, and are taking a premium on already inflated treatment costs,” Express Scripts warns its key client base: employers and health plans. “These costs are unprecedented and unsustainable,” the PBM asserts. To help those employers and health plans anticipate their Hep C costs, Express Scripts and Accredo (the company’s specialty pharmacy arm) developed an online tool, the Plan Cost and Trend Calculator, available here. If you’re a person diagnosed with Hep C, do you pay that $1,000 a day? The second chart indicates that 0.22% of patients spent over $50,000 on Rx drugs in 2014, equal to about 576,000 people in the U.S. This group of patients represents 15.7% of total Rx costs, and 0.22% of patients. It’s instructive to look at the percent of patients with annual drug costs over $50K by health plan type, shown in the third chart. Note the doubling of the cost for patients enrolled in Medicaid between 2013 and 2014: this will be due in large part to the growth of new enrollees in health insurance plans, long missing the opportunity for health care access. Of course, those said employers will pay attention to the line item of commercially-insured patients, whose drugs costs above $50K grew from just under 10% to over 16%. There’s also good news for patients: on February 3rd, Gilead (which markets Sovaldi and Harvoni) said in its quarterly earnings call that it would reduce the price of the drugs on average 46% this year in the U.S. That’s because the company will face increased competition in the Hep C category — which will drive prices to treat the condition down, benefiting the entire value chain. Express Scripts’ report mentions that high-cost drugs have historically covered small patient groups, but increasingly the FDA is approving specialty formulations that will treat conditions diagnosed in larger populations. For example, watch for heart disease to grow in this expensive-drug category in and beyond 2016.  

The post Supersize Rx: the impact of specialty drug spending and Hep C in 2014 appeared first on HealthPopuli.com.


          Parade honours Modern NZ veterans        

Kua whakahōnoretia ngā ika ā whiro o nāianei e tētahi tira hīkoi i te tonga o Tāmaki Makaurau i Pukekohe. E ai ki ngā kaiwhakarite a Te Mana Pou Hōia o Franklin he mea nui te whakanui i ngā hōia kua hoki mai ki Aotearoa me ngā hōia ō mua kua riro i te tirohanga kanohi i tēnei wikene whakamaharatanga a Armitice.

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          VA Makes Last Minute Rule Change In Flight School Requirements        

An eleventh-hour decision by the U.S. Department of Veterans Affairs (VA) has left dozens of veterans stranded in Prescott, Ariz., with limited employment opportunities and families to care for, and once again


          National Gravesite Locator for Veterans        



The US Department of Veterans Affairs has amassed an online database of the burial sites for more than five million veterans.


The Nationwide Gravesite Locator can help families, friends, and fellow veterans locate the cemeteries and plots for veterans from the Army, Navy, Marine Corps, and any other military service.

Records can be searched on last name (full name, or a 'begins with' search). You can search the US as a whole, or specific cemeteries.

Search results include name, rank, date of birth and death, war service, and burial location.

For overseas burials, use the databases maintained by the American Battle Monuments Commission, which include foreign burial records for the Mexican and Spanish-American Wars, the Civil War, World Wars I and II, the Korean War, and the War in Vietnam. 



=================


Don't forget to also check for your family history at NewspaperArchive and Newspapers.com. These are subscription databases, but they are among the most powerful research tools available for looking into family roots. And visit the main page of Free Genealogy Tools for more, umm, free genealogical tools.

          Wreaths Across America        


REMEMBER the fallen

HONOR those who serve

TEACH our children the value of Freedom


This is the motto of Wreaths Across America, a nationwide project, started by one man who simply wanted to show his remembrance for fallen soldiers.

The Wreaths Across America story began over 15 years ago when Worcester Wreath Company (a for-profit commercial business from Harrington, Maine) began a tradition of placing wreaths on the headstones of our Nation's fallen heroes at Arlington National Cemetery during the holidays.

Humbled with a new understanding about the impact the Arlington Wreath Project has made, not only in honoring the dead, but recognizing the sacrifices of the living, Morrill Worcester - President of Worcester Wreath Company committed himself to doing more, by reaching out across the country.

On Saturday, December 13th, along with members of El Toyon Chapter NSDAR, I went to the San Joaquin Valley National Cemetery in Gustine, California to attend the wreath laying ceremony. It was a very moving experience. We laid wreaths on the graves of my step-father Lyle Dean Hartley, a past regent of El Toyon Chapter NSDAR Esther Bonta and the husband of a chapter member Milton Farley.

A little about San Joaquin Valley National Cemetery - In 1989, the Romero Ranch Company donated land to the Department of Veterans Affairs for the creation of a National Cemetery. The first phase developed 105 acres of the land, and was completed in May 1992, giving enough space for the interment of over 20,000 remains.
There is a small military museum on site, which has exhibits of uniforms, medals, and other memorabilia. The California Korean War Veterans Memorial, erected in 1998. It consists of 16 five foot tall granite monoliths arranged in a circle. Engraved on each monolith is the name of the 2,495 veterans from California who died during the Korean War. The 11th Airborne Memorial is a granite and bronze monument that was dedicated on May 11, 2002, in honor of all airborne soldiers. The sculptor was William Porteus, a member of the 511th unit.
(Photo of Arlington National Cemetery by James Varhegyi)

          Spinal Manipulation Can Alleviate Back Pain, Study Concludes        
One of the most common reasons people go to the doctor is lower back pain, and one of the most common reasons doctors prescribe powerful, addictive narcotics is lower back pain. Now, research published Tuesday in the Journal of the American Medical Association offers the latest evidence that spinal manipulation can offer a modestly effective alternative. Researchers analyzed 26 studies involving more than 1,700 patients with lower back pain. The analysis found spinal manipulation can reduce lower back pain as measured by patients on a pain scale — like this one — from zero to 10. Spinal manipulation, which is typically done by chiropractors, physical therapists, osteopaths, massage therapists and some other health providers, involves applying pressure and moving joints in the spine. Patients undergoing spinal manipulation experienced a decline of 1 point in their pain rating, says Dr. Paul Shekelle , an internist with the West Los Angeles Veterans Affairs Medical Center and the Rand
          Comment on Op Ed: Vets Do Not Want the VA Privatized by k9usafret        
I am a 100% combat-related disabled and retired veteran. Having worked in government for 36 years, I find that those in support of maintaining the VA are those who stand to gain either from the status quo, or who further the concept of big government programs. So I ask, does the IRS work, or the EPA, or the INS or most other departments of the government? I don't think so. The Department of Defense is in shambles, the Department of Homeland Security fails almost every inspection, the Department of the Treasury can't manage the Secret Service or the IRS, the State Department is running and ruining the military, the Justice Department is as jaded and corrupt as it has ever been. So my friends is the Department of Veterans Affairs. High paid civilians denying benefits to vets so they can give themselves huge bonuses, managers rigging appointments, denying medical care, and scamming the Human Resources system at $400,000 a crack. So they go to the VSOs and demand support and skewing of opinions to maintain a system where they win and we lose. There are lies and then there are damn lies. We need a system that is knowledgeable of veteran's health issues and provides service (including contracted health services) immediately and cost-effectively. But in an interview for a job I was told by the Chief Medical Officer that the mission was to deny payment to vendors whenever possible and that I better tow the "party line". Several years ago I wrote a series of articles that called for the VA to be torn down. Billions of dollars in property standing idle. Lawyers paid to deny veterans their constitutional rights. The list goes on and on. The current DVA is irrevocably broken. But the civilian health system is not adequately prepared to link veteran health issues with military service to the country. Much of that can be blamed on the DVA's failures to abide by the intent of the law, on misguided executives and managers who believe it is their job to "protect" Americans from patriots who must be lying about their health issues, and on the consequences of those issues on the lives and the deaths of tens of thousands of veterans. My continued belief is that the VHA should still be torn down, and that the rest of the DVA (VBA), the BVA, and the CAVC should be held to standards that exceed all other departments, and that comply with the laws as intended, without administrative rule writing that totally obscures the intent of the law and is patently unconstitutional.
          Grand Theft Economics: Veterans Agency Made Secret Deal With Prudential         
The U.S. Department of Veterans Affairs failed to inform 6 million soldiers and their families of an agreement enabling Prudential Financial Inc. to withhold lump-sum payments of life insurance benefits for survivors of fallen service members, according to records made public through a Freedom of Information request.
          News Wrap: Top VA health official resigns after testimony        

We're sorry, the rights for this video have expired. | Listen to the Audio

JUDY WOODRUFF: Firefighters wrangled five of the 10 wildfires burning around San Diego, California, today, thanks to cooler temperatures and calmer winds.

But at the Marine Corp’s Camp Pendleton base, two fires flared up overnight.  One grew from 600 to 8,000 acres.  Elsewhere, evacuees were permitted to return home to survey the damage.  Officials are still investigating the possibility of arson.  All told, 120,000 people were under evacuation orders at some point this week.

The U.S. Department of Transportation slapped a maximum $35 million fine on General Motors today for mishandling its ignition switch defects.  The problem affected some 2.6 million cars and, according to GM, resulted in at least 13 deaths.  It took the nation’s largest automaker nearly a decade to order recalls after engineers discovered the defect.

Transportation Secretary Anthony Foxx said that’s unacceptable.

ANTHONY FOXX, Secretary of Transportation: We know no one is perfect.  But what we cannot tolerate, what we will never accept is a person or a company that knows danger exists and says nothing.  Literally, silence can kill.

JUDY WOODRUFF: For its part, GM’s CEO, Mary Barra, issued a statement saying: “GM’s ultimate goal is to create an exemplary process and produce the safest cars for our customers.  They deserve no less.”

The top health official at the U.S. Department of Veterans Affairs has resigned.  Dr. Robert Petzel gave his resignation a day after testifying before a Senate panel on the department’s failures to provide adequate health care for the nation’s veterans.  It comes in the wake of allegations of treatment delays and falsified records at VA hospitals, including one in Phoenix, where allegedly up to 40 veterans died while awaiting care.

Twin blasts went off in the Kenyan capital of Nairobi today.  At least 10 people were killed and 70 more injured.  Police said two improvised explosive devices were detonated in a market area near Nairobi’s downtown.  The White House condemned the bombings, as the U.S. ambassador to Kenya requested more security and is reducing the number of staff stationed at the embassy in Nairobi.

In Turkey, protests against lax safety conditions in the country’s coal mines turned violent today.  Police fired water cannon, tear gas and rubber bullets into a crowd of thousands gathered in the town of Soma.  That’s where almost 300 miners were killed in an underground explosion and fire on Tuesday.  The Turkish government and the mine’s operators denied any negligence was to blame for the disaster.

On Wall Street today, stocks staged a late afternoon rebound.  The Dow Jones industrial average gained 44 points to close at 16,491.  The Nasdaq rose 21 points to close at 4,090.  The S&P 500 was up seven points to close above 1,877.  For the week, the Dow slipped more than half-a-percent.  The Nasdaq gained half-a-percent.  And the S&P was largely unchanged.

Jeb Magruder, who was jailed for his role in the Watergate scandal, died on Sunday of complications from a stroke.  Magruder worked as an aide to President Nixon and then helped run his reelection campaign in 1972.  It was then that he conspired to break into the Democratic National Committee headquarters at the Watergate and to bug the chairman’s phone.  In later years, Magruder claimed that he heard President Nixon order the break-in.  Jeb Magruder was 79 years old.

The post News Wrap: Top VA health official resigns after testimony appeared first on PBS NewsHour.


          U.S. Department of Veterans Affairs Purchases 28 Additional ReWalk Exoskeleton Systems to Support National Multi-Center Trial        

VA Begins Second Year of National Study of ReWalk Robotics Exoskeleton for Personal Use YOKNEAM ILIT, ISRAEL / MARLBOROUGH, MA, April 6, 2017 – ReWalk Robotics Ltd. (Nasdaq: RWLK) (“ReWalk”), leading manufacturer and producer of exoskeleton systems, announced today that the U.S. Department of Veterans Affairs (VA) purchased 28 ReWalk Personal Exoskeleton Systems to support […]

The post U.S. Department of Veterans Affairs Purchases 28 Additional ReWalk Exoskeleton Systems to Support National Multi-Center Trial appeared first on ReWalk – More Than Walking.


          Licensed Clinical Social Worker (PRRC) - Veterans Affairs, Veterans Health Administration - Fresno, CA        
Senior social workers must be licensed or certified by a state at the advanced practice level which included an ASWB advanced generalist or clinical examination... $72,168 - $93,821 a year
From Department of Veterans Affairs - Thu, 10 Aug 2017 02:34:50 GMT - View all Fresno, CA jobs
          Suburban limits exposure        
03/03/2010
Liz Beaulieu

WEST HARTFORD, Conn. - Suburban Home Medical doesn't have its eggs in one basket; it has them in four baskets.

The provider, which opened a new location in Colchester, Conn., in January, earns a living through retail sales; hospice contracts; wholesale contracts, mostly with the Department of Veterans Affairs (VA); and insurance payments from Medicare, Medicaid, Blue Cross Blue Shield and others.

"We're a well-balanced company," said Gregory Czapiga, one of Suburban's three owners. "Eight years ago, we had five employees. Now we have 40 employees, three locations, 12,000-square feet of distribution space and seven delivery vehicles."

Czapiga, along with James Czapiga and Richard Korris, bought Suburban Home Medical in December. He ran the company for eight years, and before that, he worked for Glastonbury, Conn.-based AeroMed for five years.

Suburban Home Medical relies on each payer group for about 25% of its business, limiting the company's exposure to national competitive bidding and other reimbursement cuts, Czapiga said.

"We analyzed the competitively bid items and they account for, literally, 8% to 10% of our total volume, business-wise," he said. "So we'll not only survive competitive bidding but also submit bids and maybe do well with it."

Industry watchers have been telling providers to diversify for some time, especially by adding retail sales, but Suburban Home Medical is ahead of most, says consultant Roberta Domos.

"I advise start-ups to try and limit Medicare to 40% to 50% of their payer mix," said Domos, who owns Redmond, Wash.-based Domos HME Consulting Group.

It's a strategy that Czapiga plans on spreading. Guided by Korris, who is a real estate developer, he hopes to open two new locations each year.

"We're looking at where there's a need driven by demographics, where the competition is, whether the market is saturated, what kind of referral sources are in the area--those kinds of things," he said. "We want to expand aggressively."


          After the War: Mental Health and a Veteran's Journey Home        
The wars in Iraq and Afghanistan have posed a unique set of psychological challenges to troops resulting from multiple tours of duty and a greater prevalence of brain injury, among other factors. Experts discuss the high rates of post-traumatic stress disorder and ways in which families, communities, and the nation can support mental wellness for veterans. The panel includes Kelly Kennedy, reporter for the Times News Service and former Rosalynn Carter Fellow for Mental Health Journalism; Sonja Batten Ph.D., assistant deputy director, patient care services officer for mental health, Department of Veterans Affairs; and Col. Thomas Carden, commander, 560th Battlefield Surveillance Brigade, Georgia Army National Guard. Dr. Thomas Bornemann, director of the Carter Center's Mental Health Program, moderates and former First Lady and Carter Center co-founder Rosalynn Carter provides opening remarks.
          twitter: #locationscout.us'd: News: Location Scout Dept Veterans Affairs: News: Location Scout ...        
rrhobbs: #locationscout.us'd: News: Location Scout Dept Veterans Affairs: News: Location Scout Dept Veterans Affairs News... http://t.co/PowUveBM

          nyc.locationscout.us: News: Location Scout Dept Veterans Affairs        
News: Location Scout Dept Veterans Affairs News: Location Scout United States Department of Veterans Affairs - if you missed this post last fall, the content has been published and the Photographer /...

R. Richard Hobbs | nyc.locationscout.us | New York City area film location scout, film location manager, film location library, location and production services for film, photo, video and tv.

          Odiogo Audio-Enriched Feed / nyc.locationscout.us Weblog: News: Location Scout Dept Veterans Affairs        

News: Location Scout Dept Veterans Affairs

News: Location Scout United States Department of Veterans Affairs - if you missed this post last fall, the content has been published and the Photographer / Director Robb Scharetq has posted some of the work on his website. Location Scout … Continue reading

New York City Area Location Scout - Location Scout + Location Manager R. Richard Hobbs


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          nyc.locationscout.us | news | rrhobbs.us: News: Location Scout Dept Veterans Affairs        

News: Location Scout Dept Veterans Affairs

News: Location Scout United States Department of Veterans Affairs - if you missed this post last fall, the content has been published and the Photographer / Director Robb Scharetq has posted some of the work on his website. Location Scout … Continue reading

New York City Area Location Scout - Location Scout + Location Manager R. Richard Hobbs


          Socialist security and psychiatrists collecting data on the homeless and income        
Clinicians routinely ask indigent new clients whether they receive Supplemental Security Income (SSI) payments or Social Security Disability Insurance (DI) benefits, and this information is incorporated into treatment planning. Using questionnaire responses by 7,220 homeless people with mental illness, we first determined what demographic and clinical factors were associated with reporting receipt of SSI or DI benefits and not being in the SSA database and, second, what factors were associated with reporting not receiving benefits but have SSA records indicating otherwise. The low agreement between client reports and administrative records suggests that clinicians should verify the information provided by clients, especially those who are psychotic or medically ill, because that information is often inaccurate. -Marc I. Rosen, MD, an Associate Professor of Psychiatry at the Yale University School of Medicine

 This comes from the social security website. It was written mostly by Dr Marc Rosen of Yale and demonstrates how intrusive and inefficient our government is, particularly social security.


Summary

Clinicians routinely ask people with disabling psychiatric illnesses whether they receive Supplemental Security Income (SSI) or Social Security Disability Insurance (DI) benefits. We looked at self-reported receipt of SSI or DI by 7,220 homeless people with mental illness and compared those self-reports with information in Social Security Administration (SSA) databases. Overall agreement between the two sources was only fair (kappa = 0.60), and 41.3 percent (934/2,257) of clients reporting receipt of SSI or DI were not in SSA's databases. In multivariate analyses, people reporting receipt of SSI or DI that is unconfirmed by SSA administrative records had disproportionately more severe psychotic and medical illnesses than confirmed nonrecipients. Among recipients identified by SSA, those who did not report receiving SSI or DI were more likely to claim, apparently incorrectly, that they instead received Social Security retirement benefits. Clinicians should verify basic demographic information provided by clients, especially those who are psychotic or medically ill, because that information is often inaccurate.

Introduction

People disabled by psychiatric illness depend on Supplemental Security Income (SSI) and Social Security Disability Insurance (DI) benefits to meet their basic needs. Disability payments provide critical financial support in preventing homelessness among the indigent (Sosin and Grossman 1991) and contribute to improved outcomes when homeless mentally ill people receive treatment (Rosenheck, Frisman, and Gallup 1995). Clinicians routinely ask indigent new clients if they receive SSI or DI, and this information is incorporated into treatment planning.
Given the importance of disability payments to people disabled by psychiatric illnesses, it is ironic that no prior studies have been done on the validity of self-reported SSI/DI status among the mentally ill. Some studies have described the low reliability (Jenkins and others 2005) and accuracy (Pedace and Bates 2001; Card, Hildreth, and Shore-Sheppard 2004; Jackle and others 2004) of self-reported income among poor people, but there are no studies to inform clinicians by describing specific psychiatric and medical characteristics of people whose self-reported SSI/DI status is inaccurate. The underreporting of symptoms and the inconsistency of information provided are considerable when people with substance abuse (Stephens 1972; Rounsaville and others 1981) or psychiatric disorders (Strauss, Carpenter, and Nasrallah 1978) are asked to describe their psychiatric history and symptoms. However, there is little data concerning whether homeless people with mental illness inaccurately report basic demographic information and, specifically, whether they accurately report receipt of SSI and DI.
There are several potential explanations for why clients might report SSI/DI receipt inaccurately. The misreporting of SSI/DI benefits may reflect neuropsychological deficits. Inaccurate self-reports might track related constructs like the degree of knowledge about one's medical care, which is lower in people with cognitive deficits and reading difficulties (Baker and others 1995; Kalichman and others 2000; Baker and others 2002). Another possibility is that inaccurate self-reported income is influenced by subtle social pressures to underestimate income. Evidence for the underreporting of income by poor people is that families reporting low income in the Labor Department's Consumer Expenditure Survey reported much higher expenditures, and low income and high expenses are difficult to reconcile (Jencks 1997).
The first goal of this study, conducted in 2004, was to document the degree of agreement between a client's self-report that he or she received SSI or DI benefits and SSA administrative records of whether the person was receiving benefits. We then characterized those clients whose self-reported SSI/DI status was not consistent with SSA administrative records using comprehensive clinical data, self-reported SSI/DI status, and SSA administrative data from participants in a large study of individuals who were homeless and mentally ill. This study first determined what demographic and clinical factors were associated with self-reports of SSI/DI receipt and not being in the SSA database; it then identified what factors were associated with reporting not receiving benefits but having SSA records that indicate otherwise.

Methods

Participants and Sampling

Participants were enrolled in the ACCESS (Access to Community Care and Effective Services and Supports) demonstration study, a study of service delivery strategies for homeless people with mental illness (Randolph and others 2002). In ACCESS, agencies in 18 cities offered Assertive Community Treatment (Stein and Test 1980) to 100 participants per year for 4 years. Participants were eligible if they were homeless, had a severe mental illness, and were not engaged in psychiatric treatment at the time of enrollment. Eligible participants were identified and offered case management services. After providing informed consent, a comprehensive set of assessments was completed.

Data Collection

Research assistants using structured interviews collected data. Basic demographic data included age, sex, children in residence, race and ethnicity, years of education, longest full-time job, and veteran status. Homelessness was characterized by age at the first episode of homelessness, number of times homeless, lifetime number of years homeless, and years living in the current city of residence. Legal status questions included questions about having ever been convicted or incarcerated. History of arrests (McClellan and others 1980) and victimization (Lehman 1988) within the last 60 days were also documented. Self-reported data concerning the presence or absence of 17 medical disorders and whether the client was taking prescribed medication were also recorded. Other self-reported symptoms quantified social support (Vaux and Athanassopulou 1987; Lam and Rosenheck 1999), service utilization (Rosenheck and others 2002), a history of conduct disorder (Helzer 1981), and stability of family of origin (Kadushin, Boulanger, and Martin 1981). Participants reported the number of days in the last 60 that they had been housed and the number of days in the last 30 that they had been employed. Overall quality of life was also assessed by the question "Overall, how do you feel about your life right now?" on a scale ranging from 1 (terrible) to 7 (delighted) (Lehman 1988).
Psychiatric diagnoses were those of the admitting clinicians on the case management teams. Psychiatric measures were derived from the Addiction Severity Index (ASI) psychiatric composite problem index, a depression scale derived from the Diagnostic Interview Schedule (Robins, Helzer, and Croughan 1981), and a psychotic symptoms scale derived from the Psychiatric Epidemiology Research Interview (Dohrenwend 1982). Depression was quantified as the number of symptoms of depression out of 5 endorsed by the client, and interviewer ratings of psychosis were derived from 13 items ranked on a 0–4 Likert scale.
Substance abuse was assessed by questions drawn from the Addiction Severity Index (McClellan and others 1980), and a referring clinician rated the patient's substance use on 5-point clinical rating scales anchored by 1 (abstinence) and 5 (severe dependence) (Mueser and others 1995).
Service utilization was measured by questions concerning receipt of six types of services: assistance from a public housing agency, mental health services, general health care, substance abuse services, public income support, and vocational rehabilitation. The number of services received was calculated. Finally, the research assistant rated the reliability of the participant's data on a 5-point scale.

Income Data

Participants were asked to record how much income they had received during the past month from a list of possible sources. Participants were also asked to record earnings for the current month, even if the money had not yet been received. The sources listed included earned income, Social Security retirement benefits, Supplemental Security Income, Social Security Disability Insurance, social welfare benefits from state or county governments such as general welfare and Aid to Families with Dependent Children (AFDC), and nine other potential sources of income. Participants were asked if there was anyone who "handles your money for you (like a payee or guardian)" and, if so, whether the client's checks were mailed directly to this person.
SSA's Office of Research, Evaluation, and Statistics provided client-level data on beneficiary status by cross-matching Social Security numbers of ACCESS participants with those in SSA's Master Beneficiary Record and Payment History Update System, which record payments from the DI program, and the Supplemental Security Record, which records payments from the SSI program. SSA provided data only when its files contained a corresponding Social Security number verified by date of birth. SSA's algorithm for determining whether there is a cross-match—the Enumeration Verification System—did not require the supplied dates of birth to exactly match those in SSA's databases. A Social Security number match was verified when the years of birth agreed or when the months agreed and the years differed by one year.

Data Analysis

The purpose of the study was to determine whether participants could distinguish SSI from DI from other sources of income. We were not concerned with whether participants could distinguish SSI from DI, so receipt of SSI or DI was considered a single measure (SSI/DI). Kappa was calculated to characterize the overall agreement between self-reported and SSA verification of receipt of SSI/DI. The kappa statistic describes the agreement between two dichotomous variables with a range of zero (no agreement) to 1 (perfect agreement). Then, two similar analyses were conducted. The first analysis determined demographic and clinical factors that differentiated people who reported receiving SSI/DI but were not in the SSA database from those who did not report receiving SSI/DI and were also not in the SSA database. Chi-square and t-test comparisons between the two groups were conducted on a broad range of measures. Measures that differentiated the two groups at p<.05 were entered into a logistic regression, and backward elimination was used to identify the most salient correlates at p<.01. A similar approach was employed to compare two other groups: those reporting that they did not receive SSI/DI but in fact were in the SSA databases as receiving benefits and those who reported receiving SSI/DI and were confirmed by SSA records.

Results

Sampling and Overall Agreement Between Self-Report and SSA Databases

Altogether, 16 percent of participants ([934 + 193]/7,220) reported SSI/DI status that was not verified by the SSA database (Table 1). The majority of the discordant reports were from participants who reported having received SSI/DI but were not in the SSA database (13 percent of the total sample) and 3 percent who reported not having received SSI/DI but in fact were in the SSA database. Kappa was 0.60, indicating moderate agreement between self-reports and SSA records (Cicchetti and Sparrow 1981).
Table 1. Agreement on SSI/DI receipt between self-reports and SSA records
Receipt of SSI/DI benefits verified by SSA records? Self-reported receipt of SSI/DI benefits?
No Yes
No 4,770 934
Yes 193 1,323
SOURCE: Self-report data were collected in the ACCESS demonstration and were cross-matched with the Social Security Administration's Master Beneficiary Record, Payment History Update System, and the Supplemental Security Record.
NOTES: The data include 7,220 observations.
Kappa = 0.60

Sample Characteristics by Self-Reported and SSA-Verified SSI/DI Status

The sample characteristics shown in Table 2 indicate, as expected, relatively long durations of homelessness and high rates of psychiatric comorbidity and substance abuse. All the measures in Table 2, within the groups of those who had and had not received SSI or DI according to SSA, significantly differentiated the participant group whose self-report was concordant with SSA from participants whose self-report was discordant with SSA's administrative records.
Table 2. Baseline characteristics, by SSI/DI status according to SSA records and self-reports
Characteristic Mean or percentage (standard deviation) of those with SSI/DI according to SSA Mean or percentage (standard deviation) of those without SSI/DI according to SSA
Self-report concordant with SSA (n = 1,323) Self-report discordant with SSA (n = 193) Self-report concordant with SSA (n = 4,770) Self-report discordant with SSA (n = 934)
Demographic
Age (years) 40.4(9.5) 43.6(13.7) *** 37.5(9.4) 40.3(9.2) ***
Sex (male) 67.0% 67.7% 61.9% 56.5% **
African American 51.2% 37.4% *** 44.9% 53.2% ***
Hispanic 3.1% 5.1% 6.3% 3.2% ***
English first language 3.9% 7.2% * 6.5% 4.2% **
Years of education 11.7(2.6) 11.5(3.0) 11.7(2.5) 11.1(2.6) ***
Vocational
Veteran 22.8% 26.8% 18.7% 13.2% ***
Years at longest full-time job 3.5(4.7) 4.7(7.6) ** 3.6(4.7) 2.4(4.4) ***
Days working in last 30 0.9(3.5) 1.2(4.3) 2.4(5.7) 0.7(3.2) ***
Years homeless 3.5(5.3) 3.3(5.9) 3.0(4.8) 3.9(6.0) ***
Days housed in last 60 12.8(18.3) 9.9(16.5) * 11.3(17.1) 12.6(18.0) **
Days incarcerated in last 60 1.3(5.9) 2.6(10.0) ** 2.2(8.3) 1.4(6.9) **
Income
Percentage reporting receipt of—
Social Security retirement income 3.7% 29.2% *** 0.6% 1.0%
Food stamps 35.2% 22.1% *** 48.9% 41.7% ***
Other social welfare benefit 4.5% 9.2% ** 23.7% 7.6% ***
Number of types of benefits received 0.5(0.6) 0.7(0.7) *** 0.8(0.8) 0.6(0.7) ***
Percentage reporting someone else receives and manages check 29.3% 21.2% * 4.4% 27.6% ***
Psychiatric
Schizophrenia 51.5% 52.8% 27.9% 53.9% ***
Bipolar 22.1% 19.5% 20.4% 17.2% *
Major depression 33.9% 31.8% 56.7% 32.6% ***
Lifetime psychiatric hospitalizations 8.5(12.3) 6.4(12.2) ** 3.0(6.2) 7.8(11.4) ***
Observer-rated psychosis 11.6(7.9)% 12.3(8.8)% 10.0(7.8)% 12.8(8.3)% ***
Depression symptoms (number out of 5) 2.7(2.1) 2.5(2.1) 3.5(1.9) 2.7(2.1) ***
Substance use
Clinician-rated alcohol use 2.2(1.3) 2.0(1.2) * 2.2(1.3) 2.2(1.3)
Clinician-rated drug use 2.1(1.4) 1.8(1.2) ** 2.0(1.3) 1.9(1.3)
Years of alcohol use 5.7(8.7) 4.9(9.0) 5.9(8.4) 4.6(7.8) ***
Years of cannabis use 5.9(8.6) 4.0(8.0) ** 6.0(8.2) 5.3(8.4) *
Years of cocaine use 1.8(4.5) 1.2(3.8) 2.0(4.5) 1.3(3.7) ***
Medical
HIV seropositive 4.8% 3.1% 2.5% 5.2% ***
Percentage diagnosed with seizure disorder 10.1% 10.3% 7.2% 11.6% ***
Baseline treatment in last 60 days
Percentage receiving psychiatric Rx 70.8% 60.8% ** 62.4% 71.4% ***
Percentage receiving substance abuse Rx 30.3% 23.6% 33.8% 28.5% **
Number of services accessed 2.4(1.0) 1.6(1.1) *** 1.6(1.1) 2.3(0.9) ***
SOURCE: Self-report data were collected in the ACCESS demonstration and were cross-matched with the Social Security Administration's Master Beneficiary Record, Payment History Update System, and the Supplemental Security Record.
* Significant difference from corresponding SSA concordant group at p<.05.
** Significant difference from corresponding SSA concordant group at p<.01.
*** Significant difference from corresponding SSA concordant group at p<.001.
Comparison Among Clients not Receiving SSI/DI According to SSA: Participants Self-reporting Receipt of SSI/DI versus Those not Self-reporting Receipt. In multivariate analyses, the measures that significantly (p<.01) distinguished the 934 individuals reporting receipt of SSI/DI (without SSA verification) from the 4,770 not reporting receipt (in concordance with SSA records) are listed in Table 3. The 934 participants with unverified reports of receiving SSI/DI were more impaired in several realms. They had disproportionately less education and employment and were disproportionately more likely to have been diagnosed with schizophrenia, human immunodeficiency virus (HIV), and seizure disorders.
Table 3. Logistic regression analysis of group who reported receiving SSI/DI among the sample of those without benefits per SSA records
Measure Odds ratio 99 percent confidence limits
Demographic, vocational, and housing
Age 1.05 1.03–1.06 ***
English first language 0.55 0.32–0.96 *
Years of education 0.92 0.88–0.97 ***
Veteran 0.6 0.42–0.84 ***
Years at longest full-time job 0.91 0.88–0.94 ***
Days working in last 30 1.01 1.01–1.02 ***
Days housed in last 60 0.92 0.89–0.95 ***
Days incarcerated in last 60 0.98 0.96–0.99 **
Psychiatric
Schizophrenia 1.54 1.19–2.01 ***
Major depression 0.66 0.51–0.86 ***
Number of psychiatric hospitalizations 1.05 1.04–1.07 ***
Observer-rated psychosis 1.03 1.02–1.05 ***
Depression symptoms (number out of 5) 0.88 0.83–0.94 ***
Substance Use
Years of alcohol use 0.98 0.96–0.99 ***
Years of cocaine use 0.96 0.93–1.0 *
Medical
HIV status 1.85 1.02–3.34 *
Seizure 1.58 1.06–2.36 *
Other
Other social welfare benefit (yes or no) 0.12 0.07–0.20 ***
Number of types of benefits received 0.77 0.62–0.96 *
Self-report that someone else receives and manages check 7.3 5.2–10.3 ***
Number of services accessed in last 60 days 2.62 2.32–2.96 ***
SOURCE: Self-report data were collected in the ACCESS demonstration and were cross-matched with the Social Security Administration's Master Beneficiary Record, Payment History Update System, and the Supplemental Security Record.
NOTES: Total sample size is 5,407; 934 reported receiving SSI/DI but were shown as not receiving benefits in the Social Security Administration's records.
Somers' D = 0.91.
* Significant difference from group who reported receiving SSI/DI at p<.01 by pairwise comparison.
** Significant difference from group who reported receiving SSI/DI at p<.001 by pairwise comparison.
*** Significant difference from group who reported receiving SSI/DI at p<.0001 by pairwise comparison.
Not all functional indices were worse among those with unverified claims. Within this population of homeless people, those who had unverified claims were likely to have used alcohol and cocaine for fewer years and to have been incarcerated for fewer days in the preceding 60 than were those who did not claim receipt of SSI/DI. Self-reported depressive symptoms and a diagnosis of major depression were associated with a lower likelihood of making an unconfirmed claim of receiving SSI/DI.
Benefit status differed between the two groups. Participants with unverified claims of receiving SSI/DI were more likely to report having a payee than were those who did not claim benefit receipt. Those with unverified claims also had received fewer benefits overall.
Comparison Among Clients Receiving SSI/DI According to SSA: Participants not Self-reporting Receipt of SSI/DI versus Those Self-reporting Receipt. Participants who did not report receiving SSI/DI in contradiction to SSA's records that they actually had received benefits were more likely to have reported receipt of Social Security retirement benefits and other social welfare benefits (Table 4). In a post hoc analysis, we considered the possibility that clients who thought they received Social Security retirement benefits were disproportionately aged 62 or older, and they were. Altogether, 17.4 percent (34/195) of participants who inaccurately reported nonreceipt of SSI/DI were aged 62 or older, but only 3 percent (39/1,322) of those with concordant reports of receiving SSI/DI were aged 62 or older (chi-square 77.8, p<.0001).
Table 4. Logistic regression analysis of group who denied receiving SSI/DI among the sample of those with benefits per SSA records
Measure Odds ratio 99 percent confidence limits
Days incarcerated in last 60 1.03 1.00–1.06 *
Clinician-rated alcohol use 0.82 0.68–1.0 *
Social Security retirement income 17.45 9.10–33.43 ***
Food stamps 0.53 0.30–0.91 *
Other social welfare benefit (yes or no) 5.54 2.31–13.29 ***
Number of services accessed in last 60 days 0.34 0.26–0.45 ***
SOURCE: Self-report data were collected in the ACCESS demonstration and were cross-matched with the Social Security Administration's Master Beneficiary Record, Payment History Update System, and the Supplemental Security Record.
NOTES: Total sample size is 1,516; 193 reported not receiving SSI/DI but were shown as receiving benefits in the Social Security Administration's records.
Somers' D = 0.87.
* Significant difference from group who denied receiving SSI/DI at p<.01 by pairwise comparison.
** Significant difference from group who denied receiving SSI/DI at p<.001 by pairwise comparison.
*** Significant difference from group who denied receiving SSI/DI at p<.0001 by pairwise comparison.

Discussion

Fully 41 percent (934/2,257) of clients who reported receiving SSI/DI benefits did not receive them according to SSA. Clients whose report of receiving SSI/DI was unconfirmed were more likely to have conditions associated with neurocognitive impairment: they were disproportionately psychotic, HIV-positive, diagnosed with a seizure disorder, and occupationally impaired. Clients who misreported basic demographic information may also not have understood the benefits they receive, the question asked, or how to translate their knowledge into a correct response. The clients whose report of receiving SSI/DI was not confirmed used cocaine and alcohol for disproportionately fewer years, but this finding is not inconsistent with a cognitive explanation for anomalous self-reports—some studies indicate that within populations of people with mental illness, those who use drugs may actually be higher functioning (Ries and others 2000).
Cognitive problems also may have been a factor when participants who had received SSI/DI according to SSA did not report receiving those benefits. These clients appear to have been confused by different types of "social" benefits and apparently indicated receipt of Social Security retirement benefits and social welfare benefits instead of the actual SSI/DI they were receiving.
The overreporting of SSI/DI receipt relative to administrative databases in this homeless, mentally ill population is in contrast to the underreporting of income among poor people generally (Hotz and Scholz 2002). For example, validation of data from the Survey of Income and Program Participation suggested that self-report responses underestimated SSI receipt by as much as 23 percent (Marquis and Moore 1990). The responses of homeless people with mental illness may be affected by neurocognitive difficulties that are less salient in poor people who are not defined by homelessness and mental illness.
One clinical implication of the problematic self-reports is that when a client reports receiving SSI or DI, the assertion should be verified. The client can be asked the amount of the check or how the check came to be awarded. Clients should also be questioned to make sure the check referred to is an SSI or DI check and not another kind of payment. Information about benefit receipt can be obtained when another person receives the benefit check or by examining the clients' Medicare card. Primary Medicare beneficiaries who are too young to qualify for retirement benefits presumably receive DI.
The low agreement between self-report and SSA databases among the homeless, mentally ill population has other far-reaching implications. Data concerning sources of income are collected in the U.S. Census and several surveys specifically targeting poor people (Hotz and Scholz 2002). Accurate data about use of public support payments is crucial to assessing the impact of policies such as welfare reform (Primus and others 1999) and changes in eligibility for SSI and DI (Watkins, Wells, and McLellan 1999). In health services research, self-reported Social Security numbers and dates of birth are frequently used to cross-match data from people with known clinical characteristics with another database of interest (Friedman and others 1996; Bach and others 2002). A systematic bias is unwittingly introduced to data when a failure to cross-match is not random.
Some clients who reported receiving SSI/DI but did not appear in SSA databases probably did not cross-match with SSA databases because they provided inaccurate Social Security numbers (SSNs) or inaccurate dates of birth. In the 1996 Survey of Income and Program Participation, a full 16 percent of the SSNs provided by survey participants appeared to be inaccurate because they did not match SSNs in the Summary Earnings Record (Huynh, Rupp, and Sears 2002). One reason to suspect that inaccurate SSNs were provided is that the 1,323 participants whose reported receipt of SSI/DI was validated by SSA administrative records were similar to the 934 whose self-reported receipt was not validated (Table 2). For instance, both groups included high proportions of clients who reported that someone else received their check and managed it for them (29.3 percent and 27.6 percent, respectively). The clients who are discordant with SSA records could have some sort of non-SSA fiduciary arrangement, but the 27.6 percent reporting that someone else receives their check is consistent with other estimates that approximately a third of adults under the age of 65 who receive SSA payments based on a psychiatric disability have been assigned a payee to manage their funds (Social Security Administration 2001a, Table 7; and 2001b, Table 32).
Social Security numbers have high sensitivity and specificity in validating death against the National Death Index (Williams, Demitrack, and Fries 1992), and SSA databases are highly regarded (Waldron 2001). Yet underreporting of deaths to SSA does occur and is not random—underreporting of death information provided to SSA by third parties (such as state vital record systems) is less likely when the deceased was a woman, black, younger, unmarried, or from the South (Curb and others 1985; Wentworth, Neaton, and Rasmussen 1983; Boyle and Decoufle 1990).
Benefits for the Supplemental Security Income and Disability Insurance programs provide a vital safety net for clients disabled by psychiatric disorders. It is important that each individual's benefit status be accurately determined for that client's clinical care and that studies dependent on demographic information provided by impaired clients be independently verified so that use of the Social Security safety net is accurately described.

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Sosin, M.R., and S. Grossman. 1991. The mental health system and the etiology of homelessness: A comparison study. Journal of Community Psychology 19: 337–350.
Stein, L.I., and M.A. Test. 1980. Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. Archives of General Psychiatry 37(4): 392–397.
Stephens, R. 1972. The truthfulness of addict respondents in research projects. International Journal of the Addictions 7(3): 549–558.
Strauss, J.S., W.T. Carpenter Jr., and A.T. Nasrallah. 1978. How reliable is the psychiatric history? Comprehensive Psychiatry 19(3): 213–219.
Vaux, Alan, and Mary Athanassopulou. 1987. Social support appraisals and network resources. Journal of Community Psychology 15(4): 537–556.
Waldron, H. 2001. Results of the Office of Policy's 2001 User Satisfaction Survey. Social Security Bulletin 64(4): 33–47.
Watkins, K.E., K.B. Wells, and A.T. McLellan. 1999. Termination of Social Security benefits among Los Angeles recipients disabled by substance abuse. Psychiatric Services 50(7): 914–918.
Wentworth, D.N., J.D. Neato
          ATA Supports Department of Veterans Affairs Expansion of Telehealth        

Secretary David Shulkin and VA Continue to Champion Telehealth with White House Demonstration

(PRWeb August 03, 2017)

Read the full story at http://www.prweb.com/releases/2017/08/prweb14573310.htm


          Comment #5293        
What do you all think about Donald Trump appointing

Sarah Palin Secretary of the Department of Veterans Affairs
          House Passes Health Care Bill for Scandalized VA        
WASHINGTON – The House on Wednesday overwhelmingly approved a $17 billion emergency spending bill on veterans’ health care to hire additional medical workers throughout the federal system that has been plagued by scandals. The legislation passed on a 420-5 vote with rare bipartisan support from the Colorado delegation, and is expected to pass the Senate this week before Congress adjourns for the August recess. The measure comes on the heels of investigations into 26 veteran health facilities nationwide including Colorado, where excessive delays in receiving health care has been linked to at least 40 deaths. The legislation primarily allows veterans to bypass hospitals and clinics operated by the Veterans Affairs Department including the Fort Collins clinic to seek care at private facilities. “The reform would allow veterans to vote with their feet if they received substandard treatment at a VA facility,” said Colorado Republican Rep. Mike Coffman, a veteran of the Gulf and Iraq wars. Rep. Cory Gardner said the measure provides needed checks and balances to ensure high quality health care. “Our veterans have made immense sacrifices for our freedom, and they were promised access to the highest quality healthcare upon their return home,” the Colorado Republican said. “Unfortunately, […]
          House passes rare bipartisan measure, offers vets more options for care        
A consistently gridlocked Congress offered a rare example of bipartisanship Tuesday when the House voted 421-0  to approve a bill that allows veterans to go outside the Veterans Affairs system if appointment wait times are too long or if the veteran lives more than 40 miles from a VA hospital. The bill emerged from the
          Perry questions motive behind Bergdahl recovery        
Texas Gov. Rick Perry  is the latest Republican to ask whether last weekend’s recovery of Army Sgt. Bowe Bergdahl from Taliban forces in Afghanistan was a political move by the Obama administration to shift the media focus from the recent Veterans Affairs scandal. The Obama administration has taken heat in recent weeks for long wait
          Clergy Toolkit for PTSD        
This toolkit — developed by the National Center for PTSD in consultation with leaders of the Department of Veterans Affairs National Chaplain Center and Mental Health and Chaplaincy Program — was created for clergy who work with veterans and servicemembers who have or are at risk for developing post traumatic stress disorder. The purpose of... Read More »
          Bariatric Surgery Can Help People Keep Weight Off Long Term        
It really hit Terry White eight years ago when he was at the mall with his wife. He was out of breath every few minutes and had to sit down. "My wife told me I had to get to the gym and lose weight," he says. He had dieted most of his life. "I've probably lost 1,000 pounds over the years," says White, a realtor in North Myrtle Beach, N.C. But he put most of it back on. By age 59, he knew he was headed for disaster; he weighed 387 pounds at just 5 foot 6. With encouragement from a friend, he headed to Duke University Medical Center in Durham where he had gastric bypass surgery . It reduced his stomach to about the size of an egg so his body absorbed fewer calories and fat from food. The weight just fell off, he says. He didn't feel deprived. He just didn't want to eat that much. In seven months he'd lost 200 pounds. That was eight years ago. He's gained back a bit, but not much. It turns out his success isn't unique. Researchers with the Durham Veterans Affairs Medical Center in North
          Q&A: Permobil’s Darren Jernigan on a tough election        
11/23/2016
Tracy Orzel

NASHVILLE, Tenn. – This election hasn’t been easy on anyone, even on those who won. “I was one of the few democrats that survived in Tennessee,” said Darren Jernigan, director of government affairs at Permobil, who is about to start his third term as a state representative. “(The elections) are every two years—it’s wearing me out.” HME News recently spoke with Jernigan about “serving two masters” and what stakeholders should expect in the new political climate.  

HME News: How do you balance Permobil and public service?

Darren Jernigan: I cloned myself (laughs). We added more staff at Permobil to help me with government affairs, but Permobil is very generous to let me spend time with the legislature. The most difficult thing for me is, when I do something, I want to do it well and the “no one can serve two masters” cliché is a cliché for a reason. To keep up with both, sometimes I have to work on Permobil matters when I’m in the legislature, and sometimes at Permobil I have to work on legislative matters—they just cross over. Obviously, if I’m at Permobil and there’s an earthquake in my district, they’re going to let me go (and vice versa).

HME: What’s on your to-do list this year related to mobility issues?

Jernigan: We’re only allowed 15 bills apiece and I have a wide range of topics other than just mobility. However, NCART wants to see separate benefit recognition legislation introduced during this session. I’m not sure who’s going to introduce the bill. Since I work for Permobil, it might be a conflict. I would be able to vote for it; I just probably couldn’t champion it.

HME: What would you say is one of your biggest accomplishments so far?

Jernigan: Medicare doesn’t pay for power mobility devices used outside the home and last year we were able to eliminate the in-home rule in Tennessee. We were also able to get elevator seats off the exclusion list in the state. Medicare said, “We’re not going to pay for elevator seats—ever,” and that’s against federal law. There must be some kind of path people can go down based on medical necessity and evidence-based research.

HME: Where do you see access going in the current political climate? Should stakeholders/wheelchair users be concerned?

Jernigan: It depends on who Trump surrounds himself with and if there’s strong leadership. One positive thing: He said he doesn’t want to cut entitlements, meaning Medicare, Medicaid, Social Security; and he’s not going to touch Veterans Affairs, so that is good. We’re also a little bit encouraged that some of the remaining Republican leadership in the House and the Senate know about complex rehab and know about our issues. They’re aware of it; they’re in support. 


          Housekeeping Aid        
DEPARTMENT OF VETERANS AFFAIRS EASTERN COLORADO HEALTH CARE SYSTEM Duties This position is located in the Environmental Management Section, at the Eastern Colorado Health Care System in Denver, Colorado. As a Housekeeping Aid, you will perform a full range of light and heavy cleaning duties and routine housekeeping duties. Duties include cleaning wards, patient rooms, storerooms, offices, corridors, restrooms, shower rooms, and other areas. Housekeeping Aids sweep, mop, scrub (machine) floors,... $13.26
          GI Bill Funds; Coast Guard Safety; the Future of the Department of Veterans Affairs        
Passed in 1944 -- 70 years ago -- The Serviceman’s Readjustment Act, better known as the GI Bill, was designed to provide American vets with a number of...
          VA Issues Mobile Cloud Services Infrastructure RFI        
The Department of Veterans Affairs has released a request for information on potential contractors that can support the development of a mobile cloud services infrastructure for VA. A FedBizOpps notice posted Tuesday says the VA MCS system will replace the department’s mobile infrastructure services platform that works to facilitate common controls sharing and management across […]
          10: ACT for Coping with Trauma and PTSD with Robyn Walser        

In this episode, Robyn D. Walser, Ph.D., of the Dissemination and Training Division of the Dept of Veterans Affairs National Center for PTSD and former president of ACBS, speaks to Jen and John about an ACT approach to treating individuals who have survived trauma and who struggle with post-traumatic stress. Listen and learn with Robyn as she discusses the role of acceptance, mindfulness, and values-based work to help individuals learn to live with, and live far beyond, their trauma histories. 

About Dr. Walser:

read more


          Ethnic Korean from Uzbekistan makes impassioned plea to President Moon        
“We’re not asking to be compensated for the blood that was shed by our ancestors like the heroes of the independence movement who are registered with the Ministry of Patriots and Veterans Affairs. Nor.. …
          Women's History Month 2017: World War I Work Resources        
Library of Congress http://www.loc.gov/pictures/collection/wwipos/item/2003675265/


I've posted some specific occupations in previous posts so I thought I'd provide a list of articles and resources for learning more about women and work during the early 20th century. This will provide a better understanding of the time period and what possible occupations your female ancestor might have had.

Berks History Center - African American Occupations in the 1900s

NCpedia - Women in the 1920s in North Carolina

Wiley Online Library - Women's work in census and survey, 1911-1931
(UK)

From Mill Town to Board Room: The Rise of Women’s Paid Labor by Dora L Costa

Indiana Magazine of History - Industrial "Girls" in an Early Twentieth-Century Boomtown: Traditions and Change in Fort Wayne, Indiana, 1900—1920

Seattle General Strike Project - Where Women Worked During World War I

Australian Government - Women in wartime

Missouri Over There - US Women's Overseas Service in World War I

International Encyclopedia of the First World War - Women's Mobilization for War

Veterans Affairs Canada - Canada Remembers Women on the Home Front
          Senate Committee Stands up for Veterans Using Medical Cannabis        

Washington D.C. --  This morning, the Senate Committee on Appropriations voted 24-7 to include an amendment introduced by Senators Steve Daines (R-MT) and Jeff Merkley (D-OR) in the FY2018 Military Construction, Veterans Affairs Appropriations bill.  The amendment allows military veterans to participate in state medical cannabis programs without fear of losing their military benefits or services and enables Department of Veterans Affairs health care providers to recommend medical cannabis in compliance with state medical cannabis laws.


          A look back at the history of Memorial Day        
Memorial Day

U.S. Department of Veterans Affairs Washington, D.C. – On May 5th, 1868, three years after the Civil War ended, the head of an organization of Union veterans — the Grand Army of the Republic (GAR) established Decoration Day as a time for the nation to decorate the graves of the war dead with flowers. Major […]

The post A look back at the history of Memorial Day appeared first on Clarksville, TN Online.


          These senators just gave the Veterans Affairs secretary a deadline for answering reform-focused questions        
A dozen U.S. senators over the weekend requested President Obama’s Veterans Affairs Secretary Robert McDonald answer by Nov. 14 four questions about what, if anything, the department has done to address inter-office corruption that led to the falsification of veteran wait-times. “The GAO report states that the VA needs a new comprehensive scheduling plan to […]
          New Studies Suggest Yoga Can Ease Depression and Minimize Emotional Eating        

Several new studies have found that yoga may lower depression and emotional eating, if done on a consistent basis. At the 125th Annual Convention of the American Psychological Association, four separate studies were presented that pointed to similar positive findings about the benefits of yoga.

Lindsey Hopkins at the San Francisco Veterans Affairs Medical Center primarily examined the effects of Hatha yoga on 23 male veterans. After taking yoga classes twice a week for eight weeks, the subjects noted a decrease in depression and negative thoughts.

Alliant International University's Sarah Shallit found similar results in subjects who tried Bikram yoga, commonly known as hot yoga. For her study, Shallit examined two separate groups of women. In the first, 52 women between the ages of 25 and 45 attended yoga classes twice a week for eight weeks. Half of those women, however, were wait-listed and were not able to take the yoga classes. As you can imagine, the participants who were able to attend yoga saw their depression reduce significantly, while the other group did not.

Her findings didn't end there. When Shallit conducted a similar experiment using a separate group of women, she also noticed an increase in mindfulness and self-compassion among the participants. Not only that, but the subjects found that they were able to control the disordered or emotional eating that had been bothering them before.

Two additional studies, conducted by Maren Nyer and Nina Vollbehr from Massachusetts General Hospital, arrived at similar conclusions using entirely different groups of adults. Ultimately, all of the researchers found that the positive benefits of yoga extend beyond the physical.


Though yoga should not entirely replace treatments for depression prescribed by a doctor, it can certainly help. "At this time, we can only recommend yoga as a complementary approach, likely most effective in conjunction with standard approaches delivered by a licensed therapist," Hopkins explained. "Clearly, yoga is not a cure-all. However, based on empirical evidence, there seems to be a lot of potential."


          New certificate program offered by Puller Veterans Benefits Clinic        
Law school
William & Mary Law School will offer an online certificate program beginning in August that is designed for anyone who wants to become a knowledgeable and effective advocate for veterans and service members seeking disability compensation benefits through the Department of Veterans Affairs.
          Comment on Archie Manning’s wife and Peyton and Eli Manning’s mother, Olivia Manning by barry        
hello my name is Barry Simons i was at ft lewis washington back in the early 80's when your husband Archie was there as a guest and i was involved in a jeep rollover and got a disability to my spine in crash that your husband knows all about and is stating that he was never there and knows nothing about it witch is a lie he was there and also knows who was driving that jeep s/4 Bruce Barnes i have been fighting with veterans affairs since 1986 with no help i am disabled and can not work because of spine injury and i need your husband to step forward and to tell the truth about what happen and that is all i ever wanted but your husband just wants to still not tell the truth along with Bruce Barnes and i am suffering because of it and their lies so i guess that you and your husband don.t really care what happens to veterans of the united states and their injury,s or else he would stop telling lies about what did happen or just don,t care need help disabled veteran Barry Simons in need of help please or else you also don,t give a damn about us disabled veterans at all.
          Church and State are able to have different positions on same sex marriage.         

I have come to the conclusion that church and state can have different positions and practices on the question of same sex marriage. I believe the secular Australian state should be able to recognise same sex marriage. I also believe that this change should legally exempt religious institutions from any requirement to change their historic position and practice that marriage is exclusively between a man and a woman. For me, this change in position has come about as a result of a lot of reflection, over a long period of time, including conversations with good people grappling with deep questions of life, sexuality and faith.

One Saturday morning in Canberra, some weeks ago, a former political staffer asked to have a coffee. This bloke, who shall remain nameless, is one of those rare finds among political staffers who combines intelligence, integrity, a prodigious work ethic, and, importantly, an unfailing sense of humour in the various positions he has worked in around Parliament House. Necessary in contemporary politics, otherwise you simply go stark raving mad.

And like myself, this bloke is a bit of a god-botherer (aka Christian). Although a little unlike myself, he is more of a capital G God-Botherer. In fact, he's long been active in his local Pentecostal Church.

Over coffee, and after the mandatory depressing discussion about the state of politics, he tells me that he's gay, he's told his pastor (who he says is pretty cool with it all, although the same cannot be said of the rest of the church leadership team) and he then tells me that one day he'd like to get married to another bloke. And by the way, "had my views on same sex marriage changed?”.

As most folks know, in our family I have long been regarded as the last of the Mohicans on this one. The kids have long thought I'm an unreconstructed dinosaur for not supporting marriage equality legislation. And Thérèse just looks at me with that slightly weary, slightly exasperated, slightly pitying "there, there darling, you'll get over it one day" sort of look, that wives can be particularly good at giving to their antediluvian husbands.

Very few things surprise me in life and politics anymore. But I must confess the Pentecostal staffer guy threw me a bit. And so the re-think began, once again taking me back to first principles. First, given that I profess to be a Christian (albeit not a particularly virtuous one) and given that this belief informs a number of my basic views; and given that I am given a conscience vote on these issues; then what constitutes for me a credible Christian view of same sex marriage, and is such a view amenable to change? Second, irrespective of what that view might be, do such views have a proper place in a secular state, in a secular definition of marriage, or in a country where the census tells us that while 70% of the population profess a religious belief, some 70% of marriages no longer occur in religious institutions, Christian or otherwise.

The Christian tradition since Aquinas is one based on a combination of faith informed by reason. If the latter is diminished, then we are reduced to varying forms of theocratic terrorisms where the stoning of heretics and the burning of witches would still be commonplace. In fact if we were today to adhere to a literalist rendition of the Christian scriptures, the 21st century would be a deeply troubling place, and the list of legitimized social oppressions would be disturbingly long.

Slavery would still be regarded as normal as political constituencies around the world, like the pre-civil war American South, continued to invoke the New Testament injunction that "slaves be obedient to your masters" as their justification. Not to mention the derivative political theologies that provided ready justifications for bans on inter-racial marriage and, in very recent times, the ethical obscenity that was racial segregation and apartheid.

Similarly with the status of women. Supporters of polygamy would be able to justify their position based on biblical precedent. Advocates of equality would also have difficulty with Paul's injunction that "wives should be submissive to their husbands" (As a good Anglican, Thérèse has never been a particularly big rap for Saint Paul on this one). The Bible also teaches us that people should be stoned to death for adultery (which would lead to a veritable boom in the quarrying industry were that still the practice today). The same for homosexuals. And the biblical conditions for divorce are so strict that a woman could be beaten within an inch of her life and still not be allowed to legally separate. 

The point is that nobody in the mainstream Christian Church today would argue any of these propositions. A hundred years ago, that was not necessarily the case. In other words, the definition of Christian ethics is subject to change, based on analysis of the historical context into which the biblical writers were speaking at the time, and separating historical context from timeless moral principles, such as the injunction to “love your neighbour as yourself”.

Against this particular Christian norm, and its secular moral corollary of "do no harm", and, in particular, "do no harm to others, especially the vulnerable", we have seen a range of social reforms over the decades where traditional, literalist biblical teachings have been turned on their head, often with the support of the churches. Including relatively recent legislative actions by Australian legislatures to decriminalize homosexuality. And much more recently, under my Prime Ministership, action to remove all legal discriminations against same sex couples in national statutes including in inheritance, taxation, superannuation, veterans affairs, family law, defence housing, Centrelink, child support, health insurance, citizenship and aged care.

Which brings us back to same sex marriage. I for one have never accepted the argument from some Christians that homosexuality is an abnormality. People do not choose to be gay. The near universal findings of biological and psychological research for most of the post war period is that irrespective of race, religion or culture, a certain proportion of the community is born gay, whether they like it or not. Given this relatively uncontested scientific fact, then the following question that arises is should our brothers and sisters who happen to be gay be fully embraced as full members of our wider society? The answer to that is unequivocally yes, given that the suppression of a person's sexuality inevitably creates far greater social and behavioural abnormalities, as opposed to its free and lawful expression. 

Which brings us to what for some time has been the sole remaining obstacle in my mind on same sex marriage - namely any unforeseen consequences for children who would be brought up by parents in a same sex married relationship, as against those brought up by parents in married or de-facto heterosexual relationships, by single parents, or by adoptive or foster parents, or other legally recognised parent or guardian relationships. The care, nurture and protection of children in loving relationships must be our fundamental concern. And this question cannot be clinically detached from questions of marriage – same sex or opposite sex. The truth is that in modern Australia approximately 43 per cent of marriages end in divorce, 27 per cent of Australian children are raised in one parent, blended or step-family situations, and in 2011-12 nearly 50,000 cases of child abuse were substantiated by the authorities of more than 250,000 notifications registered. In other words, we have a few problems out there.

That does not mean, by some automatic corollary, that children raised in same sex relationships are destined to experience some sort of nirvana by comparison. But scientific surveys offer important indications. One of the most comprehensive surveys of children raised in same sex relationships is the US National Longitudinal Survey conducted since 1986 – 1992 (and still ongoing) on adolescents raised by same sex partners. This survey, published in the Journal of the American Academy of Paediatrics in 2010, concluded that there were no Child Behaviour Checklist differences for these kids as against the rest of the country. There are a number of other research projects with similar conclusions as well. In fact 30 years of research has seen the Australian Medical Association, the American Medical Association, the American Academy of Paediatrics and the American Psychological Association acknowledge that same sex families do not compromise children’s development.

Furthermore, there is the reality of a growing number of Australian children being raised in same sex relationships. Either as a result of previous opposite-sex relationships, or through existing state and territory laws making assisted reproduction, surrogacy, adoption and fostering legally possible for same sex couples or individuals in the majority of Australian states and territories. Furthermore, Commonwealth legislation has already recognised the legal rights of children being brought up in such relationships under the terms of Australian family law. Therefore, the question arises that given the state has already recognised and facilitated children being raised in same sex relationships, why do we not afford such relationships the potential emotional and practical stability offered by the possibility of civil marriage? 

Finally, as someone who was raised for the most important part of his childhood by a single mum, I don’t buy the argument that I was somehow developmentally challenged because I didn’t happen to have a father. The loving nurture of children is a more complex business than that.

So where does this leave us in relation to the recent and prospective debates before the Australian Parliament? Many Christians will disagree with the reasoning I have put forward as the basis for changing my position on the secular state having a broader definition of marriage than the church. I respect their views as those of good and considered conscience. I trust they respect mine as being of the same. In my case, they are the product of extensive reflection on Christian teaching, the scientific data and the emerging reality in our communities where a growing number of same sex couples are now asking for marriage equality in order to give public pledge to their private love and for each other, and to provide the sort of long-term relationship commitment that marriage can provide for the emotional stability important for the proper nurture of children.

Further, under no circumstances should marriage equality legislation place any legal requirement on the church or other religious institutions to conduct same sex marriages. The churches should be explicitly exempt. If we truly believe in a separation of church and state, then the church must be absolutely free to conduct marriage ceremonies between a man and a woman only, given the nature of their current established theological and doctrinal positions on the matter. This should be exclusively a matter for the church, the mosque and the synagogue. It is, however, a different matter for a secular state. The Church must be free to perform marriages for Christian heterosexual couples without any threat of interference from the state. Just as the state should be free to perform marriage services for both heterosexual and same sex couples, and whether these couples are of a religious faith or no religious faith.

These issues properly remain matters of conscience for all members of the Parliament. Labor provides a conscience vote. The Liberals and the Nationals do not. They should. If they don't, then we should consider a national referendum at an appropriate time, and which would also have the added advantage of bringing the Australian community along with us on an important social reform for the nation. And for the guys and girls, like the former staffer who came to see me recently in a state of genuine distress, we may just be able to provide a more dignified and non-discriminatory future for all.

Some will ask why I am saying all this now. For me, this issue has been a difficult personal journey, as I have read much, and talked now with many people, and of late for the first time in a long time I have had the time to do both. I have long resisted going with the growing tide of public opinion just for the sake of it. Those who know me well know that I have tried in good conscience to deal with the ethical fundamentals of the issue and reach an ethical conclusion. My opponents both within and beyond the Labor Party, will read all sorts of political significances into this. That's a matter for them. There is no such thing as perfect timing to go public on issues such as this.

For the record, I will not be taking any leadership role on this issue nationally. My core interest is to be clear-cut about the change in my position locally on this highly controversial issue before the next election, so that my constituents are fully aware of my position when they next visit the ballot box. That, I believe, is the right thing to do.


          Sanders Introduces Bill to Strengthen Veterans' Health Care        

Sen. Bernie Sanders (I-Vt.), former chairman of the Senate Veterans Affairs committee, introduced legislation Thursday to expand and improve veterans' access to health care by addressing the large number of unfilled positions in the Veterans Health Administration.


          VA expands telehealth services with new ‘Anywhere to Anywhere’ initiative        
The Department of Veterans Affairs announced a new telehealth initiative on Thursday that pairs regulation changes with a new mobile app to expand healthcare services to the nation’s veterans. VA Secretary David Shulkin unveiled the agency's plan to allow providers to practice across state lines via telehealth, a move that “dramatically expands our current capabilities.”
          Sanders may offer choice for Democrats in 2016        
Four years ago, Sen. Bernie Sanders made headlines with a passionate, 8-hour speech on the Senate floor lambasting the Bush-era tax cuts and bemoaning the growing gap between rich and poor.

Now Sanders, one of the Senate's two Independents, is taking that message on the road. On his itinerary:  The early presidential primary states of Iowa and South Carolina.

On Wednesday Sanders was in Charlotte to accept an award from the American Legion during its national convention. Sanders, who chairs the Senate's Veterans Affairs Committee, was honored with the Legion's Patriot Award.

"The cost of war doesn't end when the last shots are fired or the last missiles are launched," he told the Legion audience. "The cost of war continues until the vet receives all of the benefits that he or she has earned."

But when Sanders' met with me, it wasn't veterans that he wanted to talk about. It was the same subject he talked about four years ago and one he's cared about for a long time.

"The main issue that I have is that in America today the middle-class is disappearing while the gap between rich and poor is growing wider," he said. "...We need more people in politics working for ordinary people and not just the top 1 percent."

Sanders, who turns 73 in two weeks, says he hasn't made up his mond about 2016. And he's under no illusions about the prospect for a Democratic Socialist from Vermont getting the nomination, particularly in a field that could include a well-funded Hillary Clinton.

"I realize I'm not a household name," says Sanders, who refuses corporate donations though he has taken money from organized labor.

But he thinks there might be an opening for somebody with the right message. And he's going around the country seeing if audiences agree.

"I think the average American is a lot more frustrated with the establishment than a lot of people perceive," he says. "I think there's receptivity for voices that are going to speak for a working class that is being battered."
          A Tap of the Gavel in Honor of Judge William J. Furber Jr. at his Retirement        
The end of a year often brings with it some retirements in government and legal circles and none was more noticeable last week than that of Montgomery County President Judge William J. Furber Jr.

Photo of Portrait of Judge William J. Furber Jr.
Furber, 68, of Narberth, retired after more than 23 years on the county bench. Throughout his tenure, Furber was known for his leadership qualities and his reputation as a jurist was impeccable. Furber’s knowledge of the law, temperament and wisdom garnered much respect from colleagues and the lawyers who practiced in his courtroom. He was known as a true gentleman, a man who wore his signature bow tie to work on many days.

Having sat in his courtroom covering trials on many occasions, I was always struck by Furber’s fairness, courteousness, respectful tone and patience. I recall covering Furber’s Jan. 6, 2012, installation as president judge and I can say the judge certainly fulfilled the promises he made at that time.

“When it comes to courthouse culture, I am old school – courteousness, patience and respect and the willingness to listen are important traits for judges and lawyers alike. I believe in decorum. These courtrooms are sacred to me,” Furber told the crowd during a heartfelt speech in 2012. 

“You can have the greatest and most well-funded programs in the world, but if you don’t know how to bring out the best in people, with basic courtesy and respect, then the effort will fail,” Furber added.

I think those are powerful words to live by, for every judge.

A kind man, Furber always acknowledged the support he received from his wife, Welcome, his three sons and his courthouse family, administrative assistant Lois Joiner, court clerk Liz Oreo, court reporter Lisa Neal and court criers Bob Miller and Joe Wallen.

On Dec. 30, county Commissioner Joe Gale presented Judge Furber with a citation on behalf of the board of commissioners in recognition of his retirement and many years of service. The event was held prior to Veteran’s Treatment Court, which Furber presided over since its inception in 2011.

Screen shot of Commissioner Joe Gale's tribute to Furber via Twitter
“We, the Commissioners of Montgomery County, do hereby commend and congratulate the Honorable William J. Furber Jr. on the occasion of his retirement after many years of dedicated public service and express our gratitude for his exemplary service and contributions to the citizens of Montgomery County,” the citation read.  
Photo of Portrait of Judge William J. Furber Jr.


Furber, a graduate of the University of Maryland and Temple University School of Law who was elected to the bench in 1993 and who was retained in 2003 and 2013 for additional 10-year terms, beamed with pride during the event.  

Furber, who served in the Marine Corps, presided over the specialty court that was formed to enhance public safety and reduce recidivism rates among veterans who are charged with crimes. Under the program, veterans are connected with community treatment services through the U.S. Department of Veterans Affairs while receiving appropriate dispositions to their criminal charges.


During his time on the bench, Furber also presided over civil, family and criminal court. Prior to being elected a judge in 1993, Furber worked as a county prosecutor from 1974 to 1976 and then was a litigation specialist and partner with the Norristown firm Wilson, Drayer, Morrow and Furber from 1976 to 1991. In 1991, Furber became a sole practitioner with an office in Norristown.


So, as you leave the bench Judge Furber, I want to thank you for your many years of service and congratulate you on a retirement that is well earned. Enjoy! You will be missed around the county halls of justice.

          Acting SecArmy co-hosts Soldier for Life town hall        
Acting Secretary of the Army Patrick J. Murphy co-hosted an online town hall Wednesday to answer questions about transition and Veteran benefits. Also online with the secretary and his team of advisors were representatives from the Veterans Affairs and the Army's Soldier for Life Office.
          Physician Assistant - Veterans Affairs, Veterans Health Administration - Boston, MA        
The consolidated facility consists of the Jamaica Plain Campus, the West Roxbury Campus, located on the Dedham line;... $97,678 - $142,906 a year
From Department of Veterans Affairs - Wed, 09 Aug 2017 02:39:25 GMT - View all Boston, MA jobs
          Nurse Practitioner - Veterans Affairs, Veterans Health Administration - Boston, MA        
The consolidated facility consists of the Jamaica Plain Campus, the West Roxbury Campus, located on the Dedham line;... $83,569 - $147,063 a year
From Department of Veterans Affairs - Wed, 09 Aug 2017 02:39:24 GMT - View all Boston, MA jobs
          Our Immigration System Doesn't Care if You're a Traumatized Vet—You'll Be Deported Anyway        
No mercy from ICE for veterans with PTSD.

The following is an excerpt from the new book  Without a Country: The Untold Story of America's Deported Veterans by J. Malcolm Garcia (Hot Books, September 2017) available for purchase from Amazon, Indiebound and Hot Books: 

Hector Barrios, a Vietnam veteran, lived in Tijuana. I decide to stop by the small house where he rented a room. A friend of his, Jesus Ballesteros, meets me on a sidewalk nearby, next to a red pickup that Barrios used to sell secondhand clothes from. I consider the narrow street, the house across the way with its leafy terrace and the sounds of water splashing from hoses in the driveway. Small boys scamper on the hot concrete, watering plants.

Jesus takes me into the room Barrios rented. It can’t be more than nine by ten feet. A bed with a pink comforter takes up most of the space. At the foot of the bed, propped against a dresser mirror, is a large piece of cardboard with more than a dozen photos of Barrios. Several appear to be in Vietnam, outside tents with green Jeeps in the background. Barrios looks gaunt. He has a full black mustache, his tired eyes alive with an inviting smile. I sense that sleepless nights have grooved the wearied lines in his cheeks.

A green military jacket hangs from a coat rack and desert camouflage caps decorate the paneled walls. I notice a wrinkled newspaper clipping of Barrios as a young man, playing soccer, next to a calendar with an angelic portrait of Jesus. A photo of the pope is tacked crookedly to one side.

Barrios was born in 1943 and moved to the U.S. when he was eighteen. He served in the Army from 1967 to 1969. In 1968 he was sent to Vietnam, where he suffered head wounds in combat. He earned the National Defense Ribbon, the Vietnam Service Medal, the Vietnam Campaign Medal, and the Army Commendation Medal. But the honors did not relieve the pain of his injuries, and he began using heroin. Barrios was deported from the U.S. in 1999 for possession of marijuana. His addiction to heroin continued in Tijuana.

“Every day incoming fire, everything, fighting—you didn’t know if you were going to come back home,” he said in an interview with another reporter before his death. “It changes one’s life. It changes everything. I came back crazy.”

He always talked about Vietnam, Jesus says. How his commander died in front of him. They had been very close. They promised each other that if one of them got hurt, the other would bring him in. Barrios kept his promise.

“He had a big heart for people,” Jesus continues. “He never mistreated anyone.”

Barrios continued using heroin, however; he developed respiratory problems and died April 21, 2014. His family considered sending his body to the U.S. Despite his deportation, he remained entitled to a full military funeral since he had received an honorable discharge. But because the U.S. had thrown him out, his family buried him in Mexico and maintains his room as he left it.

“No one sleeps here except his ghost,” Jesus says.

If you Google Hector Barrios, you’ll find photos of deported veterans standing at attention beside his coffin, the black and yellow insignia of his unit—the First Cavalry Division—adorning the funeral home walls. Army veteran Fabian Rebolledo, a close friend of Barrios, was among those in attendance. He also suffered from war, Jesus tells me.

I meet with Rebolledo in Las Playas de Tijuana, in a house cluttered with unpacked boxes of clothes, stacked ­suitcases, and a bed, about a half-hour bus ride from the support house. The salt-air-rusted fence separating Mexico from the U.S. rises not far from his home. The brown cliffs of scorched mesas climb above a valley to the east while the sunset burns the pounding Pacific in bright orange hues.

Rebolledo chases a friend’s collie out of the house and shows me in. He has on a blue Adidas sweatshirt and jeans. Like his friend Barrios, he has an inviting smile and an easy laugh, yet he speaks without betraying much emotion. He has a wrestler’s build and moves easily within the maze of boxes. A thin mustache traces a dark line beneath his nose. He sits in a chair across from me, an American flag behind him. “Yes, sir,” “No, sir,” he responds to some of my questions, slipping into Army-think. He sits in a high-back chair facing me. I sink into a sofa, weak springs buckling beneath the cushions.

Rebolledo spent his early childhood in Cuernavaca, Morelos, south of Mexico City. His family’s cramped house had two beds, a table, and a stool. A thin wood porch wrapped around the house. He and his parents and five brothers and sisters shared the beds. In the summer they slept outside on palm leaves, the early luster of warm mornings waking him. He would get up and fetch water in buckets hanging from the stick he balanced over his shoulder.

His oldest brother and sister moved to Los Angeles when he was eleven. A year later they paid for his father and another brother to come over. The following year, 1988, they sent for thirteen-year-old Fabian.

California. It was so big, he recalls. The buildings. The expressways. The expanses of land and houses and shopping malls that stretched for miles until they were so far away they shimmered uneasily on the horizon. At school, American students would say, Hey, you little motherfucker. He didn’t know what they meant. He could not speak or pronounce English, but he listened and slowly began to understand.

His father worked construction and restaurant jobs. His mother sewed for a tailor. Rebolledo began washing dishes at a restaurant in Almonte when he was ten. He still remembers the address, 12050 Magnolia Blvd. He doubts it’s still there.

He graduated from high school and enrolled in community college but dropped out to help his parents. He found work in farmers’ markets. Sold shoes and boots, silly belt buckles, watches and sandals. Worked construction. In 1994, he became a permanent resident through a petition his father filed to adjust his immigration status.

That was a high. There were lows, too. A girlfriend broke up with him and he bought a beer to cope with his broken heart. He liked it. Liked it too much. He got wasted all the time. I need to do something, he recalls thinking. I’ll end up in an institution, rehab, or the cemetery. In 1997, he enlisted in the Army. For the discipline. To answer the question, “What am I going to do with my life?” He was 23.

First stop after he enlisted, Fort Sill, Oklahoma. As soon as he stepped off the bus a drill sergeant started screaming. Maggots! he yelled. Rebolledo liked it. The sergeant’s sweaty face, his snarling mouth. He saw the shouting as an act, something funny. He enjoyed the rush of hurrying to obey a command. Even now, as he thinks of it, his heart quickens. Push-ups, sit-ups, running. The shooting range. The hand-grenade field. Road marches. Twenty klicks. Sometimes it was raining or snowing, hot or cold or windy. Okay, weatherman, he would say to himself. Okay, bring it on. The sergeant yelling in your face, spitting in your face. Rebolledo bore it all, digging it, defying it. He never quit.

After thirteen weeks, he volunteered for Airborne School. What the hell? It paid $150 a month more. He was attached to Charlie Battery of the Eighty-Second Airborne Division and trained as an assistant gunner.

He can’t remember specifics from his first jump out of a C-130. He was the third jumper. His legs shook. Hell, his whole body shook, heart in his throat. He thought he’d puke. He fell like a sack of weights before his chute opened, jerking him up like a yo-yo. He just had a few seconds to figure out where and how to land. Pull a strap and hope to come down softly. Took a while to learn.

When he hit the ground on his first jump, he didn’t get up for a little bit. Good thing he had Kevlar to absorb the jolt. But when the shock wore off, he gloried in the feeling that he had fallen through the sky. He still remembers all of it. If he had the opportunity to do it now, he’d do it, do a jump despite his bad knees. Just last night he had a dream that he had jumped out of an aircraft, falling through all that sky.

In 1998 he met his wife, Bertha. Her niece was a friend and sometimes when Rebolledo called her in California, Bertha would answer and they would talk for hours. Within a month, he proposed to her over the phone and then paid her a visit. He thought she was pretty. Not supermodel pretty, but pretty. Soft skin, long black hair, black eyes, a nice body. They married the next day. He’s like that. When he wants something, he doesn’t second-guess himself. He goes out and gets it.

In February 1999, his battery was deployed to Kosovo. He had not paid attention to the war there. He had assumed he would be sent to Kuwait to deal with Saddam Hussein in Iraq. He packed his duffle. Bertha, pregnant at the time, returned to California to live with her parents.

Kosovo morphed into a bad dream. Rebolledo had not been overseas long when the Red Cross notified his unit that his wife had miscarried. I’m sorry, a captain told him. You have an hour to pack up and go home. Instead, Rebolledo walked to his tent and played dominoes. When his captain checked on him, Rebolledo told him, It’s no good to go back. How good will I be watching the news of all you here? The baby won’t come back whether I stay or go.

You’re a bad motherfucker, the captain said.

He imagined who his child might have been in the face of innumerable horrors he saw as he patrolled Pristina, the capital of Kosovo, and swept the area for land mines. An uncontrollable anger crept up on him.

A sniper shot him in the leg one afternoon while he patrolled a corn field. Six shots from a semi-automatic. He thought a branch had hit him but when he stepped forward, his leg couldn’t support his weight and he collapsed. He was evacuated to a hospital in Moldova.

At times the war overwhelmed him. Seeing the country all blown to shit, himself almost with it. Kids all fucked up. To him it wasn’t human that people would do this to one another.

He felt helpless and lashed out. He beat up a soldier calling out for his mother and hugging his rifle. Hey, get the fuck up, Rebolledo said, and punched him. Straighten the fuck up.

His sergeant reported him. He was demoted, but a week later he was given his rank back, and he returned to the field more aggressive than before. He didn’t take shit from anybody. What do you want now, man? he would say if he felt challenged. His only thought: stay alive. Like this one time he found a Serb trying to blow up a municipal building. The kid ran off before he could catch him. Little fucker rigging C-4 explosives. That sort of shit drove Rebolledo bat shit. Be alert, he would remind himself. Stay alive.

His commanding officers knew what Rebolledo could do with his anger. They would ask him to “give a little correction” to captured Serb soldiers. That meant covering their faces and beating the shit out of them. Then leave them in a heap on a road or some village for the Kosovars to finish off.

Don’t do it, man, his gunner told him one night when Serb prisoners were turned over to them.

Who the fuck are you to tell me what to do? They’re orders. If you don’t like them, you know who you can complain to.

Eventually, he did stop. It got to be too much. Beating them up with his rifle. Kicking them. Afterward, he’d lie down and think that what he was doing was wrong, but he rationalized that it was just an order. Protect the mission. He felt further and further removed from his family. He called his wife every night until he had nothing to say to her and then he stopped calling. When his unit was ordered home in September 1999, Rebolledo didn’t want to leave. His life was in Kosovo, not the U.S. But he had no choice. He returned to Fort Bragg, feeling as if he had landed in a foreign country. Too accustomed to being in the field among dead bodies, he slept outside. He got wasted all the time and cited for drunken driving. But drunk or sober, he was home. In March 2000, he received a general discharge and returned to civilian life. Four months later, his wife gave birth to a son.

Rebolledo found work as a security guard. In 2005, he got back into construction and also received another DUI. He dreamed of Kosovo, of dead babies. His temper flared. Yet he met all his familial obligations. He built a construction business, bought a house. He put food on the table, money in the bank. He would eventually seek help from the Department of Veterans Affairs for post-traumatic stress disorder (PTSD).

The Great Recession broke him. Three construction jobs canceled. He owed $5,000 a month for a warehouse where he stored his equipment. His trucks were repossessed. He had to sell the house.

In May 2007, Rebolledo was charged with felony forgery for attempting to cash a $750 check that he said he got for doing a stucco job. He was given probation. Authorities arrested him again three months later, this time for driving with a suspended driver’s license as a result of his DUIs, a violation of his parole. He was sentenced to sixteen months in prison and came to the attention of immigration. He was released after eight months and turned over to Immigration and Customs Enforcement (ICE) for removal proceedings.

The immigration officials transferred him to a detention center in El Centro, California, in 2009. His wife divorced him, and the following year he was deported to Mexicali, Mexico. He had no money. Only his prison clothes, gray on gray sweats. On the bus ride to the border, a guard told him, You’re a vet, right? So am I. OK, you didn’t hear this from me. Check it out. You have seventy-two hours to get back into the States before your residency card is canceled.

In Mexicali, Rebolledo called his sister. She spoke to their father. He met Rebolledo in Tijuana and brought his residency card. Crossing back into California, Rebolledo told a border patrol officer, I was in the Eighty-Second Airborne.

I’m a Marine, the guard said. Come on, come on, you can go, I don’t need your ID.

Living with his parents in LA again, Rebolledo worked construction. For two years, no problem. Then in January 2012, a police officer pulled him over for speeding near a Carl’s Jr. He had no license, no state identification. The officer brought him into the Baldwin Park Police station and ran his fingerprints. No warrants, but his prints were sent to ICE.

About six weeks later, six ICE agents showed up at his ­parents’ house. Six-thirty in the morning. Rebolledo got out of bed to answer the door. Squinting. His parents standing behind him. The sun barely up, the houses of the ­neighborhood slowly revealing themselves within the fading darkness. Nothing else. No neighbors about. The noise of a car somewhere far off.

Step out a minute sir, one of the agents told him. Are you Fabian?

Yes.

Do you have ID?

Rebolledo gave them his card from Veterans Affairs.

Where were you deployed?

Kosovo.

Really? I was in Pristina.

Really?

I was with the 379th.

I was with the 505th Engineering.

Can I see your DD214?

Rebolledo showed him his discharge papers. The officer said that two other officers with him were veterans, too. He walked a few paces away from Rebolledo to confer with them.

I can’t deport a vet, Rebolledo overheard him say.

What do we do? one of the officers said.

No one spoke. Rebolledo heard their shoes scuff the concrete as they shifted their bodies, not saying anything. Heads down, glancing at one another. Thinking.

Say he wasn’t here.

They gave Rebolledo his DD214 back.

Sorry, you’re not who we’re looking for, the first officer said.

A month later, about six-thirty in the morning again, Rebolledo’s mother woke him up. ICE is here, she said. Sure he would be taken in this time, he hugged his parents goodbye. He dressed in a T-shirt and jeans and met the agents at the front door. He showed them his VA card. They consulted amongst themselves as the previous agents had, returned his card and apologized for bothering him.

But on the morning of June 24, 2012, his veteran status no longer mattered to the half-dozen ICE agents who confronted him at his parents’ house. Seven in the morning. He was dressed and preparing to pick up his son at his ex-wife’s. A trip to the mall to buy the boy some clothes topped his agenda.

Today is not your lucky day, one of the ICE agents said.

They escorted Rebolledo to a white van. He was held eight hours before he was deported to Mexico with twenty other men. He was the only vet. He got out of the bus and stood in line to cross into Tijuana. About four in the afternoon. The sun blazing, his handcuffed wrists sweating in the heat. A border patrol officer caught Rebolledo’s glance at him and pulled him out of line. He pushed him against the bus and shouted,

You think you’re fucking tough.

Yeah, I do, Rebolledo told him.

The officer punched him in the stomach.

You’re just another fucking immigrant.

Leave him alone, an ICE agent said. He’s going out.

Fuck all of you, Rebolledo said.

I’m sorry, the ICE agent said.

Later, local news stations interviewed Rebolledo and six other deportees at a hotel where they had pooled their money to rent a room in Tijuana. A woman walking past the hotel saw them being interviewed. Two days later, she noticed Rebolledo on the street and stopped to speak to him. He told her his story and she offered to let him stay at her home until he got situated. He eventually met Hector Barajas-Varela and lived with him in Rosarito for about seven months helping other deported vets.

Rebolledo no longer receives his military pension, and no longer receives physical therapy for leg and back injuries he suffered jumping out of planes. At first friends, family, and people supportive of deported vets sent him donations of $20, sometimes even $50. But now he hasn’t gotten anything in months. People get tired of donating.

The house he lives in now is falling apart. The ceiling leaks. Mildew stains the cracked walls. He has agreed to repair the damage in exchange for not paying rent. He points to fresh smears of drying cement as evidence of his work. Not a good way to live but decent for Tijuana, Rebolledo says.

At night, he puts on a DVD for company and falls asleep to the voices of Mexican actors he doesn’t know. Some days he helps a neighbor. An old friend from California might be here next Monday or Sunday. He’ll bring canned food. Day by day, Rebolledo gets by.

Excerpted from the new book Without a Country: The Untold Story of America's Deported Veterans by J. Malcolm Garcia (Hot Books, September 2017) available for purchase from Amazon, Indiebound and Hot Books. 

 

 

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          Can You Pass the US Citizenship Test?        
Ninety-one percent of the country answered at least six questions correctly. See how you stack up.

Anyone hoping to become a naturalized US citizen must pass a civics test that assesses their knowledge of US history and government. To pass, applicants need to get at least six of 10 questions right.

Most people pass: as of September 2016 (the latest figures available) the national success rate was 91%. Think you can, too? Take our test below.

What is the name of the Speaker of the House of Representatives now?
Which state was not one of the original 13?
Who is the "Father of Our Country"?
Who wrote the Declaration of Independence
Who is the Commander in Chief of the military?>
How many amendments does the Constitution have?
Who is the Chief Justice of the United States now?
How many voting members does the House of Representatives have?
Who was President during World War I?
Name one of the states that borders Mexico

Answers: 

1) Paul D. Ryan 2) Vermont 3) George Washington 4) Thomas Jefferson 5) The President 6) 27 7) John Roberts 8) 435 9) Woodrow Wilson 10) California 

 

Source: Orbitz.com


          Journalist who fired AR-15 bazooka awarded National Defense Service Medal        
AR15
WASHINGTON, D.C. – A journalist from the New York Daily News has been awarded the National Defense Service Medal in recognition of his honorable service during a time of crisis, a Pentagon spokesperson announced today. The recipient will also be eligible to receive disability compensation from the Department of Veterans Affairs within the next decade. […] More
          Information Security Program Survey        
Scenario...
Information Security Program Survey


As a new graduate of UMUC’s cybersecurity program, you have decided to apply in a competitive selection process to a joint federal-state government sponsored cybersecurity training program for new graduates (apprentices). As part of your application package, you must submit an essay (narrative) containing a written analysis of an information security program. You can use the worksheet to help organize your information.

The application package provides you with the following information:

For your application to this program you are asked to prepare a high-level summary of an information security program. Your summary should demonstrate that you are able to read, understand, apply, and write about common information security concepts at the apprentice level. Your summary must include an analysis that addresses strategic fit (how well the information security program supports the organization’s goals and objectives), breadth and coverage of the information security program (people, processes, technologies), any known or previously uncovered program deficiencies or implementation issues, and any stated costs and benefits of the program.

Choose one of the organizations listed in Table 1, review the pertinent documents, and then prepare a three- to five-page narrative summarizing your analysis of the organization’s information security program. Uniform Resource Locators (URLs) are provided for the pertinent documents and web pages.

Table 1


Listing of Information Security Programs for Applicant Essays
Organization Website
Strategic Plan
Information Security Program
Program Evaluation Report

Department of Health and Human Services
http://www.dhhs.gov/
http://www.hhs.gov/secretary/about/priorities/priorities.html
http://www.hhs.gov/ocio/policy/index.html#Security
http://www.gao.gov/new.items/d06267.pdf

Department of Veterans Affairs
http://www.va.gov/
http://www.va.gov/op3/Docs/StrategicPlanning/VA_2010_2014_Strategic_Plan.pdf
http://www1.va.gov/vapubs/viewPublication.asp?Pub_ID=56
http://www.gao.gov/new.items/d10727t.pdf

Internal Revenue Service
http://www.irs.gov/
http://www.irs.gov/pub/irs-pdf/p3744.pdf
http://www.irs.gov/irm/part10/index.html
http://www.gao.gov/new.items/d10355.pdf

National Aeronautics and Space Administration
http://www.nasa.gov/
http://www.nasa.gov/pdf/516579main_NASA2011StrategicPlan.pdf
http://www.nasa.gov/offices/ocio/itsecurity/
http://www.gao.gov/new.items/d104.pdf

State of Maryland
http://www.maryland.gov/
http://www.statestat.maryland.gov/gdu.asp
http://doit.maryland.gov/support/Documents/security_guidelines/DoITSecurityPolicy.pdf
http://www.ola.state.md.us/Reports/Fiscal%20Compliance/DoIT09.pdf

University of Nebraska Medical Center
http://www.unmc.edu/
http://www.unmc.edu/wwwdocs/strategic-plan_06-10_v3-brochure1.pdf
http://www.unmc.edu/its/docs/UNMCInformationSecurityPlan-Sept2010.pdf
Audit report not available. Use http://www.gao.gov/new.items/d10361.pdf

Vanderbilt University Medical Center
https://www.mc.vanderbilt.edu/
http://www.vanderbilt.edu/oor/about/strategic-plan1-2009.pdf
https://www.mc.vanderbilt.edu/security/
Audit report not available. Use http://www.gao.gov/new.items/d10361.pdf

Proposed solution...

In an effort to preserve and protect the availability, confidentiality, and integrity of all State own information, the State of Maryland defines in this policy a set of rules and guidelines that each agency concerned must adhere to. The policy set forth in the analyzed document is intended mainly to all State employees in the Department of Information Technology, Agency, Employees and Contractors. The aforementioned audience has been specifically targeted due to the fact that employees in each of these three categories are one way or other exposed to crucial and sensitive information of the State.


Asset management, Security Program, Electronic Communications, Physical Security, Network Security, Access Control, Communication and Operations Management, and finally Policy Violations will be the attention focal point of the state information security policy document.

First, the document points to Asset management. It is comprised of the inventories of asset, Information Classification Policy, System Security Categorization Policy under which the Federal Information Security Management Act (FISMA) has defined Confidentiality, Integrity and Availability; then Security Categorization Applied to Information Systems (Maryland Department of Information Technology, 2010). Accountability is very important in asset management. To achieve it, all major information systems assets shall be accounted for and have a named owner (Maryland Department of Information Technology, 2010)

The second facet discussed in the policy is Security Program. It provides a strong foundation for understanding and implementing security throughout an agency (Maryland Department of Information Technology, 2010). Security Program also defines minimum components that must be included within the program, and these are IT Security Policy, Risk Management Process, Systems Development Life Cycle Methodology, IT Security Certification and Accreditation, IT Disaster Recovery Plan, Security Awareness, and finally IT Incident Response Process.

Electronic communication is another point discussed in the security policy document. It basically defines how users of state electronic communication systems should take ownership of the electronic communications created, received, or stored on the State electronic communications systems and to inform users of the systems about their rights and duties with respect to electronic communications (Maryland Department of Information Technology, 2010). This policy also sets forth acceptable and unacceptable actions by the various State electronic system users in respect to the use of the state's electronic communication systems.

Moreover, Physical security is defined in this policy as providing means to limit or restrict physical access to the State's IT information processing, storage areas, and storage devices and its supporting infrastructure. To achieve this goal, agencies must secure IT areas with controls commensurate to the risks; ensure secure storage of media; obtain personnel security clearances where appropriate; ensure secure media reuse; ensure the secure destruction of storage media (Maryland Department of Information Technology, 2010). Access to important areas will be granted only to employees, contractors, technicians and vendors who have legitimate business responsibilities in those areas. Even for these personnel, authorization to the areas is granted depending on frequency of the need and must have a prior approval of the area's manager. The concerned personnel must also be issued proper authentication means in order to get access. Besides, the agency in charge of the security area must ensure that any physical access controls are fully auditable (Maryland Department of Information Technology, 2010).

Network security is very important in keeping the information security of the State safe and secure. To achieve this security measure, State agencies must at a minimum ensure that all networks are protected from unauthorized access at all entry points (Maryland Department of Information Technology, 2010).

Furthermore, Access control is added to this important State information security policy due to its critical importance. To insure that only appropriate users can access information for authorized use only, the State again sets minimum requirements that each agency must establish. Among the minimum requirements set, it is worth to notice Authentication, Authorization, an audit trail and finally security-related events and periodic reviews of system logs (Maryland Department of Information Technology, 2010).

Communication and Operations Management are also discussed. They are comprised on one end of system communications, and at the other of Operation Management. The key elements of System communications protection are backup protection, denial of service protection, boundary protection, use of validated cryptography (encryption), public access protection, and protection from malicious code while Operations management refers to implementing appropriate controls and protections on hardware, software, and resources; maintaining appropriate auditing and monitoring; and evaluating system threats and vulnerabilities (Maryland Department of Information Technology, 2010). As set in other state's agencies, there are also minimum requirements for accomplishing Communication and Operations Management. Among the many important measures outlined, it is worth to notice basic but crucial procedures such as the use of encryption, firewall, and deployment of appropriate anti-virus and intrusion detection and prevention systems.

Finally, a policy violation has been added to remind the audience of this document that a corrective action up to termination can be warranted in case of non-compliance.

The analysis of the Information Security policy developed by the State of Maryland has an important role to play: support the Governor's Delivery unit objectives which are mainly divided in four essential categories: Opportunity, Security, Sustainability, and Health. In order to accomplish each one of these categories, data is generated, analyzed, and plot as graphs to compare past data and projected data (Governor O’Malley’s StateStat, 2008). The availability, accuracy and integrity of the data utilized are very important in setting the goals. Unavailability of data or application can lead an operation to cease to function, or cause serious downtime that can lead to lost productivity, lost revenue, damaged customer relationships, bad publicity, angry customers, idle employees, and lawsuits (Stanford University, 2004). For the data to be available for use, the security policy will help to prevent a potential misuse of the State's electronic communication system which could lead to security breaches or possibly cyber attacks against the State's government critical information. At the same time, the policy will also provide enterprise data security layers deemed necessary in protecting the State's electronic systems, thus helping towards the accomplishment of the Governor's goals. Authentication, authorization, acceptable and unacceptable use, confidentiality and risk assessment have been defined accordingly. All these are indispensable security-related features. In order to carry out its goals though, the State's IT teams need to focus on the risk assessment. In this ideology, the principal goal of an organization’s risk management process should be to protect the organization and its ability to perform their mission, not just its IT assets; therefore, the risk management process should not be treated primarily as a technical function carried out by the IT experts who operate and manage the IT system, but as an essential management function of the organization (Goguen, Feringa, & Stoneburger, 2002).

Although the document does not highlight any prior known or previously uncovered program deficiencies or implementation issues, and any stated costs and benefits of the information security policy, it supports the goals set forth by the Governor's office as included in this analysis. It defines measures needed to be taken by anyone employed by the State including contractors, as well as various agencies within the State's government.

                                                                    References


Goguen, A., Feringa, A., & Stoneburger, G. (July, 2002). Risk Management Guide for Information Technology Systems. Retrieved June 9, 2011, from NIST Web site: http://csrc.nist.gov

Governor O’Malley’s StateStat. (2008). Governor's Delivery Unit. Retrieved June 9, 2011, from Governor O’Malley’s StateStat Web site: http://www.statestat.maryland.gov

Maryland Department of Information Technology. (2010, September). Information Securituy Policy. Retrieved June 9, 2011, from Maryland Department of Information Technology Web site: http://doit.maryland.gov

Stanford University. (2004). Overview of High Availability. Retrieved June 9, 2011, from stanford University Web site: http://www.stanford.edu



          Mental Health Characteristics of Sexual Minority Veterans        
Mental Health Characteristics of Sexual Minority Veterans Source: Journal of Homosexuality This study examines the mental health characteristics of sexual minority (lesbian, gay, and bisexual, or LGB) veterans, compared these characteristics to those of an existing Veterans Affairs (VA) sample, and examined the relationship between mental health and anxiety around concealment of LGB identity while [...]
          Veterans increasingly filing disability claims due to MRE exposure        
Veterans increasingly filing disability claims due to MRE exposure
WASHINGTON — More than 100 veterans have in recent months filed non-combat related disability claims with the Department of Veterans Affairs due to years of overexposure to meals, ready-to-eat, and that number is expected to rise, sources confirmed today. Some 20 military veterans announced their intentions to protest at the headquarters of the VA later this week, in an […] More
          VA to implement prescription drug grab bag policy        
va prescription pills
WASHINGTON — After nearly 50 years of being inundated by impatient and ungrateful veterans, the Department of Veterans Affairs has announced a plan to replace examination and diagnosis with massive drug issuance; all of which will be done blindly. The policy, which is set to take effect Jan. 1st, calls for the installation of large glass cases in […] More
          Video Documents American War Heroes Sleeping On San Diego Streets        
Share this
homeless sleeping next to the U.S.S. Midway aircraft
carrier museum, Downtown San Diego

With all the vehicles on the streets of America sporting those little yellow “Support
Our Troops,” ribbons, it is truly ironic that we have more than 200,000
veterans who are homeless.  But not many Americans realize it. 

Mark Schulze and Patty Mooney, of Crystal Pyramid Productions, a San Diego
video production company, shot footage at the 20th anniversary of Stand Down
in 2007 for the Veterans Administration (VA).  Stand Down is a three-day
event that allows homeless veterans to come in off the streets for a shower,
hot meals and a change of clothing. 

Additionally, the veterans also receive
medical, dental and holistic treatment, as well as counseling and legal advice
from caring volunteers.  The San Diego Stand Down became the model for
dozens of other Stand Downs that have been generated across the country by
people who thought it a tragedy to have our war heroes sleeping on our streets.

A homeless Iraq war vet and her pet

Schulze and Mooney were shocked to learn of the huge number of homeless veterans
in the U.S.  After spending two days interviewing and getting to know
some of the men and women who had served our country, some without limbs, and
all without homes, Mooney broke down in tears.  “Three days of reprieve
from the streets and now they have to go back out there.  We have to do
something for them!” she told Schulze.  He comforted her, “Why
don’t we do what we do best?  Let’s make a documentary.”

Documentary producers Patty Mooney and Mark Schulze interview
David "The Water Man" Ross who appears in "The Invisible
Ones."

It took a year for the couple to make “The Invisible Ones: Homeless
Combat Veterans”.  They interviewed Congressman Bob Filner, Chair
of the Veterans Affairs Committee; Congresswoman Susan Davis, Chair of the
Military Personnel Committee; Gary Becks, Director of Rescue Task Force; Dr.
Jon Nachison, Co-Founder of San Diego Stand Down; Al Pavich, Former Commander
and Retired CEO of VVSD (Veterans Village of San Diego); Darcy Pavich, Chaplain
and Stand Down Coordinator; Brigadier General Bob Cardenas; Robert Schmidt,
Director of Vince Lombardi Association; Jessica Brian and Michael Kilmer, Veterans
Administration Outreach Therapists, and several homeless veterans.

A homeless veteran at Chicano Park, San Diego

All contributions to this documentary have been pro bono, even down to the
music, box cover graphics, website creation and DVD replication.  Mooney
edited at night and on weekends, grappling with technical difficulties, and
whenever she thought of quitting, she remembered, “there are veterans
who are homeless tonight and we have to help them.”

The couple delivered the completed DVD to Darcy Pavich, at the 2008 Stand
Down.  The chaplain’s eyes welled up as she said, “Do you
know how many video crews have come and gone over the last 20 years who said
they would send us clips?  You are the first ones who did what you said
you were going to do.”

Churches, veterans associations, philanthropy clubs and others are welcome
to request the DVD for free and share it with their members.  All revenue
generated from sales and showings of the documentary will go to homeless veterans
organizations such as VVSD and the National Coalition for the Homeless.  A
website, www.theinvisibleones.org informs
visitors how they may be of assistance to homeless veterans.  Money is
welcome; volunteering time is priceless.

For further information on “The Invisible Ones: Homeless Combat Veterans” go
to www.theinvisibleones.org or
call (619) 644-3000.


          Therapeutic Medical Physicist - Veterans Affairs, Veterans Health Administration - Jackson, MS        
Master's degree or higher in a physics, science, or engineering discipline recognized by an accredited college or university with at least 30 semester hours in... $101,409 - $131,833 a year
From Department of Veterans Affairs - Thu, 18 May 2017 08:54:22 GMT - View all Jackson, MS jobs
          Victoria Advocate January 4, 2016        

Farenthold brings VA paperwork training for medical community Congressman Blake Farenthold, R-Texas, partnered with Port Lavaca Memorial Hospital to bring training Tuesday to assist the medical community in dealing with paperwork to get promptly reimbursed through the Department of Veterans Affairs.

The post Victoria Advocate January 4, 2016 appeared first on .


          Let's Embarrass Rom/Ry in November        


So I long ago realized Obama will win. It may or may not be close. A good friend, Rock Hackshaw, a local blogger and politician, predicted "it won't even be close" some months ago. And he was one of the first people I know to have predicted an Obama win in 2008.

The Rom/Ry ticket advocates a return to the horribly failed Bush policies that gutted the American economy and created our largest deficits ever. America still is angry at the Greedy Oil Party for the stupid failures of the Bush years and they realize that Rom/Ry want to go back to those failed Bush policies. But we need to do more.

It is Congress I am worried about. We need to hold the Senate and make gains in both the Senate and the House. Ideally we would win big in both, but that will take a lot of work. But it is work worth doing.

But I also think we have a real shot of embarrassing the Republicans on their home ground, and this dovetails with gains I would like us to make in Congress and on local levels. Looking at the race for the presidency we have:

Mittens "1%" Rom, former governor of Massachusetts

Paul "teabagger elitist" Ry, congressman from Wisconsin

Barack "making history" Obama, former Senator from Illinois

and Joe "I don't plagiarize anymore" Biden, former Senator from Delaware.

Now I don't know of any close races in Delaware, but I do know that Massachusetts, Wisconsin and Illinois are states with some pretty darned critical races, and in addition to simply seeing Obama/Biden defeat Rom/Ry, I would love to see the Greedy Oil Party SLAMMED into defeat in the same states that these Pres and VP candidates come from.

I want to see us come as close to sweeping every close race possible in Wisconsin (a key battleground state for several years), Massachusetts, and Illinois. In the process we can help some really damned good Democrats win over really sleazy GOPers.

Here is my new (partial) strategy for November:


To donate to the following candidates, please visit my Embarrass Romney/Ryan 2012 Act Blue website. I will match at least partly the first three donations made. Our future hangs in the balance this year, so I am hoping you guys make me shell out a LOT of money on this. I can't afford it but I feel I can't afford NOT to.

If we win most of these races, we will be REALLY kicking ass this year.

NOTE: I base my choices partly on candidates I like, partly on Democracy for America, partly on Progressive Majority, and partly on a conservative-website-I-tend-to-follow's view of what they consider close races.

Let's begin with the Rom's own state of Massachusetts. He was Gov there, and not as bad as most Repubs, but not great. Now Romney won't win Mass even though he is a former Gov...but it will be so much more satisfying if he not only loses himself, but his party loses two close and key races for Congress: Senate and MA-6. Both are close races.

MA-SEN:

This is one of our most important fights this year. It is a toss up race that is really neck and neck. Winning a major Senate seat race in Romney's own state would be really, really sweet.

Elizabeth Warren is a great candidate. Check out her profile on Democracy for America's website.


MA-6:

This is a close House race in Massachusetts. Holding onto this seat helps us in Congress.




Now let's turn to one of the most important swing states in the country. We have been fighting anti-union extremism here for 2 years now, and we have been winning several recall elections on the state level. Paul Ryan comes from Wisconsin. Wisconsin has a strong progressive, pro-labor, pro-farmer background that could turn so solidly against the Republicans their heads would spin. Democrats haven't fought hard enough for this state's heart and soul. The Rom picked Ryan because they want to make us fight for Wisconsin. Well let's turn the tables. We WILL win Wisconsin for Obama. I have no doubt about that. But let's make our win go deeper. Let's win every close Congressional seat and let's defend our new lead in the state senate.

My family first moved to Wisconsin (Milwaukee) after coming from Europe. So I feel some personal, family connection to winning in Wisconsin. My visits to Wisconsin (pretty much Madison for conferences) have been very enjoyable experiences. I would love to see Wisconsin follow its strong progressive history right about now and solidly reject the Rom/Ry advocacy of returning to failed Bush policies. Here are the key races:

WI-SEN:

The tea party is really aiming for this seat. We need to defend it if we want to hold onto the Senate. We also need to show Ryan that his greedy and cruel vision for Wisconsin and America is a failure and that his own state prefers the more progressive vision of Tammy Baldwin.

You can read more about Tammy Baldwin at Democracy for America.




WI-01:

Rob Zerban is running for Paul Ryan's own seat. I say lets fight the right on their own territory. If we can give Ryan a run for his (ample) money right in his own district it will send a clear message how sick America is of his extremist views.

WI-07:

This is a key House race. This is a real chance to pick up a seat from the Republicans.

Patrick Kreitlow has been endorsed by the Intl. Association of Firefighters, Steelworkers Union, National Farmers Union, NARAL Pro-Choice America Intl. Brotherhood of Teamsters, AFL-CIO, League of Conservation Voters, Planned Parenthood Action Fund Sierra Club, United Auto Workers, WI Federation of Nurses, and WI Alliance for Retired American, among others.

WI-08:

This is another pick up opportunity for Democrats in the House.

Jamie Wall has been endorsed by Green Bay Firefighters, the Alliance of Retired Americans, the Teamsters, Human Rights Campaign, American Federation of Teachers- Wisconsin, American Nurses Association, United Auto Workers, and many others.


WI-SD-18:

Jessica King is one of my favorite Democrats. And she has been for several years.

Jessica King is one of the best things to happen to the Wisconsin State Senate, winning one of the hard fought recall elections against the right wing extremist Republicans. Jessica King is intelligent and very capable and will make an excellent State Senator.

She has been endorsed by Progressive Majority and is one of America's best progressives. Let's make sure she wins re-election.

WI-SD-32:

Jennifer Shilling is another Progressive Majority endorsed candidate who won one of the recall elections. And this is another seat worth defending.

WI-SD-22:

Bob Wirch was one of the Democrats targeted by Republicans for recall...but we beat them, defending Bob's Senate seat. Let's show him we still have his back. Bib Wirch is also endorsed by Progressive Majority.

WI-SD-30:

Dave Hansen was also one of the Democrats targeted by Republicans for recall...but again, we beat them. Let's show him we still have his back. Dave Hansen is also endorsed by Progressive Majority.


NOW I want to turn to the state that elected Obama to the Senate: Illinois. It would be great to sweep the close races in Rom's Massachusetts and Ry's Wisconsin. But it would ALSO be sweet to sweep the many close races in President Obama's Illinois. Here they are (sorry Biden...don't find close races in Delaware):

IL-17:

This is a seat we can pick up from the Greedy Oil Party. But it's going to be close.


IL-11:

This is a close race and one that we absolutely have to win to make gains in Congress...particularly if we want Congress to start accepting global warming as an issue we need to deal with.

Bill Foster is one of my favorite candidates. He was a renowned scientist turned businessman who has already served in Congress. It is time to send him back to Congress. We need more people with Bill's intelligence, practicality and scientific outlook.

Bill Foster has been endorsed by the Associated Firefighters of Illinois, AFL-CIO State Federation of Illinois, Illinois Federation of Teachers, Amalgamated Transit Union Local #308, and many others.



IL-13:

This is another very close race and an important pick up opportunity for Democrats.

Dr. David Gill has been endorsed by the United Auto Workers, AFL-CIO, Planned Parenthood Action Fund, Sierra Club, United Mine Workers of America, Democracy for America, Progressive Democrats of America, National Nurses United, and many others. He is a true progressive and would be VERY valuable to have in Congress.



IL-08:

Captain Tammy Duckworth was a Black Hawk helicopter pilot fighting in Iraq. She lost both legs and part of the use of her right arm when her helicopter was shot down, and was awarded the Purple Heart for her combat injuries.

President Obama appointed Captain Duckworth to be Assistant Secretary of Veterans Affairs where she sought to improve the standard of care for Vets. She oversaw VA's effort to end Veteran homelessness and lead initiatives for female Vets and increased accessibility and accountability with the new Office of Online Communications.

We have a REALLY good shot at picking up this seat.



IL-12:

This is a seat we could lose. If we want to make gains in the House, we need to defend it. The Greedy Oil Party is really trying to take this seat from us.

Bill Enyart is the former head of the Illinois National Guard. He is pro-labor and would be a committed Congressman.

IL-10:

This is a close race but one we have a good shot of winning.

Brad Schneider has been endorsed by the Associated Firefighters of Illinois, United Auto Workers, League of Conservation Voters, NARAL, Human RIghts campaign, United Brotherhood of Carpenters & Joiners, and many others.




Help me win these critical races and in the process embarrass the Greedy Oil Party.

Again, you can donate through my visit my Embarrass Romney/Ryan 2012 Act Blue website. And I will try to match at least partly the first three donations made.





          Serving The Needs Of Student Veterans        
In 2009, there were approximately 500,000 veterans receiving education benefits and attending US colleges. By 2013, more than one-million student veterans were using their GI benefits to pursue advanced educational opportunities, and that number is estimated to increase by 20% in the next few years. Joining us to look at today’s veterans on campus are Dave Merriss , assistant director at the Northern Kentucky University Veterans Resource Station ; Terence Harrison , University of Cincinnati Veterans Programs & Services manager; and, Christopher Klug , assistant director for Xavier University’s Center for Veterans Affairs . For a list of additional resources for veterans, click here .
          Joint Hearing on the Statewide Radio System        

Joint Hearing - Senate Communications & Technology, Senate Law & Justice, and Senate Veterans Affairs Emergency Preparedness Committees - June 7, 2017

 

The post Joint Hearing on the Statewide Radio System appeared first on Senator Chuck McIlhinney.


          The amazing Fort Lewis        
One of the most famous forts around the world is the Fort lewis. In the year, 1961 it was legal to hunt the alligators. And the historians could easily use a boat to look around at various caves and forts. This really helped them to explore new and better things. The Fort Lewis Washington had enjoyed a lot on his last days in army in the year. He travelled a lot and also helped the world known about a lot of new forts and cities. He also explored a number of caves. His expeditions are famous all over the world.

The expeditions of historians such as lewis as well as Clark can be compared to the expeditions of an astronaut, who land on moon for the first time. The difficulties as well as troubles in both the expeditions are the same. A lot of hardships have been tackled in achieving both of them. Though, the 30-tons of provisions collected and taken on the group-of-Discovery voyage's twenty eight-month dangerous voyage to the Pacific Ocean as well as back assisted it to be successful massively. All these facts have made Fort lewis homes really as well as renowned all over the world.

An increasing amount of experts as well as service associates are making use of their VA home mortgage assistance from the section of Veterans Affairs. The Fort lewis homes loan degree has developed more than thirty percent from the previous year. The residence loan plan has persisted to be a well-liked alternative in the present housing market place. Officers declare it is due to the prohibiting of a lot of no-down compensation credit courses in the predictable mortgage business by the side of with first-class loan conditions.

Fort lewis pcs have been using a lot of hours reviewing the market place for a probable big business site in the South Western section of Colorado. Gathering with administrators, business group as well as calling businesses we discovered fairly a bit about the district as well as the upcoming outlooks there for someone starting a business. Ft lewis Washington is a well known historian.

A developing number of experts as well as service associates are utilizing their Fort lewis homes credit advantage from the section of experts Affairs. Thus all these historians as well as their expeditions’ are very famous. They have shown the worlds a lot of new caves, islands, ports, towns as well as seas. Their valuable contributions are always remembered as well as appreciated. A number of historians namely lewis, Clark as well as Hubert Crowell has made their valuable contributions in exploring the world and making a mark in the history. All these have also minutely explored the fort lewis map.

Reference website: www.fortlewisva.com
          VA Home Loans for Housing        

A growing number of veterans and service members are using their VA home loan benefit from the Department of Veterans Affairs. The VA's home loan program has continued to be a popular choice in the current housing market.
The VA home loan volume has improved more than 30% from last year. Officials say it is due to the exclusion of many no-down payment loan programs in the conventional mortgage industry along with good loan terms.

Loans which characteristic no down payment are becoming very difficult to get with conventional financing. One eyewitness recalls driving a popular Los Angeles freeway and seeing a sign for "10percentdown dot com" which many believe replaced their "ZeroDownLoans" dot com sign. Just recently this year, legislation passed a law for the VA to use a local approach in finding maximum loan amounts on its zero-down payment home loans.

If it hadn't been for the VA home loan series I never would have been able to buy my first two homes. Now years later I'm helping military families transitioning to Fort Belvoir, Quantico or anywhere in the Military District of Washington use the VA Home Loan Program to buy homes.

There seems to be an sketch flying around Northern Virginia that you can't use a VA loan to buy a foreclosure property. THIS IS NOT TRUE! In the past month I've closed on two foreclosure properties in Prince William County with buyers using a VA loan without any problems. The electricity does need to be on when the evaluator shows up but that is an easy problem to solve with a couple of phone calls and if you are having a home inspection you want the electricity on anyway.

For a first time buyer a VA loan solves the down payment issue. VA does not require any down payment, ZERO, NADA, ZILCH and a seller can contribute up to 4% towards closing costs.

For more information about Fort Lewis housing visit: www.fortlewisva.com

Tag:- McCord air base force, Ft Lewis Housing, Fort Lewis Washington, Military Relocation, Fort Lewis homes


          Nov 13: Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades and Veteran Cultural Competency 2017 (Free Webcast)        
The Practising Law Institute is offering a free webcast of a live presentation from San Francisco entitled Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades and Veteran Cultural Competency 2017 on November 13, 2017 from 12:00 pm to 8:00 pm. IMPORTANT! If you get accredited by the VA before you attend this training, the first three hours will satisfy the VA’s CLE requirement. Attorneys and other advocates must be accredited to practice before the VA.To obtain accreditation you must complete this form:www.va.gov/vaforms/va/pdf/VA21a.pdf. Accreditation by the VA may take several weeks, so do not delay filing your application.You can speed up the process by emailing the form to: OGCAccreditationMailbox@va.gov. Within 12 months after accreditation you are required to complete three hours of qualifying CLE. The morning session of this program satisfies that requirement, but only if you have already received your accreditation from the VA. If you have not received it, you should still watch this program, but keep in mind that you will need to complete three additional hours of CLE within 12 months after receiving your accreditation. Attorneys and other advocates who become accredited will be listed on a national VA list, and are entitled to represent veterans in their claims for benefits, on a pro bono basis, and for attorney’s fees on appeals, where they are available. Why You Should Attend There are over 21 million veterans in the U.S.; many of them are not aware of the benefits to which they are entitled. Medical and financial assistance are available to those who have served in the military, but many veterans most in need are not receiving VA benefits. Navigating the VA claims system and applying for discharge upgrades before the Department of Defense are difficult and complex processes. Attorneys play an essential role in removing barriers to VA benefits, such as: Lack of evidence to “service-connect” their injuries or disabilities. Lack of current medical or mental health evidence documenting severity of symptoms for accurate disability ratings. VA eligibility determinations for those given less than fully honorable discharges for behaviors that were related to minor disciplinary infractions or symptoms of Post- Traumatic Stress or other service-related disabilities. What You Will Learn Nearly 45% of veterans returning from Iraq and Afghanistan seek compensation from the Department of Veterans Affairs (VA) for service related injuries; 30% of these veterans who file for VA benefits include claims for Post-Traumatic Stress. Many of those who should receive benefits will be denied. Many service members who may be VA eligible are unaware of their legal right to pursue VA benefits, and of those who do apply, more than 90% will be denied. All of them will wait months or years for the VA to issue decisions on their claims. Learn how to navigate the VA claims process and to become an effective advocate for veterans in need. This all-day program will provide an overview of VA disability law and military discharge review law. You will gain an understanding of different types of military discharges, why they are important, and how you can help veterans with less than Honorable discharges. The first three one-hour sessions provide the basics you need to represent veterans before the VA. It will also cover the interactions between VA benefits and other public benefits, such as SSI and SSDI. The morning session fulfills the VA’s requirement for qualifying CLE within the first 12 months of your VA accreditation. The 4:45 session, Veteran Cultural Competency: Combat to Community will help veterans’ advocates to understand the challenges that veterans face in their transition to a noncombat community, and provide tips on interviewing and providing legal services to veterans with disabilities. The 5:45 to 8:00 sessions will provide attorneys with the tools that they need to assist veterans in upgrading their discharge status and removing stigmatizing information from their discharge documents. Who Should Attend Attorneys seeking meaningful pro bono opportunities and any advocate who wants to help change the life of a veteran with a disability. Attorneys seeking to meet VA’s CLE requirements for new and continuing VA accreditation should also attend. Finally, attorneys who hope to expand their practice areas to include veterans’ cases where fees are available should register for one or more of the sessions. More Information and Registration
          Which type of violence is the state?        
As Barack Obama said, a state is a legal monopoly on violence.


Well said. But which type of violence? There are four major types of violence: resource predation, process predation, monkey dance and group monkey dance. So which one is the state?

Let's look at the example of the American federal government.

I think we can safely discard the monkey dance option. At least in theory, a good policeman or soldier is expected to deeply regret that violence is "necessary" as he is applying it. His violent triumphs are not his own, but the state's.

So the people who call themselves "the state" must be something between resource predators (aiming at controling vitim's stuff and otherwise leave the victim free) and process predators (aiming at controlling the victim itself). Let's see where the major executive departments and agencies sit on the spectrum.

Pure resource predators

Department of the Treasury. That's an easy one to classify because they run the IRS. The video below shows that people operating the tax system think about it as a tool for efficient resource extraction from the population.


IRS is the enabler of all the predations of the government.

Department of Veterans Affairs. Takes money from one group of people and gives it to 
another group of people so a clear resource predator.

Department of Agriculture. As above.

Social Security Agency. As above.

Department of Housing and Urban Development. As above, except they take money from one group of people and give houses to another.

Both resource and process predators

Department of Homeland Security. Customs Service, which is a part of this department, is a resource predator like the IRS. Uniformed people telling others where they are allowed to live and how they must travel are process predators.

Department of the Interior. Their function is to manage selected natural resources. Their involvement in managing lives of the Native people seems like process predation.

Intended to be process predators but with a resource side-effect

Agencies in this category have an official mandate to be process predators. However their actions result in cartels which makes them enablers of resource predation.

Federal Reserve. Their objective is to coordinate productive efforts of the population using monopoly money.The wealth transfers they create as side effect makes them the champions of this category.

Department of Commerce. They collects data on people's productive activities to intelligently coerce them to achieve Department's aims. This is so process.

Department of Labor. As above

Department of Health and Human Services. They coerce people into using methods of medical treatment the Department prefers (including limiting access to medicines), which is a process predator thing to do.

Department of Transportation. They coerce people into using methods of transportation the Department prefers. Control of transport routes results in control of movement which is a form of process predation.

Pure process predators

Agencies in this category are not completely pure process predators, because they draw salaries from the federal budget and also they monopolise any useful services may render. They are also openly used as tools by resource predators (for example by enforcing tax laws). But the functions they perform are as close to process predation as it gets.

Department of Justice. They will prosecute you if the instruction say so, regardless if it makes any sense or makes anyone any money.

Department of Education. They do not run schools directly (its state level counterparts do). But the compulsory schooling they represent is a particularly ugly form of process predation because it applies to children.

Department of State. The executioner of foreign policy. Uses all available means to make people who live in designated locations behave in the way which serves other people's objectives.

Department of Defense. An extension of the Department of State so the same logic applies. It applies additional process predation during drafs when it enslaves people into the military. But even during "normal" times it applies a lot or process predation towards its own people. The video below shows what I mean.


Department of Energy. They produce nuclear weaponry so they belong to the same category as Department of Defense.


So overall, the American federal government is a half way house between a resource predator and a process predator.

The largest difference between different states on the planet is location on the resource / process predation scale. The best ones are limited to efficient resouce predation and run reasonably free economies with low taxation. The worse ones, like Pol Pot's Cambodia or North Korea, are more into pure process predation regardless of the economics of it.
          Spinal Manipulation Can Alleviate Back Pain, Study Concludes        
One of the most common reasons people go to the doctor is lower back pain, and one of the most common reasons doctors prescribe powerful, addictive narcotics is lower back pain. Now, research published Tuesday in the Journal of the American Medical Association offers the latest evidence that spinal manipulation can offer a modestly effective alternative. Researchers analyzed 26 studies involving more than 1,700 patients with lower back pain. The analysis found spinal manipulation can reduce lower back pain as measured by patients on a pain scale — like this one — from zero to 10. Spinal manipulation, which is typically done by chiropractors, physical therapists, osteopaths, massage therapists and some other health providers, involves applying pressure and moving joints in the spine. Patients undergoing spinal manipulation experienced a decline of 1 point in their pain rating, says Dr. Paul Shekelle , an internist with the West Los Angeles Veterans Affairs Medical Center and the Rand
          Badania: aspiryna może być pomocna w walce z rakiem piersi        
Naukowcy z Kansas City Veterans Affairs Medical Center (USA) dowiedli, że kwas acetylosalicylowy (aspiryna) może być pomocny w zwalczaniu raka piersi i zapobieganiu nawrotom choroby. Wyniki swoich badań opublikowali w czasopiśmie ,,Laboratory Investigation".
          Senate Bill 826 Printer's Number 1036        
An Act authorizing the Department of General Services, with the approval of the Department of Military and Veterans Affairs and the Governor, to grant and convey to Monroe County Municipal Waste Management Authority, or its successors or assigns, certain lands, buildings and improvements situate in Stroud Township, Monroe County....
          Joseph Rocha to attend Orlando Pride Festivities        
Come Out With Pride 2009 marketing director Mikael Frank Audebert extended an invitation to Joseph Rocha, a Navy veteran who was recently featured in the news for his 2-year long hazing and abuse by fellow officers. He will be in attendance on Friday October 9, 2009 at the official pride event Armed & Ready being held at TASTINGS downtown Orlando. Armed & Ready pays tribute to heroes, especially Gay veterans, in the Military. The event will be entertaining all while bringing awareness to the outdated and unjust "Don't Ask, Don't Tell" policies of the U.S. government.

Joseph will then fly to Washington DC for the National Equality March and to promote the repeal of " Don't Ask, Don't Tell" policies.

Joseph's attendance is made possible thanks to the generosity of RE/MAX Town Center and Charlie Orden.

More information on Pride weekend official events: http://www.comeoutwithpride.org

Excerpt from an AP bulletin:

Joseph Rocha, now 23, decided to leave the Navy in 2007 by telling his commander he was gay, in violation of the military’s "don’t ask, don’t tell" policy. He has been diagnosed with post-traumatic stress disorder from the constant hazing while he served with military dog handlers based in Bahrain to support the Iraq war.

An internal Navy investigation into his unit found dozens of examples of hazing and sexual harassment against multiple sailors between 2005 and 2006. The result of the investigation was not clear; a copy of the report released under the Freedom of Information Act has all recommendations blacked out.
Joseph Rocha, now 23, decided to leave the Navy in 2007 by telling his commander he was gay, in violation of the military’s "don’t ask, don’t tell" policy. He has been diagnosed with post-traumatic stress disorder from the constant hazing while he served with military dog handlers based in Bahrain to support the Iraq war.


An internal Navy investigation into his unit found dozens of examples of hazing and sexual harassment against multiple sailors between 2005 and 2006. The result of the investigation was not clear; a copy of the report released under the Freedom of Information Act has all recommendations blacked out...

...Rocha said he enlisted in the Navy in 2004 to demonstrate his commitment to earning an appointment to the U.S. Naval Academy after he wasn’t admitted to the school.

In June 2007, he was accepted at the academy prep school in Newport, R.I., where candidates can build the academic skills they need to be accepted to the four-year academy. While there, Rocha said depression resulting from his experience in Bahrain made him decide to tell school officials he was gay. He was isolated from other students for two months, then honorably discharged in October 2007.

"I was faced with the idea of being in a navy that condoned this for another decade," Rocha said. "I wouldn’t have allowed myself to live like that anymore."

A letter from Rocha’s doctor at the Department of Veterans Affairs in San Francisco confirms that he has been diagnosed with PTSD.

Rocha, now a student at the University of San Diego, hopes he can one day return to serve openly in the military as a Marine Corps officer.

"I’m just waiting for the policy to be repealed," Rocha said.
          Re: Marriage and Death records        
I find a WWII draft registration card for Josephus Brewer, born in Newbern, NC on 10 Nov 1917, mother's name Ada. Is this the right one? Written at the top of the card are the words Discharged 1-16-46. That corresponds with the listing in the U. S Department of Veterans Affairs BIRLS Death File for Joseph Brewer, born 10 Nov 1917, d. 05 Feb 1991, Enlisted Jun 1943, Released Jan 1946. Those dates also correspond to the listing in the U. S. WWII Army Enlistment Records for Joseph Brewer, enlisted in Richmond, VA 27 May 1943.
In the U. S. Public Records, Vol.2 on Ancestry, I find l listings for Joseph Brewer, born 10 Nov 1917, living in Richmond, VA at 806 Brook Hill Rd.
I looked up Joseph S. Brewer in beenverified.com, and it listed a deceased Joseph S. Brewer living at that same address, with Inez H. Brewer living at the same address.
I found this obituary for Mrs. Inez H. Brewer, but I did not find an obituary for Joseph, d. 5 Feb 1991. Maybe there is information here that can help you.
BREWER Mrs. Inez H. Brewer: Newspaper Obituary and Death Notice

Richmond Times-Dispatch (VA) - Saturday, October 7, 2000
Deceased Name: BREWER Mrs. Inez H. Brewer
BREWER Mrs. Inez H. Brewer, retired Richmond Public Schools English teacher, departed this life October 5, 2000. She is survived by her devoted daughter, JoAnne Brewer Martin; granddaughter, Robin C. Harris; grandson, Lon T. Martin; great-grandchildren, Christopher-Sean L. Harris and Lon T. Martin Jr.; grandson-in-law, Christopher L. Harris; nieces, nephews, cousins, other relatives and friends. Her remains rest at the W.S. Watkins & Son Funeral Home, where her family will receive friends 5 to 6 p.m. Sunday. After 11 a.m. Monday, her remains will rest at Ginter Park Baptist Church, where funeral services will be conducted at 12 noon. Rev. R. Lee Gillman Jr. officiating. Interment Oakwood Cemetery.

I found at least three Public Member trees on Ancestry which include Inez H. Gobble (Brewer ) who died 5 Oct 2000. If you have access to these trees, maybe you can contact one of the owners for more information.

I hope I have identified the person you are looking for.

Margaret
          Senate Bill 353 Printer's Number 377        
An Act authorizing and directing the Department of General Services, with the approval of the Governor and the Department of Military and Veterans Affairs, to grant and convey to the Pennhurst Memorial Preservation Alliance, or its assigns, a certain tract of land with certain improvements on it situate in East Vincent Township, Chester County....
          UPDATED CHRONOLOGY OF DUKE LACROSSE CASE: FEBRUARY 2007        
By sceptical

(Thanks to Quasi, Baldo and Q.A. for suggestions and comments on the final draft.)

THURSDAY FEBRUARY 1: In his blog “Durham-in-Wonderland,” Prof. KC Johnson of Brooklyn College describes a Duke University course-- “Hookup Culture at Duke”—being offered this spring. Cross-listed by women’s studies and cultural anthropology, the course is taught by instructor Anne Allison, a member of the “Group of 88” professors who signed a controversial April 6, 2006 ad in the Chronicle shortly after rape allegations against Duke lacrosse players by Crystal Mangum. The goal of the course is: “To understand ‘hooking-up’ at Duke in terms of larger frameworks of race, capitalism/consumerism, class, lifestyle, identity, (hetero)normativity, and power, and 2) to enable students to critically assess both the nature of Duke hook-ups and the institutional setting of Duke itself.” Johnson gives the course as an example of “a campus culture where 88 faculty members could sign a rush-to-judgment public denunciation and then, months later and after the underlying case has imploded, issue a “clarifying” statement proclaiming that they’d do it all over again.”

FRIDAY FEBRUARY 2: NPR runs a segment “Duke President takes fire over lacrosse case” by Adam Hochberg in which Duke VP John Burness attacks the lacrosse players:

“But Duke Vice President John Burness defends the school's response. He says administrators stand by their decision to punish the team for its party behavior, which he says included not only hiring exotic dancers, but also directing racial slurs toward them. And he says Duke has little choice but to let the criminal charges play out in court. Burness says that alumni continue to donate to Duke at record levels, and that — coupled with a stable application rate — convinces him the university responded well. But while one of the accused players now has graduated from Duke, the others haven't decided whether to return. The father of one of them says he hesitates to send his son back to a university that, in his words, didn't "stand up for our boys."

SATURDAY FEBRUARY 3: The Raleigh News & Observer (N&0) reveals criticism of Durham District Attorney Mike Nifong by North Carolina Gov. Mike Easley in a speech given January in New York. Easley calls Nifong the worst appointment he had ever made, and confirms that Nifong had violated an agreement not to run (he had been interim DA).

SUNDAY FEBRUARY 4: Duke lacrosse fans and supporters stand together at the Durham County Courthouse, where former lacrosse players Collin Finnerty, David Evans, and Reade Seligmann previously appeared to face felony charges for alleged rape. More than 100 people then walk 3 miles from the courthouse toward Duke’s lacrosse field in support of the 3 men. At the end of the walk, there is applause for the lacrosse team as they practice on the field. Two activist groups spearhead the gathering -- Concerned Duke Mothers, formed in response to the initial rape accusations, and Ethical Durham, a group that encourages Duke students to vote and support ethical causes. After previous protests where people taunted the lacrosse players, supporters say it is time to show the accused players who’s behind them. Their ranks include DA Nifong's former campaign manager, Jackie Brown. “(We’re wearing) the fantastic lies buttons, for those fantastic lies (Nifong) told,” Brown says. “That makes me feel like my son is in a good place at Duke, in Durham, and that there are other people who believe in justice,” says Tracy Tkac, whose son plays on the lacrosse team.

MONDAY FEBRUARY 5: A critical hearing in the Duke lacrosse case previously scheduled for today has been postponed until May as the new special prosecutors continue to study evidence. The accuser in the case, Crystal Mangum, was expected to appear at the hearing and defense attorneys planned to ask Superior Court Judge W. Osmond Smith III to throw out her photo identifications of the defendants. Legal experts have said without the accuser's photo identifications, prosecutors would probably have to dismiss the charges against the three former lacrosse players.

Black journalist Cash Michaels closes down his website “ourheartsworldlatest” with an attack on supporters of the indicted Duke lacrosse players:

“Virtually every other site devoted to the subject is authored and administered by journalist-or-detective-wannabes who believe their rank speculation, blatant lies and blanket condemnation of anyone who is not a Duke Three supporter qualifies them to be the ultimate authority of what's right and wrong in this case, if not in life. Here's hoping none of these egomaniacs ever run for public office where they respectively live. Neo-Nazism simply just doesn't merit a place on the ballot. But then there are the hate-filled mice these Pied Pipers of bias and ignorance attract out of the woodwork and onto their message boards, infesting the truth with their unique brand of vicious untruths about the accuser, her family, her supporters--Black and white, the African-American community, and this website. For the most part, ignoring the ignorant is always good advice, because what these unfortunate people crave is attention for their morally malnourished behavior. But there are times when it is not only worthy, but necessary to publicly counter out-and-out coldblooded lies about our honest, community-based efforts to support the rights of the Duke case accuser.”

TUESDAY FEBRUARY 6: Two members of the Durham grand jury that indicted 3 lacrosse players tell ABC News that they now have second thoughts about the case. The grand jurors spoke anonymously since grand jury proceedings are secret. One juror says the indictments were a mistake while the other stands by the original decision. "Knowing what I know now and all that's been broadcast on the news and in media, I think I would have definitely made a different decision," one of the jurors says. "I don't think those charges would have been the proper charges, based on what I know now." Because of more recent developments concerning the case, however, both say they have doubts about the charges. They also say they don’t understand why DA Nifong did not drop all charges when the rape charge was dropped Dec. 21.

The N & O reports that a nonprofit corporation set up to help 3 former Duke lacrosse players defray legal expenses is about a quarter of the way towards recouping an estimated $3 million in legal fees spent to date. The Association for Truth and Fairness, incorporated in Delaware on April 19, has raised about $750,000, according to one of the three founders. Legal bills have mounted for Evans, Finnerty and Seligmann since they were charged with rape at a lacrosse team party last March. The accused have hired a team of defense lawyers that has spent hundreds of hours on the case. The team has hired private investigators, pollsters, and experts on DNA and forensics. Kevin Finnerty, father of Collin Finnerty, does not quibble with estimates of the $3 million spent so far. "Unfortunately, that is accurate," Kevin Finnerty says. James Cooney, a Charlotte lawyer who represents Seligmann, states a trial would push the price higher. "It would be extremely expensive," Cooney says. Sherman Joyce, an Evans family friend who helped organize the nonprofit, explains the goal is to raise $5 million to pay the lacrosse legal bills and more.

Chronicle columnist Kristin Butler explores why some media outlets have now identified rape accuser Crystal Mangum while many newspapers, including the Chronicle, have not. In a column titled “The worst, kept secret…” Butler argues that there is a double standard for women who falsely accuse men of rape, and that false accusations are not rare events:

“For one thing, there is no especially compelling reason to believe that printing the names of false accusers will keep future victims from reporting rapes; there is, however, evidence to suggest that false rape allegations are much more common than many people are aware, and that the media's policies may even create a perverse incentive to cry rape. Indeed, the FBI estimates that 9 percent of rape claims are "unfounded"-- -defined as dismissed with no charges filed: this is several times the 2-percent rate often quoted by the media. Much more disturbing were the results of a study conducted by Eugene Kanin, professor of sociology at Purdue University, which found that 41 percent of rapes reported in an unnamed Midwestern town over a 9-year period were ultimately retracted by complainants. In a secondary study that has disturbing implications for campuses like this one, Kanin found that fully 50 percent of rape claims at two unnamed "large, public universities," were eventually recanted.”

FEBRUARY 7: Two former members of the grand jury that indicted 3 Duke lacrosse players can be charged with contempt for talking about the case. Superior Court Judge Orlando F. Hudson Jr. says he could not believe it when he heard the two grand jurors on an ABC Television program talking about the Duke case. The judge calls the secret grand jury process the most sacred in the judicial system. The judge would not give details about what he might do, but he states grand jurors who discuss a case can be charged with contempt of court, a misdemeanor offense that can carry up to 30 days in jail and a $500 fine. "It was pretty clear to me that the jurors are in violation of North Carolina law," Hudson says.

Defense attorneys for the 3 indicted lacrosse players meet again with the North Carolina special prosecutors today, their second session in as many weeks after having had no meetings at all with DA Nifong. They decline to disclose what was discussed.

KC Johnson reports a petition from the Duke Conservative Union already signed by 200 students is on the group’s website and on Facebook. The petition demands an apology from the “Group of 88,” Duke faculty who signed an ad in the Chronicle on April 6, 2006. The petition reads in part:

“In the ad they not only tacitly supported the accusations of the now utterly discredited accuser, but praised protestors who similarly rushed to judgment, while levying baseless accusations of racism against our student body. In a time of intense emotions and enormous stakes, when our community dearly needed a call for calm, for patience, for rational and careful thinking, these professors instead took a course of action which escalated tensions, spurred divisions along race and class and brought our community into greater turmoil. Their actions also further undermined the legal process and most likely emboldened a rogue district attorney.”

THURSDAY FEBRUARY 8: The N&O reports that Linwood Wilson, DA Nifong’s chief investigator in the Duke lacrosse case, was reprimanded in 1997 by the state commission that licenses private detectives. After an appeal of the board's decision was unsuccessful the following year, Wilson allowed his investigator's license to expire-- ending a 16-year career as a private eye that was marked by repeated complaints and at least 7 formal inquiries into his conduct. In a July 15, 1997, letter to the state Private Protective Service Board, Wilson complained that the reprimand would hamstring his ability to testify at trials. "When a letter is placed in my permanent file it is open to the public and therefore could be damaging to my creditability in court," Wilson wrote. "I could be cross examined by any attorney who has gotten a copy of my file." In a Jan. 24 article, the N&O reported that Wilson's file at the state board contained records of allegations from 20 years ago that he made false statements on the witness stand and set up an illegal telephone tap. In both cases, state investigators wrote in internal memorandums they thought Wilson had likely broken the law, but no charges were filed. Wilson, 58, says in an interview last month that his integrity had never been called into question and that he "retired" as a private eye in 1998 because he was tired of the acrimony that comes with working divorce and child custody cases.

The group Friends of Duke University places an ad in the Chronicle challenging the “Group of 88” faculty and their “Clarifying Statement” issued January 17 by “Concerned Faculty.” In a press release, FODU spokesman Jason Trompbour states:

“We remain sincere in our efforts to reach out to them. We are dismayed that, not only would they chose to ignore our efforts, but that they would instead respond with a defiant refusal to admit mistake either in judgment or expression and that they would insult the motives and/or intelligence of their critics. We do not begrudge members of the Group of 88/Concerned Faculty their right to call attention to social issues of concern to them. We instead condemn the unfair public vilification of members of the lacrosse team done in the course of expressing their concerns.”

FRIDAY FEBRUARY 9: Durham political activist Beth Brewer files a civil complaint against DA Nifong seeking to remove him from office. Later, a judge says he will issue an order on Monday to stay any action on the complaint. Superior Court Judge Orlando Hudson says the complaint filed today basically mirrors ethics charges the North Carolina State Bar filed against Nifong within the past two months. Citing provisions in North Carolina General Statutes Chapter 7A-66 on the removal of district attorneys, Brewer charges Nifong with willful misconduct and conduct prejudicial to the administration of justice that brings the office into disrepute. Last year, Brewer organized a political action committee, "Recall Nifong -- Vote Cheek," to elect Durham County Commissioner Lewis Cheek as district attorney, even though he had decided he was not running for the office. "This was filed by a woman who tried to defeat me through the political process," Nifong says after he had a chance to review the complaint. "Since that wasn't successful, she obviously tried to pursue this through this particular remedy." The complaint is significant, former federal prosecutor Dan Boyce says, and raises questions not only about Nifong's ability to serve as district attorney, but also his right to practice law. Nifong also says in an interview that he is looking forward to defending himself against the State Bar's ethics charges and that he is working with his attorneys on a response, which is due Feb. 23. "I wish everyone would withhold judgment until they hear the evidence, as well as my response," he tells WRAL, adding that there is more to the Duke lacrosse case than what the media has reported.

SUNDAY FEBRUARY 11: James (Jimmy) Regan, a Duke lacrosse player (class of 2002) and U.S. Army Ranger, is reported killed by a roadside bomb in Iraq. Assistant Coach Kevin Cassese played with Regan for three years, and addressed the current team: “What I said was that he was a guy who worked hard every day, who would do anything for his teammates, and would do anything to make the team better.” Cassese spoke of Regan’s performance in the 2002 ACC Championship game, when Regan scored four goals. Jack Moran, Regan’s high school lacrosse coach, says, “You couldn’t ask for a better person”—someone who passed up the opportunity to go to law school to serve his country, because “he felt there was a higher calling.” Regan served a tour of duty in Afghanistan before being stationed in Iraq. It would take over 2 ½ years until Duke University included Regan’s name on a war memorial in a ceremony led by U.S. Secretary of Veterans Affairs Eric Shinseki.

MONDAY FEBRUARY 12: Beth Brewer, the Durham resident who last week filed court papers seeking the removal of DA Nifong from office, questions a judge's decision to delay action on the issue. Brewer filed a civil complaint against Nifong on Friday, alleging willful misconduct and conduct prejudicial to the administration of justice that brings the office into disrepute. Judge Orlando Hudson says the civil complaint mirrors ethics charges the North Carolina State Bar has filed against Nifong, and he issues an order today that would defer Brewer's complaint until after the State Bar hearing in the case is completed. "Due process of law requires that the district attorney be allowed to defend himself before one tribunal at a time regarding the allegations," Hudson writes in the ruling. But Betty Tenn Lawrence, an Asheville lawyer representing Brewer, challenges Hudson's authority to postpone the removal proceeding. State law dictates that the judge act on a civil complaint within 30 days, Lawrence writes in a letter to Hudson. Hudson tells WRAL that his decision to delay action on the complaint constitutes acting on it. Brewer and her attorney could file a motion asking the state Court of Appeals to force Hudson to take some other action, but there was no word today on whether they plan to do so.

Police are investigating allegations that a Duke University student was raped at an off-campus party around 3 a.m. yesterday. More than 50 people attended a rowdy party over the weekend at 405 Gattis St., a duplex where several male Duke students live, according to Durham police. Neighbors say large number of cars were parked along the street and loud music blared from the house. An 18-year-old woman (months later self-identified as Katie Rouse) says she was raped in a bathroom of the residence, according to a Durham police news release. Police had not charged anyone but released a description of a suspect. The man is described as being in his late teens or early 20s, about 6-foot-1 and wearing a black do-rag, a gray and blue jeans, according to a police news release. Yesterday afternoon, beer cans and sweatshirt bottles were strewn throughout the lawn and bushes of the residence.

Members of the “Group of 88” hold a forum at Duke to discuss issues relating to the lacrosse case. They accused their critics of “McCarthyism” and urged them to “shut up and teach,” in the words of Prof. Charles Piot.

In a Chronicle column “Alumns: Withhold your support,” senior Steven Miller writes:
“The lacrosse scandal brought to light in a new way many of the tragic problems facing our University and the unwillingness of the administration to correct them. If we truly love Duke, and truly support its students, then we will take action to repair the University we love and to protect all its students present and future. If we truly love Duke, then we will demand that it live up to its ideals. What sense is it for alumni to criticize Duke, see Duke be totally unresponsive to their criticisms and then to keep the checks rolling in? Is it any wonder Duke perpetually ignores the grievances of its students and alumni? “

Blogger John-in-Carolina discusses the differences between the so-called “Wanted” and “Vigilante” posters which appeared on the Duke campus following rape charges against the Duke lacrosse team. There were four versions of the text-only “Wanted” posters which were produced for Durham CrimeStoppers by Durham Police Cpl. David Addison. The “Vigilante” poster contains the photographs of 43 Duke lacrosse players and was produced anonymously. Both posters inflamed public opinion against the lacrosse team

TUESDAY FEBRUARY 13: Mary Katherine Ham writes a blogpost “A tale of two rapes in Durham” in which she and contrasts the media and public reactions to rape allegations against white lacrosse players made by a black woman last year to those concerning the recent rape in which the accuser, a Duke freshman, is white the alleged suspect is black:
“There's another accusation of rape floating around Durham this week. The accuser was allegedly attacked at a house party this Saturday. The accuser is white. The suspect is black. Heard anything about that? Yeah, I didn’t think so. The mainstream media has bent over backward to keep race out of this. Even those who first gave a description of the alleged rapist as a “black man” later redacted that from their reports. The News & Observer never printed it at all. And none has pointed out, as the Duke Chronicle has done, that the alleged victim was white, making this a mirror image of the Duke lacrosse case."

WEDNESDAY FEBRUARY 14: Duke University administrators will wait for Durham police to finish their investigation of a freshman's allegations that she was raped at an off-campus party before doing an inquiry of their own. Larry Moneta, vice president of student affairs, says he heard about the incident early Sunday. "We're providing direct support to the woman," he asserts. Durham police were called to 405 Gattis St. at 3 a.m. Sunday after an 18-year-old (later self-identified as Katie Rouse) reported being raped in a bathroom there. No charges have been filed. Members of Phi Beta Sigma Fraternity Inc., one of whom lives at the house, organized the party that started Saturday night and continued into early Sunday. Police filed a second incident report from the home shared by several Duke students and owned by Arcadia Land Management, which, according to county property records, is an Oklahoma company. At 11:11 a.m. Sunday, police filed an incident report for three drug violations: possession of marijuana, Oxycontin and cocaine. As news of the reported rape spread through the blogosphere Monday, many people questioned whether DA Nifong would show the same interest in the investigation as he did the Duke lacrosse case. According to the Chronicle: “The alleged victim ‘is doing as well as can be expected,’ Dean of Students Sue Wasiolek said. University officials said Monday that they had met with members of the fraternity after the report was filed by the alleged victim, who Wasiolek confirmed is white.”

In a two-part blogpost, Prof. KC Johnson examines the actions of the “potbangers” who held protests outside the lacrosse house at 510 N. Buchanan St. after Crystal Mangum alleged she was raped there. He contends that as evidence grew of the innocence of the lacrosse players, the “potbangers” used other charges, such as racism and sexism, against the lacrosse team. “The one constant in this progression: having come out strongly against the players early on, the potbangers were determined to find something to justify their assault on the lacrosse players’ character,” according to Johnson.

A Chronicle article reveals that the rapper Common criticized the Duke lacrosse team during a concert at Emory University in April, 2006. Common is scheduled to appear during Last Day of Classes (LDOC) festivities. Several students who attended a concert held at Emory University April 19, 2006 said that Common incorporated lines such as, "I'm the boss, f--- those boys from Duke lacrosse" into his act while freestyling. "That was the first time he brought it up-as a punchline-and then emphasized it later," says Tal Hirshberg, Trinity '04 and a third-year law student at Emory. Hirshberg adds that about 40 minutes after the first mention of Duke lacrosse in the concert, Common said he "really believes in [his] heart that those boys in Duke lacrosse did it-- that they raped a black princess." LDOC Chair Beth Higgins, a senior, says she had not been aware of the incident during the LDOC committee's proceedings with Common. "I am very shocked that that happened," Higgins says. "I'm surprised he accepted the offer if he felt that way."

THURSDAY FEBRUARY 15: In a letter to the Chronicle, Duke economics professor Roy Weintraub takes strong issue with the “Group of 88’s” assertion that those who disagree with them are guilty of McCarthyism. Weintraub writes:
“So I read with astonishment the recent panelists' invocation of McCarthyism as their characterization of the criticism they have received for their public statements or writings. They face no death sentence, no jail time, no threats from Trustees or administrators of employment termination, no loss of income, no loss of custody of their children, no loss of their passports, no reduction whatsoever in their public or private circumstances. I don't ask the panelists to shut up and teach. I ask them instead to understand that for various Duke faculty, staff, administrators, students, parents and alumni to disagree with them in public or in private is neither McCarthyism nor an academic travesty and betrayal of the values of our institution, but is rather an expression of their believing otherwise.”

FRIDAY FEBRUARY 16: Prof. William Anderson of Frostburg State University points out in detail actions taken by state actors in the lacrosse case which he asserts have been illegal, and their attempts to cover-up those actions. He says: “Granted, I have my doubts that the North Carolina authorities really are interested in investigating and prosecuting their own, but, nonetheless, I figure that it does not hurt for the readers to know about the commission of crimes, especially when they are committed by the police and prosecutors... Thus, I will lay out some of the actions taken by police and prosecutors that clearly are legal violations, and then let the actions speak for themselves.”

Blogger John-in-Carolina investigates the role of Durham Police Cpl. David Addison in propagating the lacrosse hoax. Addison acts as liason to CrimeStoppers and also serves as a police spokesman. John- in Carolina notes:

“March 24 was a very busy day for Addison: the Duke lacrosse story was breaking. In WRAL – TV’s first report on the case, Addison told the public: ”You are looking at one victim brutally raped. If that was someone else's daughter, child, I don't think 46 [DNA tests] would be a large enough number to figure out exactly who did it.”

That same day Addison spoke to the Raleigh News & Observer which the next day reported in a story the N&O told readers concerned “sexual violence”:

”[A]uthorities vowed to crack the team's wall of solidarity.
‘We're asking someone from the lacrosse team to step forward,’ Durham police Cpl. David Addison said. ‘We will be relentless in finding out who committed this crime.’”
Addison went days telling the public about the “victim” who’d been “brutally raped.”


The Johnsville News blog hands out tongue-in-cheek “Freedom of the Press Awards” for reporters’ and editors’ questionable coverage of the Duke lacrosse case. “Winners” include Samiha Khanna, Anne Blythe, Ruth Sheehan, Melanie Sill and Linda Williams of the N&O; John Stevenson and Bob Ashley of the Herald-Sun; Cash Michaels of the Wilmington Journal; Duff Wilson of the New York Times; and Shadee Makalou of the Duke Chronicle,

SUNDAY FEBRUARY 18: LieStoppers features a post about a New York Journal of Law article by Henry Korn titled “District Attorney Scandal in Duke University Case.” The Korn article summarizes the actions of DA Nifong in the case and concludes:

"There are sure to be many more developments in the story of how Mr. Nifong conducted the prosecution of the three Duke University students that will have direct impact on his license to practice law. This is a story that squarely teaches that 'rushing to judgment' without wisely stepping back and reviewing the evidence runs directly counter to the ethical obligations that govern how attorneys are required to conduct themselves. The harm of such ignorant conduct is that others are grievously wounded. Familiarity with, and adherence to, the code of professional responsibility provides the foundation for attorneys to avoid abuse of their license and harm others by so doing."

MONDAY FEBRUARY 19: Police make an arrest in connection with a Duke University freshman's allegation that she was sexually assaulted at an off-campus party earlier this month. Michael Jermaine Burch, 21, of 322 Junction Road, Durham, is charged with second-degree rape. He is being held in Durham County Jail in lieu of $50,000 bail. The arrest came eight days after Durham investigators were called to 405 Gattis St. early Feb. 11. Members of Phi Beta Sigma fraternity threw a party at the rental property where one member of the fraternity and three other Duke students lived. The party drew more than 50 people and spilled outside the duplex. The 18-year-old accuser, later self-identified as Katie Rouse, told investigators she was sexually assaulted about 3 a.m. in a bathroom. She went to Duke University Hospital, according to police radio reports. Burch is not registered as a student at any college or university. He was arrested as he left his job at the Rose's department store on N.C. 54.

Two supporters of DA Nifong—Victoria Peterson and Jackie Wagstaff -- organize a “District Attorney Appreciation Week” in Durham. The sole event is a barbequed chicken lunch attended by Nifong staffers, the two organizers, and two other women. The Herald-Sun reports that Nifong suggests the event's organizers are more in tune with reality than countless out-of-state hecklers who criticize his handling of the controversial Duke lacrosse case. "If you rely on certain media, you might think there is universal disapproval of me," Nifong says, referring largely to national television outlets that have relentlessly hammered him over the lacrosse incident. "But if you're closer to home, you realize that's not true," he adds.

Prof. KC Johnson analyzes the on-air performance of broadcaster Nancy Grace regarding the Duke lacrosse case. He states she has used innuendo, non-existent evidence, unawareness of basic facts of the case, and denigration of skeptics in her commentary about the case.

TUESDAY FEBRUARY 20: Sports Illustrated publishes an article by S.L. Price titled “The season after” describing the upcoming return of the Duke lacrosse team for its first game since the team’s season was cancelled last year because of the rape allegations.

“When they come out for warmups against Dartmouth, the team will be divided into thirds, with each wearing a special shirt bearing the number of one of the accused. But any hope of turning the experience into motivational fodder "is jaded by the fact that three of our close friends are undergoing a horrible experience," says senior co-captain Ed Douglas. "For me to try to find a good thing in this whole process seems almost smug."

And the players know that many in the public believe their irresponsibility cost their coach his job. That's why they are keeping a lower social profile on campus this year, why the seniors have pledged themselves to what Douglas calls "a sober preseason." That's why, just minutes before they walked out to practice last Thursday, Sue Pressler, Mike's wife, addressed the team in the locker room, something she never did in all the years her husband was coach. She spoke of the elephant still looming over the case -- that the public still believes something happened that night -- and that it's time for that elephant to die. She told the players that the Pressler family has never blamed them for what happened, told them she loved them, told them it was time to stop running and be proud again.”

NCCU law professor Irving Joyner is criticized by Prof. KC Johnson. Joyner, who is the “case monitor” for the North Carolina NAACP, has been outspoken in his criticism of the lacrosse players, whose March, 2006 party he calls “perverted,” and in his pro-prosecution support for DA Nifong and the Durham Police. Johnson states, “Even to the end, Joyner has tried to get the case to trial. Almost alone among observers, he contended that the dropping of rape charges made it more likely to get convictions”

WEDNESDAY FEBRUARY 21: Duke lacrosse defendant Reade Seligmann could be leaving Duke and be headed to play for Brown in the Ivy League. Brown University Sports Information Director Chris Humm confirms that the school is trying to recruit the 6-foot-1 midfielder for its men's lacrosse team. Seligmann, 20, of Essex Fells, N.J., was suspended last spring from Duke after he was indicted on charges of kidnapping, rape and sexual assault stemming from an off-campus lacrosse team party. Seligmann graduated from the Delbarton School, a Roman Catholic school in Morristown, N.J. He won three state lacrosse titles while he attended the school but saw limited playing time after arriving at Duke. There, he played only in six games and scored one goal before Duke President Brodhead canceled the season in April. In January 2007, Duke invited Seligmann and Collin Finnerty, 20, to return as students in good standing. Evans, 23, graduated from the university in May.

DA Nifong has been granted an extension to file a written response to ethics charges leveled against him for his handling of the Duke lacrosse case. Nifong's response to the North Carolina State Bar complaint was due Friday Feb. 23, but the Bar's disciplinary commission moved the deadline to Wednesday Feb. 28 because one of Nifong's attorneys is ill. The State Bar has accused Nifong of withholding evidence from lawyers defending 3 lacrosse players charged with sexually assaulting a stripper, of lying to the court and to bar investigators, and making misleading and inflammatory comments about the players. Legal experts say Nifong could be disbarred if he's convicted. Also today, ABC-11 reports that last week the special prosecutors interviewed Nifong as part of their continuing investigation into the case. The Attorney General's office confirms that the meeting took place, but did not release details.

The N&O reports on differences in public reaction between rape charges stemming from the lacrosse party and those from the more recent alleged attack at an off-campus party:
“Now there are new sexual assault allegations from another off-campus Duke party, and avid chroniclers of the twists and turns in the lacrosse case ask: "Where are the potbangers?"
"That's a good question," said Manju Rajendran, one of the organizers of the potbanger protests. "Why is there not a massive reaction every time a rape occurs? I feel like that should happen any time there's rape." Some say the city is fatigued by the lacrosse case and people might be treading carefully because of the controversy and criticisms lobbed from near and far.
"Normally with a rape case, police do the investigation, and charges are filed, and it goes through court," said Orin Starn, a Duke professor who has been critical of big-time college sports programs. "The lacrosse case was something of an anomaly. It became a media event that was covered and dissected and debated, both locally and nationally."

(…) Bloggers, who have chronicled the details on Web sites, take delight in blasting "the potbangers" and the so-called "Group of 88" at Duke, professors who endorsed a student newspaper ad that deplored racism and sexual assault on campus. Some of the most dedicated have posted MTV-style videos with captions and music. One of the more telling accounts captures the protesters marching down Buchanan Street in a simple video that was posted on YouTube. In that video, the protesters call Duke Provost Peter Lange outside his house across the street from the hip-high stone wall rimming Duke's East Campus. At the time, no charges had been filed, and Lange urged the protesters not to rush to judgment. The crowd hurled questions, asking why Duke had not punished the players, why no disciplinary actions had been taken.

"We don't know the facts, what happened in the house," Lange said. "We are waiting for the police investigation to discover the facts. This is an extremely serious crime if it happened."
A wait-and-see attitude seems to be prevailing in the more recent case.

(…)Tim Tyson, one of the professors who was at a Buchanan Street vigil, said recently that his intent was not to attack the lacrosse players but to draw attention to the larger issues of sexual violence, classism and racism that the case seemed to embody.

"I wasn't confident at that time that I knew what happened," Tyson said. "It still seems clear to me that something ugly happened in that house. ... I don't think people should be used as things. If there only had been an ugly incident and no allegations of rape, I still would be disappointed with the students."

THURSDAY FEBRUARY 22: WEBCommentary contributor Michael Gaynor calls on Duke President Brodhead to resign in a post “Duke under Brodhead: Failed crisis management 101.”
“As president. Mr. Brodhead (1) failed these student athletes; (2) failed their parents who had placed their trust in Duke University as a guardian of their sons; and (3) failed to validate a system of honor, which should be the basis of student life at Duke. Some of the other actions of some of the members of the lacrosse team at that off-campus party last spring were wrong, to be sure, but that did not in any way justify the phony criminal accusations that not only intimidated Duke University, but also were eagerly embraced by a significant segment of the Duke community (as well as the Durham community and the national media) determined to treat them as true because they fit their agenda.(…) President Brodhead should resign, because he failed to manage the Duke crisis competently and courageously. He failed to demonstrate the courage, sense of honor and strong judgment that a leader must have to be successful. He failed the parents of the accused students and, most importantly, he failed to properly lead Duke University through a crisis and instead made it worse by lending credence to the ludicrous accusations by a person who quickly could have been determined by President Brodhead not to be a credible person…”

FRIDAY FEBRUARY 23: The Duke lacrosse team gears up for its game tomorrow-- the first since the season was canceled last year. Thus far, Duke practices have generated a lot of attention this year. Team co-captain Matt Danowski is getting used to all the onlookers. “All the media attention has given people insight into our lives and the people we are,” Danowski says. “We welcome it." Saturday's home opener is expected to draw a large crowd, and the school is beefing up security. The game will also be televised live nationally. On Saturday, players will wear warm-up jerseys with the numbers 45, 3 and 6 to represent the three players accused of sexual assault: Finnerty, Evans and Seligmann. John Danowski tells WRAL that he's been helping Finnerty look at lacrosse programs at other schools. Seligmann is considering an offer from Brown University. Evans graduated last year.

Six Duke professors write an article in the Chronicle suggesting that Duke should “move forward” from the lacrosse controversy. The article states, in part:

“The time has come to move forward. The primary issue is how we live as a community at Duke-- how we behave toward each other, the values we espouse, the rules we pledge to uphold in our interactions. Now is the time to turn what has been a time of crisis into an opportunity for constructive change-to help make Duke a model of mutual respect and caring. Whatever happened at the lacrosse party last spring, three facts remain undisputed: racial epithets were used; a Duke student group hired two female strippers for the entertainment of young men; and underage drinking was encouraged. In the ensuing months, we have heard our students grapple with these and related issues that reflect patterns of behavior found, not only on our campus, but-according to colleagues elsewhere-at our peer institutions as well.”

The article is analyzed in a blogpost titled “Chafe’s Embarrassment” by KC Johnson and in another titled “Juxtapositional Fallacies” by Duke professor Michael Gustafson, who writes:
“In being told the three "undisputed" facts, we are being told to forget that the Coleman Report quashed any sense of racism on the team; to forget that men on the team publicly stated their outrage over racist comments, if made, by their teammates; to forget that Devon Sherwood called those 46 men his brothers; to forget that the women on the lacrosse team - empowered, strong, intelligent women led by an empowered, strong, intelligent woman publicly wore their thoughts on their wrists about the innocence of three of those men.

We are being given a false dilemma - either show outrage against the lacrosse team and its party and support those who made noise about it, or deny that racism and sexism and assault exist. Either believe that the entire campus culture is flawed (and we're the ones to fix it), or support sexist insults and racial division."

The Chronicle reports that the Campus Cultural Initiative committee will recommend several proposals-- summarized here by Prof KC Johnson in his “Durham-inWonderland” blog:
“1) A mandatory “diversity” course for all Duke students. This proposal could be called the “Group of 88 Enrollment Initiative,” since Group members disproportionately teach such classes. 2) Residential changes to prevent “the practice of assigning housing to selective living groups and social/affinity/interest groups.” 3) Reducing time athletes can spend on travel and practice—a proposal, as one Chronicle commenter observed, effectively demands the withdrawal of Duke from the ACC. The report does not appear to have demanded a reduction of time that non-athletes are allowed to spend on extracurricular activities. 4) Raising the “low end of the admissions standards” to ensure a better-qualified student body—a fine idea in theory, but one that almost certainly seems to be hypocritical, since advocates of “diversity” in admissions almost always advocate broadening the range of admissions standards.”


SATURDAY FEBRUARY 24: The Duke men’s lacrosse team wins its first game of the season, defeating Dartmouth 17-11. Zach Greer has six goals and Bo Carrington has two assists. The game is nationally televised and 70 journalists request credentials for the event. A crowd of 6,485 watches the game—the second largest crowd ever at Koskinen Stadium on the Duke campus.

The AP carries a feature article by Eric Tucker about former Duke lacrosse coach Mike Pressler’s new job leading Bryant University men’s lacrosse team:

“The last time Mike Pressler prepared for a lacrosse season, his Duke team was among the nation's best. But after an escort service dancer accused three lacrosse players of sexually assaulting her at a March team party, Duke canceled its season, and Pressler resigned. He feared he'd never coach again. "No way I thought I'd be sitting here doing this again," Pressler told reporters Friday at Bryant University, the northern Rhode Island school that hired him as lacrosse coach. "There was a time during the summer where I thought my career was over." Duke and Bryant open their seasons today -- Bryant hosts Adelphi University, and Duke hosts Dartmouth. (…) Pressler admitted satisfaction about the mounting questions dogging the criminal cases and said he stood by his players from the outset. "We believed in the truth. I knew the truth the day after it happened. I stood by the truth," Pressler said. "You can only imagine when 50 people believe one truth and 50 million believe another -- and nobody wavers." He said he remains in touch with his former players, saw them last Christmas when he was in Durham and has recommended Seligmann and Finnerty to coaches at other schools. Both were invited to return to Duke in good standing; Evans graduated last year.”

SUNDAY FEBRUARY 25: The Washington Post runs a feature article by Adam Kilgore titled “A relief for this to be over” which gives reactions of Duke lacrosse players, their parents, their coach John Danowski, Duke faculty and Durham residents to the resumption of play by the lacrosse team yesterday. The article reveals Coach Danowski met with the players’ parents prior to the game against Dartmouth. It concludes:

“The accuser's selection of Seligmann, Finnerty and Evans -- which players viewed as random -- buried a troubling notion in the players' minds: It could just as easily have been them. "You see the families, and we feel like it could have been us where they were," John Walsh said. "It could have been anybody." Danowski said before the game that he hoped for nice weather Saturday, so his players could have "a day in the sun." He got his wish, but the day, pristine and void of controversy, will not make the case go away. Once the indictments are settled, further litigation against the school and the state remains possible. And the Duke players will continue to wrestle with everything that has happened. "The one thing I have seen this week, I have seen a little survivor's guilt," Danowski told the parents before the game. "I'm starting to hear that from a couple young men. I told them: 'If that's what you're feeling, in the end that's not good or bad, right or wrong. Your feelings are your feelings. Tell someone you know, tell someone you trust. Talk about it.' "

MONDAY FEBRUARY 26: WRAL reports the new prosecutors in the Duke lacrosse case appear to be making progress in their assessment of the evidence. Special prosecutors Jim Coman and Mary Winstead took over last month after DA Mike Nifong removed himself from the case. Sources tell WRAL the accuser in the case, Crystal Mangum, has already been interviewed by the new prosecutors in the case. In contrast, Nifong alleges he did not question the accuser until nearly nine months after she claimed three former lacrosse players assaulted her. A representative for state Attorney General Roy Cooper’s office tells WRAL that Coman and Winstead are in the process of talking with people and reviewing evidence connected to the case.

In a comprehensive and balanced article, Christina Asquith presents the views of four members of the Group of 88 and also their critics. The article examines actions and statements by the Duke academics following the onset of the rape allegations and subsequent events. The article is published on-line at diverseeducation.com.

Chronicle columnist Stephen Miller compares the Duke campus’ reaction to Crystal Mangum’s rape charges against white lacrosse players in March, 2006, and the reaction to a recent rape allegation against a black man. He states:

“[In 2006] Protesters swarmed our campus and the city streets, they screamed vulgar condemnations, they tarred the whole team as complicit in a stonewall cover-up, they put up wanted posters, banged pots and pans. They cried out for justice and vengeance, demanded suspensions, expulsions and incarcerations. Worst of all, as they feverishly disregarded due process, they helped create an atmosphere of hysteria and madness which could only serve to embolden an unhinged district attorney who had the power to breathe life into the fantasies of the growing mob. But when a black man was recently accused of raping a white Duke student at a party hosted by members of a black Duke fraternity, suddenly these great defenders of virtue fell silent. There have been no protesters, no signs, no one chanting and screaming in front of the house where at least one member of Phi Beta Sigma Fraternity, Inc. live demanding they "come forward" with what they know. No one is demanding President Brodhead take action or that we cure a sexist and racist campus culture in response to these accusations. No professors are running ads that convey guilt or claiming, as they did before, to know the alleged crime was racially motivated.”

TUESDAY FEBRUARY 27: Attorneys for 3 former Duke lacrosse players file a new motion accusing DA Nifong of withholding evidence, including more DNA results than originally thought. Now the defense wants all DNA test results from the case. "If the information we had December was explosive, then this is doubly explosive," says Wade Smith, defense attorney. Private lab director Brian Meehan had admitted under oath he and Nifong withheld DNA evidence. Adding to that revelation, the defense has filed a 39-page motion today. It says another report Meehan sent to the defense last month shows more DNA was found on the accuser than was previously disclosed. The DNA did not match the 3 defendants in the case. Defense attorneys say they are still waiting on the complete report on DNA taken from the accuser. According to the N&O, “In the motion filed Tuesday, defense lawyers said they realized that they have received only 11 of the 22 DNA sequencing charts from the samples tested. ‘The defendants are still in the dark,’ the motion said. ‘The statistical likelihood is that such data will show that there was even more exculpatory, unidentified male DNA discovered by DNA Security in the rape kit extractions that, by Jan. 12, 2007, still had not been reported to the defendants by Mr. Nifong and Dr. Meehan in any way.’”

A report released today says Duke University could become a more “inclusive academic community” by changing its curriculum, housing system, alcohol policies and other key aspects. The report is the final product of the Campus Culture Initiative (CCI) Steering Committee, which Duke President Brodhead appointed last spring following the arrests of 3 Duke lacrosse players for an alleged rape at an off-campus party. The CCI report calls for changes in areas such as dining and residential housing, including an end to the practice of assigning West Campus housing to selective living groups such as fraternities. According to the report, the social life of Duke students is too often organized around drinking, and “the risk of another alcohol-related death in the Duke community is very real.” The report calls on Duke officials to “re-orient social life on campus to reduce the centrality of alcohol and enable more non-alcohol events and venues.” While the committee praises the record of Duke student-athletes in both competition and the classroom, they said “strong and persistent forces” nationally make it more difficult to balance academics and athletics. The report recommends that Duke officials should decrease practice and travel time demands on its student-athletes and calls for stronger ties between athletic programs and other parts of the university. The committee also recommends higher admission standards for Duke athletes. Brodhead says in a statement that none of the proposed changes are a “done deal,” nor are any of them off the table as university officials begin to debate their implementation.

WEDNESDAY FEBRUARY 28: DA Nifong files a reponse to the State Bar allegations against him. He states that he was given inaccurate information about the case by Durham police; that he was under no obligation to give the defense more information about the exculpatory DNA findings because he did in fact turn over the underlying raw data before any trial; and that his public statements about the case were made before specific individuals were actually charged. The response also reads in part:
"A well-connected and well-financed (but not, I would suggest, well-intentioned) group of individuals--most of whom are neither in nor from North Carolina--have taken it upon themselves to ensure that this case never reaches trial. (And if this seems like paranoid delusion to you, perhaps you should check out websites such as former Duke Law School graduate and current Maryland attorney Jason Trumpbour's www.friendsof“dukeuniversity.blogspot.com/, which has not only called for me to be investigated, removed from this case, and disbarred, but has also provided instructions on how to request such actions and to whom those requests should be sent.)”
LieStoppers publishes the text of the State Bar’s amended complaint merged with Nifong’s point-by-point responses.

SPECIFIC REFERENCES:

February 1: KC Johnson on “Hook-up Culture at Duke” spring course

http://durhamwonderland.blogspot.com/2007/02/group-of-88-for-credit.html

February 2: John Burness criticizes lacrosse players in NPR segment

http://www.npr.org/templates/story/story.php?storyId=7138250

February 3: N&O reveals Gov. Easley criticized Nifong in New York speech

http://durhamwonderland.blogspot.com/2007/02/easley-nifong-my-worst-appointment.html

http://johninnorthcarolina.blogspot.com/2007/02/why-easley-stumbled.html

http://liestoppers.blogspot.com/2007/02/easleys-comments-questioned.html

February 4: Lacrosse Supporters Hold March in Durham

http://www.wral.com/news/local/story/1192760/

http://www.newsobserver.com/2007/02/05/59454/walkers-stand-behind-defendants.html#storylink=misearch

http://durhamwonderland.blogspot.com/2007/02/walk-update.html

http://triangle.johnlocke.org/blog/?p=338

http://www.youtube.com/watch?v=3_wz3XcgesM&feature=player_embedded

February 5: Key hearing postponed until May

http://abclocal.go.com/wtvd/story?section=triangle&id=4985186

February 6: Two members of grand jury speak out

http://abcnews.go.com/GMA/story?id=2852337&page=1

http://dukechronicle.com/article/2-lax-grand-jurors-speak-charges

February 6: Non-profit raises $750, 000 for lacrosse defense

http://www.newsobserver.com/2007/02/06/31519/nonprofit-raises-750000-toward.html#storylink=misearch#ixzz1Ssy8GI9o

http://dukechronicle.com/article/lax-legal-fees-rise-groups-pitch

February 6: Kristin Butler on naming rape accusers

http://dukechronicle.com/article/worst-kept-secret

February 7: Special prosecutors meet with lacrosse defense attorneys

http://abclocal.go.com/wtvd/story?section=triangle&id=5012322

February 7: Judge Hudson Threatens Grand Jury Members with Contempt for Speaking

http://www.wral.com/news/local/story/1196412/

http://www.newsobserver.com/2007/02/08/57587/grand-jurors-tv-appearance-angers.html#storylink=misearch

http://www.webcommentary.com/php/ShowArticle.php?id=gaynorm&date=070208

February 8: Complaints Against Linwood Wilson Revealed

http://www.newsobserver.com/2007/02/08/85486/das-investigator-was-rebuked.html#storylink=misearch#ixzz1SszJpLq9

http://durhamwonderland.blogspot.com/2007/02/wilsons-ethical-lapses_08.html

http://dukechronicle.com/article/defense-questions-lax-investigator

February 8: Friends of Duke University places Chronicle ad challenging “Group of 88”

http://friendsofdukeuniversity.blogspot.com/2006/02/press-release-no-6.html

http://durhamwonderland.blogspot.com/2007/02/friends-of-duke-confronts-group-of-88.html

http://liestoppers.blogspot.com/2007/02/fodu-statement.html

http://today.duke.edu/showcase/mmedia/pdf/socialdisasterad.pdf

February 9: Beth Brewer files civil complaint asking Nifong’s removal

http://liestoppers.blogspot.com/2007/02/7a-66-affidavit-filed.html

http://www.wral.com/news/local/story/1198676/

http://www.wral.com/news/local/story/1201028/

http://sports.espn.go.com/ncaa/news/story?id=2760682

http://www.newsobserver.com/2007/02/13/79043/effort-to-oust-nifong-delayed.html

http://durhamwonderland.blogspot.com/2007/02/removal-motion-filed.html

http://johninnorthcarolina.blogspot.com/2007/02/that-affidavit-got-results.html


February 11: Former Duke lacrosse player Jimmy Regan reported killed in Iraq

http://durhamwonderland.blogspot.com/2007/02/regan.html

http://dukechronicle.com/article/lacrosse-story-worth-covering

http://liestoppers.blogspot.com/2007/02/sgt-james-regan.html

http://abclocal.go.com/wabc/story?section=news/local&id=5021881

http://www.armytimes.com/news/2007/05/ap_specops_memorial_070524/

http://www.athenstalks.com/memorial-sgt-james-j-regan

http://dukechronicle.com/article/gen-shinseki-rededicates-war-memorial

February12: Girl charges rape at off-campus party

http://www.newsobserver.com/2007/02/12/88762/duke-student-says-she-was-raped.html#storylink=misearch#ixzz1StBf68uL

http://dukechronicle.com/article/student-alleges-sexual-assault-east-house

http://abclocal.go.com/wtvd/story?section=triangle&id=5024691

http://media.mgnetwork.com/ncn/pdf/070212_duke_rape.pdf

February 12: Lawyer for Brewer questions delay in her civil complaint against Nifong

http://www.newsobserver.com/2007/02/10/36728/judge-is-asked-to-remove-nifong.html

http://liestoppers.blogspot.com/2007/02/parallel-proceedings.html

February 12: “Group of 88” members hold forum at Duke

http://durhamwonderland.blogspot.com/2007/02/group-of-88-rehab-tour.html

http://durhamwonderland.blogspot.com/2007/02/condemned-to-repetition.html

http://durhamwonderland.blogspot.com/2007/02/piot-principle.html

http://dukechronicle.com/article/faculty-speak-out-threats-intimidation

http://johninnorthcarolina.blogspot.com/2007/02/no-known-connection-to-duke.html

February 12: Columnist Steven Miller urges Duke alums to withhold donations

http://dukechronicle.com/article/alums-withhold-your-support

February 12: John-in-Carolina on the “Wanted” and “Vigilante” posters

http://johninnorthcarolina.blogspot.com/2007/02/wanted-vigilante-not-same.html

February 13: Mary Katherine Ham on “A tale of two rapes in Durham”

http://townhall.com/tipsheet/marykatharineham/2007/02/13/a_tale_of_two_rapes_in_durham

February 14: Duke holds off investigation of alleged rape pending police inquiry:

http://www.newsobserver.com/2007/02/13/57894/duke-waits-on-inquiry-results.html#ixzz1StCkaiVJ

http://dukechronicle.com/article/east-rape-investigation-continues

February 14: KC Johnson on the “potbanger” protests

http://durhamwonderland.blogspot.com/2007/02/when-potbangers-were-riding-high.html

http://durhamwonderland.blogspot.com/2007/02/potbangers-airbrush-past.html

February 14: Chronicle reveals rapper Common criticized Duke lacrosse team

http://dukechronicle.com/article/ldoc-act-criticized-lax-players

February 15: Prof. Roy Weintraub in a letter attacks charges of McCarthyism

http://dukechronicle.com/article/disagreement-not-mccarthyism

http://johninnorthcarolina.blogspot.com/2007/02/duke-prof-disagreement-is-not.html

February 16: William Anderson on the cover-up

http://www.lewrockwell.com/anderson/anderson171.html

February 16: John-in-Carolina on the role of Durham Police Cpl. David Addison

http://johninnorthcarolina.blogspot.com/2007/02/addison-series-1-this-horrific-crime.html

http://johninnorthcarolina.blogspot.com/2007/02/wanted-vigilante-not-same.html

http://johninnorthcarolina.blogspot.com/2007/02/addison-series-2-crimestoppers-will-pay.html

http://johninnorthcarolina.blogspot.com/2007/02/addison-series-3-not-my-poster_24.html

February 16: The Johnsville News hands out “awards” for poor media coverage

http://johnsville.blogspot.com/2007/02/dukenifong-hoax-north-carolina-media.html

February 18: LieStoppers on New York Journal of Law article criticizing DA Nifong

http://liestoppers.blogspot.com/2007/02/nifong-makes-new-york-law-journal.html

February 19: Suspect arrested in Gattis St. alleged rape

http://www.wral.com/news/local/story/1208088/

http://abclocal.go.com/wtvd/story?section=...ngle&id=5047790

February 19: KC Johnson on broadcaster Nancy Grace

http://durhamwonderland.blogspot.com/2007/02/graceless.html

Feburary 19: Jermaine Burch charged with rape of Duke freshman at off-campus party

http://www.newsobserver.com/2007/02/20/55111/man-charged-with-raping-duke-student.html#ixzz1StE9A8wO

http://dukechronicle.com/article/dpd-makes-arrest-east-assault

February 19: “District Attorney Appreciation Week” in Durham

http://durhamwonderland.blogspot.com/2007/02/only-in-durham.html

http://liestoppers.blogspot.com/2007/02/news-of-weird.html

http://liestoppers.blogspot.com/2007/02/damn-appreciation-week.html

February 20: Sport Illustrated on “The season after”

http://sportsillustrated.cnn.com/2007/more/02/20/scorecard0226/index.html

February 20: KC Johnson on NCCU law professor Irving Joyner

http://durhamwonderland.blogspot.com/2007/02/joyners-jurisprudence.html

February
          A Farewell to Armed Sources        
Hello Armed Sources Readers. Friday is my last day as a reporter for the Houston Chronicle. I’m leaving the newspaper to take a job with another news organization in Washington, D.C. I came to the Chronicle as a rookie crime reporter in 2006. In 2009, I started reporting on military and veterans affairs. Within months,
          VA gave gamblers, addicts and thieves control of disabled vets’ money        
  How did chronic gamblers, drug addicts, psychiatric cases and convicted thieves get permission from the U.S. Department of Veterans Affairs to manage disabled veterans’ money?  A Houston Chronicle/Hearst Newspaper investigation led by reporters Lise Olsen and Eric Nalder tackled this disturbing question on Sunday:  They survived the Nazis, the Viet Cong and the Taliban. But
          Cornyn calls on VA to ‘end epidemic of fraud’ plaguing disabled veterans        
U.S. Sen. John Cornyn on Thursday called on the Department of Veterans Affairs to “end the epidemic of fraud” plaguing a program meant to protect disabled veterans and their assets. Cornyn, R-Texas, sent a letter today to VA Secretary Eric Shinseki, urging him to give the matter his immediate attention and initiate a review into
          Disabled veterans fleeced by VA-appointed money managers        
An article published in Sunday’s Houston Chronicle examined cases of fraud and theft in a U.S. Department of Veterans Affairs program meant to protect disabled veterans and their assets. If VA determines a veteran is too disabled to manage money, the department appoints a family member or professional as a fiduciary to pay the vet’s
          Hundreds Of Vets Turn Out For NYC Office Of Veterans Affairs Jobs Fair        
Over 500 New York City area veterans stood in the cold Thursday to meet with dozens of employers at a job fair held by the Mayor's Office of Veteran's Affairs (MOVA).
          'They deserted him': Veterans' department accused of contributing to digger's suicide        
Combat veteran Jesse Bird took his own life after losing a claim for permanent impairment he had been pursuing for almost two years. Now his family is accusing the Department of Veterans Affairs of pushing him to kill himself.
          Comment on Trump Jr., Kushner, Manafort Met With Russian Lawyer by Bill P        
You must have really drank a lot of Trump's cool aid. I listed provable facts you make opinion statements not back up by fact. Your ego is getting the better of you "I've shredded your analysis as to why the fact that if both FCA and GM had folded that millions of jobs would not have been lost. This has been proven by several papers written by Economic Professors. Try a little unbiased research!" You don't list the Economic Professors or the title of their papers, just more general bullshit from a low information troll. Where is your proof? Anyone can make these asinine statements. As for your list of Trump accomplishments all you did was copied and paste this long list of some things accomplished but a number of them have little or no effect currently. Here is your list with my comments on at least 20 of them. 01. Supreme Court Judge Neil Gorsuch - when you control the Senate it's not diifcult 02. 59 missiles dropped in Syria. - Hours after the U.S. missile strike, Syrian government's warplanes took off from the Shayrat base to attack rebel positions again, including the town of Khan Shaykhun.[11] Commentators attributed the ability of the Syrian government to continue to operate from the base to the fact that the US gave Russia, Syria's ally, an advanced warning regarding the strike, which enabled Syrians to shelter many of its aircraft from the attack. The attack accomplished very little as shownn by the Syrian jets taking off hours after the attack. President Obama had Seal Team ^ kill Osama Bin Laden on5/2/2011, a much bigger accomplishment!   3. He took us out of ‘TPP’ - Trump formally withdrew the United States from the Trans-Pacific Partnership -- a 12-nation deal that had been negotiated under former President Barack Obama. Nothing changes because of Trump's move. Congress had not yet approved the TPP -- its fate was bleak on Capitol Hill no matter what the White House did -- and the deal had not yet taken effect. 04. Illegal immigration is now down 70% (the lowest in 17 years) - Border Patrol data support Trump’s claim. In March, Border Patrol recorded 12,193 apprehensions at the southwest border, the lowest in at least 17 years.It’s worth noting that apprehension rates have been declining since the 2007/8 recession, and significantly so since their peak of 1.6 million in 2000. 05. Consumer confidence highest since 2000 at index 125.6 - This index has steadily from 2011 through 7/2017. You used the 3/2017 #, since then it has dropped to 117.3 as of 6/2017. 06. Mortgage applications for new homes rise to a seven-year high. - However currently "NEW YORK (Reuters) - U.S. mortgage application activity recorded its steepest drop since December as interest rates on 30-year fixed-rate home loans climbed to their highest level in nearly two months, Mortgage Bankers Association data released on Wednesday showed. 07. Arranged 20% tariff on soft lumber from Canada. - This is from 4/2017, the actual tariff will be less, in the 15% range. The National Association of Home Builders stated this new tariff isn't the answer "The U.S. relies on Canada for approximately one-third of its lumber needs because of the limited domestic timber supply available for harvesting.". "A robust housing market is essential to stimulate job and economic growth. With the U.S. housing sector regaining its footing, imposing arbitrary protectionist restrictions to subsidize domestic lumber producers will blunt this forward momentum and make homeownership more expensive for hard-working families," said MacDonald. "Clearly, this is not the way to resolve the U.S.-Canada lumber trade dispute or to boost the American economy." 08. Bids for border wall are well underway. That is news from early April 2017, as of the end of June 2017. "Despite Trump's push to build a wall along the southern border of the US, no contracts have been awarded to construction firms. Will it be a solar wall, transparent wall or both? 09. Pulled out of the lopsided ‘Paris Accord.’- The rest of the G20 countries are going froward with it. Donald Trump has opened the door to a reversal of his decision on the Paris Agreement on climate change saying that "something" could happen regarding the deal during his trip to France for Bastille Day (July 14th) 10. Keystone pipeline approved.- old news as of 3/24/2017. Keystone XL is facing a new challenge: The oil producers and refiners the pipeline was originally meant to serve aren't interested in it anymore. The lack of interest has put the pipeline's fate in jeopardy. The company, based in Calgary, Alberta, has said it wants enough customers to fill 90% of Keystone's capacity before it proceeds. The uncertain outlook for Keystone XL stands in contrast to Mr. Trump's upbeat rhetoric in March. This is from Fox News. 11. NATO allies boost spending by 4.3% - something good and actually true 12. Allowing VA to terminate bad employees.- another good thing 13. Allowing private healthcare choices for veterans.- one more good thing but this already in existance form 2014. What Trump did was temporarily extend the Choice Program. The popular Veterans Choice Program, created after the 2014 health care scandal in the Department of Veterans Affairs, is designed to give veterans more treatment options if they can’t get an appointment at a VA facility within 30 days or they live more than 40 miles from the nearest VA hospital. But the program is running out of money. The Choice Program needs funding. 14. More than 600,000 jobs created - that's a good start but you fail to mention that President Obama had 75 straight months of job growth, inherited a country in the midst of the Great Recession and added 11.3 million jobs. 15. Median household income at a seven-year high.- The median income has been increasing since 2011. The median household income for 2015 was 55,775 and in 2016 it was 56,516. You tend to ignore what happened prior to Trump being president. 16. The Stock Market is at the highest ever in its history. - The S&P 500 is up 10.6%, DJIA is up 11.8% and the Nasdaq is up 17.9% since Trump becam president. These are record high for these indices. They didn't happen overnight - the S&P 500 is up 170.3%, DJIA is up 141% and Nasdaq is up 268.6% while President Obama was in office 17. China agreed to American import of beef. - minor achievement China imports $2.5 billion worth of beef from all countries. Additionally Cargill Inc, another major beef processor, said that only a small percentage of the total current U.S. cattle supply would qualify for exports to China under the terms of the new trade agreement. 18. $89 billion saved in regulation rollbacks. - The American Action Forum, a center-right policy institute, released a report Tuesday documenting the most recent ways the administration and Congress have used the Congressional Review Act to repeal regulations.The report found the recent repeal and delay of regulations Could lead to $86 billion in net fiscal effects for taxpayers from deregulation. That's could not have or will. 19. Rollback of a regulation to boost coal mining.- An April report from Columbia University’s Center on Global Energy Policy documents the massive job losses in the coal industry over the last six years. By the end of 2015, the report states, "the industry had collapsed, with three of the four largest US miners filing for bankruptcy along with many other smaller companies."The authors said the main culprit was the surge in cheaper natural gas production driven by the shale revolution and competition from renewable energy. Environmental regulations — which Trump has targeted — also hurt coal mining, but were a "significantly smaller factor." IEEFA report, "Research Brief: U.S. Coal Phase-Out Blow by Blow," April 2017: At least 46 coal-fired generating units at 25 electricity plants in 16 states will likely close, convert to natural gas, or be intentionally curtailed in 2017 and 2018 as the U.S. electricity sector moves increasingly away from coal and toward other sources of power. Even if more coal mines opened the work would be handled by automation mostly and a minor amount of human jobs. 20. MOAB for ISIS - this could help defeat ISIS but it will not do it alone. 21. Travel ban reinstated. 22. Executive order for religious freedom.- Donald Trump has signed a religious-liberty executive order that — if reports are correct — is constitutionally dubious, dangerously misleading, and ultimately harmful to the very cause that it purports to protect. In fact, he should tear it up, not start over, and do the actual real statutory and regulatory work that truly protects religious liberty.The order doesn’t do anything "vigorously," and it doesn’t "protect" anything at all. Next — and this is important to understand — an executive order cannot repeal a statute, and legal restrictions on political activity by churches are statutory. They’re part of the so-called Johnson Amendment 23. Jump started NASA 24. $600 million cut from UN peacekeeping budget. 25. Targeting of MS13 gangs 26. Deporting violent illegal immigrants. 27. Signed 41 bills to date - What was the top 5 major accomlishment bills that he signed. Please don't list the Russian Sanctions bill, Trump has already tweeted how bad this is. 28. Created a commission on child trafficking 29. Created a commission on voter fraud. 30. Created a commission for opioids addiction. 31. Giving power to states to drug test unemployment recipients. 32. Unemployment lowest since May 2007. 33. Historic Black College University initiative 34. Women In Entrepreneurship Act 35. Created an office for illegal immigrant crime victims. 36. Reversed Dodd-Frank 37. Repealed DOT ruling which would have taken power away from local governments for infrastructure planning 38. Order to stop crime against law enforcement. 39. End of DAPA program. 40. Stopped companies from moving out of America 41. Promoted businesses to create American Jobs. 42. Encouraged country to once again ‘Buy American and Hire American!’ 43. Cutting regulations two for every one created 44. Review of all trade agreements to make sure they are America First 45. Apprentice program 46. Highest manufacturing surge in three years. 47. $78 Billion promised reinvestment from major businesses like Exxon, Bayer, Apple, SoftBank, Toyota… 48. Denied FBI a new building. 49. $700 million saved with F-35 renegotiation. 50. Saves $22 million by reducing White House payroll. 51. Dept. of Treasury reports a $182 billion surplus for April 2017 (2nd largest in history.) 52. Negotiated the release of six U.S. humanitarian workers held captive in egypt. 53. Gas prices lowest in more than 12 years. 54. Signed an Executive Order to promote energy independence and economic growth 55. President Trump has worked with Congress to pass more legislation in his first 100 days than any president since Truman. 56. Has already accomplished more to stop government interference into people’s lives than any president in the history of America. 57. Has given head executive of each branches six month time frame dated March 15 2017, to trim the fat, restructure and improve efficacy of their branch. Observe the pushback, the leaks, the lies, the hysterics as entrenched POWER refuses to go Silently into the Night! 58. Donation of his salary to charity.
          Thank you, Veterans, for keeping us free!        

from the US Department of Veterans' Affairs site:

History of Veterans Day

World War I – known at the time as “The Great War” - officially ended when the Treaty of Versailles was signed on June 28, 1919, in the Palace of Versailles outside the town of Versailles, France. However, fighting ceased seven months earlier when an armistice, or temporary cessation of hostilities, between the Allied nations and Germany went into effect on the eleventh hour of the eleventh day of the eleventh month. For that reason, November 11, 1918, is generally regarded as the end of “the war to end all wars.”

Soldiers of the 353rd Infantry near a church at Stenay, Meuse in France.

Soldiers of the 353rd Infantry near a church at Stenay, Meuse in France, wait for the end of hostilities.  This photo was taken at 10:58 a.m., on November 11, 1918, two minutes before the armistice ending World War I went into effect

In November 1919, President Wilson proclaimed November 11 as the first commemoration of Armistice Day with the following words: "To us in America, the reflections of Armistice Day will be filled with solemn pride in the heroism of those who died in the country’s service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations…"

The original concept for the celebration was for a day observed with parades and public meetings and a brief suspension of business beginning at 11:00 a.m.

The United States Congress officially recognized the end of World War I when it passed a concurrent resolution on June 4, 1926, with these words:

Whereas the 11th of November 1918, marked the cessation of the most destructive, sanguinary, and far reaching war in human annals and the resumption by the people of the United States of peaceful relations with other nations, which we hope may never again be severed, and

Whereas it is fitting that the recurring anniversary of this date should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace through good will and mutual understanding between nations; and

Whereas the legislatures of twenty-seven of our States have already declared November 11 to be a legal holiday: Therefore be it Resolved by the Senate (the House of Representatives concurring), that the President of the United States is requested to issue a proclamation calling upon the officials to display the flag of the United States on all Government buildings on November 11 and inviting the people of the United States to observe the day in schools and churches, or other suitable places, with appropriate ceremonies of friendly relations with all other peoples.

An Act (52 Stat. 351; 5 U. S. Code, Sec. 87a) approved May 13, 1938, made the 11th of November in each year a legal holiday—a day to be dedicated to the cause of world peace and to be thereafter celebrated and known as "Armistice Day." Armistice Day was primarily a day set aside to honor veterans of World War I, but in 1954, after World War II had required the greatest mobilization of soldiers, sailors, Marines and airmen in the Nation’s history; after American forces had fought aggression in Korea, the 83rd Congress, at the urging of the veterans service organizations, amended the Act of 1938 by striking out the word "Armistice" and inserting in its place the word "Veterans." With the approval of this legislation (Public Law 380) on June 1, 1954, November 11th became a day to honor American veterans of all wars.

Later that same year, on October 8th, President Dwight D. Eisenhower issued the first "Veterans Day Proclamation" which stated: "In order to insure proper and widespread observance of this anniversary, all veterans, all veterans' organizations, and the entire citizenry will wish to join hands in the common purpose. Toward this end, I am designating the Administrator of Veterans' Affairs as Chairman of a Veterans Day National Committee, which shall include such other persons as the Chairman may select, and which will coordinate at the national level necessary planning for the observance. I am also requesting the heads of all departments and agencies of the Executive branch of the Government to assist the National Committee in every way possible."

President Eisenhower signing HR7786, changing Armistice Day to Veterans Day.

President Eisenhower signing HR7786, changing Armistice Day to Veterans Day. From left: Alvin J. King, Wayne Richards, Arthur J. Connell, John T. Nation, Edward Rees, Richard L. Trombla, Howard W. Watts

On that same day, President Eisenhower sent a letter to the Honorable Harvey V. Higley, Administrator of Veterans' Affairs (VA), designating him as Chairman of the Veterans Day National Committee.

In 1958, the White House advised VA's General Counsel that the 1954 designation of the VA Administrator as Chairman of the Veterans Day National Committee applied to all subsequent VA Administrators. Since March 1989 when VA was elevated to a cabinet level department, the Secretary of Veterans Affairs has served as the committee's chairman.

The Uniform Holiday Bill (Public Law 90-363 (82 Stat. 250)) was signed on June 28, 1968, and was intended to ensure three-day weekends for Federal employees by celebrating four national holidays on Mondays: Washington's Birthday, Memorial Day, Veterans Day, and Columbus Day. It was thought that these extended weekends would encourage travel, recreational and cultural activities and stimulate greater industrial and commercial production. Many states did not agree with this decision and continued to celebrate the holidays on their original dates.

The first Veterans Day under the new law was observed with much confusion on October 25, 1971. It was quite apparent that the commemoration of this day was a matter of historic and patriotic significance to a great number of our citizens, and so on September 20th, 1975, President Gerald R. Ford signed Public Law 94-97 (89 Stat. 479), which returned the annual observance of Veterans Day to its original date of November 11, beginning in 1978. This action supported the desires of the overwhelming majority of state legislatures, all major veterans service organizations and the American people.

Veterans Day continues to be observed on November 11, regardless of what day of the week on which it falls. The restoration of the observance of Veterans Day to November 11 not only preserves the historical significance of the date, but helps focus attention on the important purpose of Veterans Day: A celebration to honor America's veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good.


          A War That Lasts a Lifetime – The War Against PTSD        
Tony and Hadji's Story

The Department of Veterans Affairs estimates that 11 to 20% of all combat veterans, dating back to Vietnam, have PTSD. Tony Austin served as an active duty Marine from 2006 to 2010. Most notably having served overseas for Operation Enduring Freedom (OEF) 2008 in Helmand Providence, Afghanistan with the 24th Marine Expeditionary Unit (MEU). No one knows how, or to what extent, serving in a theater of combat will affect them.

Tony’s struggles aren’t just with PTSD, but with being a civilian again and constantly being made aware of how detrimental PTSD is to veterans in general. Having lost many brothers and sisters in arms to both war and PTSD Tony’s purpose and fulfillment in life that came with serving his country as an active duty Marine is over. Having Hadji, his PTSD dog, has empowered Tony to start doing things that were lost to him; from the simplicities of grocery shopping to attendance of his daughter’s sporting events. Having Hadji has not only given Tony a new outlook on life, but has led to countless encounters with so many people; civilians and veterans alike. Knowing how impactful having a PTSD service dog can be, for not only the veteran in need but their family as a whole.

Tony has founded Dog Tags and Capes, Inc. a new nonprofit organization in Kaukauna, WI designed to rescue dogs, train them to be PTSD service dogs, and unite the community and veterans around a central focus; dogs. Read more about Tony and Hadji by going to their website: dogtagsandcapes.com




          Department of Veterans Affairs Chooses Cyfin Reporter as Its Internet Monitoring Solution        

The U.S. Department of Veterans Affairs recently purchased Wavecrest Computing's Cyfin Reporter software to monitor employee Web access. Cyfin Reporter offers organizations a clear view into employees' Web activity with it's accurate Web-use reporting.

(PRWeb October 21, 2008)

Read the full story at http://www.prweb.com/releases/2008/10/prweb1473894.htm


          General Eric Shinseki To Be Obama's Veterans Affairs Secretary        
[+2] Discussion by BumbleBeeBoogie on 12/07/08 8:37 AM Replies: 9 Views: 635
Tags: Obama Cabinet
Last Post by hawkeye10 on 12/09/08 5:56 PM
          VA Can’t Say Definitively Its Nursing Homes Have Bucked Deficiencies: GAO        

By Greg T. Rinckey The U.S. Department of Veterans Affairs still cannot provide assurances that patient care problems identified years ago at some of its 132 nursing homes have been resolved, according to the federal government’s watchdog agency. In a …

The post VA Can’t Say Definitively Its Nursing Homes Have Bucked Deficiencies: GAO appeared first on Albany NY Lawyer | Washington DC Attorney | San Diego CA Attorney | Colonie | Saratoga | Schenectady | Troy | Tully Rinckey PLLC.


          704 Local Veterans Died In New Hampshire In The Past Year        
It took nearly thirty minutes to read all 704 veterans’ names. These were not the few who died in service, but the many who died over the past year throughout New Hampshire. When Jerome Forte’s name was called, Dennie Forte stood and walked to the front of the hall at Manchester’s Veterans Affairs Medical Center. There, Democratic U.S. Senator Maggie Hassan handed her a rose. The ritual would repeat itself hundreds of times that morning. Forte’s husband – he went by Jerry – died from a brain tumor last May. Forte still has the audio tapes they sent each other while he was serving in Vietnam. At the time, Forte was a student at the University of New Hampshire. “It was hard,” she said. Her then-boyfriend was in the Air Force, and her brother was with the Special Forces green beret. “So there I am as a college student, kids are protesting, we’re having classes canceled etc., and I have two people very dear to me in uniform. And that’s what I feel sort of, is going on today, you’re pushed
          CACI Awarded Prime Position on $22.3 Bn Multiple-Award Contract With Department of VA        
CACI International Inc ( NYSE MKT: CACI ) announced today that it has been awarded prime position on a $22.3 billion multiple-award contract to provide information technology (IT) services and solutions for the Department of Veterans Affairs (VA) under the Transformation Twenty-One Total Technology (T4) Next Generation (NG) contract vehicle. This 10-year indefinite delivery, indefinite quantity contract represents continuing work in CACI's Health market area. The T4NG contract is in place to ...
          State Veterans Office Balances Needs Of Wide Range Of Ages        
Vermont has one of the oldest veterans' populations of any state in the country. Because of these demographics, the state office on Veterans Affairs says it's trying to balance the needs of veterans who served in World War II and the Korean War with the concerns of younger veterans.
          Veterans Day: Of Soldiers and Families        

World War I was known as “The Great War.” It officially ended with the signing of the Treaty of Versailles on June 28, 1919.  Although fighting had stopped several months earlier when an armistice between the Allied Nations and Germany went into effect on the eleventh hour of the eleventh day of the eleventh month. That’s why President Wilson proclaimed November 11 as the first commemoration of Armistice Day according to the U.S. Department of Veterans Affairs.


          Thousands Volunteer To Help Count Homeless In LA County        

LOS ANGELES (CBSLA.com) — Thousands of volunteers took to the streets Tuesday night to kick off a three-night effort to count homeless people in the Greater Los Angeles area. The count is organized by the city- and county-run Los Angeles Homeless Services Authority. The tally will include most of Los Angeles County, with the cities of Long Beach, Glendale and Pasadena under different jurisdictions. The count, which will continue on Wednesday and Thursday nights, is an effort to “put a face on who the homeless are and paint a picture about the state of homelessness,” Los Angeles Homeless Services Authority spokeswoman Naomi Goldman said. The authority is hoping to cover as much as 95 percent of the census tracts, she said. One volunteer, Angelica Lopez, said she had to get involved since she has seen an increase in the homeless population recently. “I see it on my way to work and on my way home,” she said. “It t just seems like its affecting everybody.” Andy Bales of Union Rescue Mission said the problem has become much worse in recent years. “It’s an absolute epidemic,” he said. “It’s an absolute crisis.” A myriad of factors are to blame, according to experts, including rising rents and a mental health crisis. The Los Angeles City Council is meanwhile working on new rules to govern encampments and tents on public sidewalks. The volunteers’ data gathered is used to help the authority request and allocate funding for homeless services, she said. Past homeless counts have yielded demographics on the number of people who are chronically homeless, victims of domestic violence or sufferers of mental illness, and whether they are single, part of a family or an unaccompanied minor. The Los Angeles Homeless Services Authority has been doing the count on a biannual basis since 2005. The last count, done in 2015, found that there are more 44,000 homeless people in the Los Angeles area — a 12 percent increase from the 2013 figure. This year’s count is being done earlier than usual thanks to funding from the U.S. Department of Veterans Affairs, and marks “the first year of what is hoped to be an annual count,” Goldman said. More information about the count is available at http://www.theycountwillyou.org. (©2015 CBS Local Media, a division of CBS Radio Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. Wire services contributed to this report.)
          VA News Highlights        
Several headlines from the Department of Veterans Affairs in recent days.  Click the links to read the full stories. Statement from Veterans Affairs Secretary Eric K. Shinseki on the American Jobs Act – Shinseki comments on the proposed Act which … Continue reading
          New Scam in Kentucky Claims to Represent Group Raising Money for Veterans        
One of the latest scams making the rounds in Kentucky involves a caller who claims to be raising money to cover Veterans Affairs medical bills and aid homeless veterans. The caller claims to represent a bogus charity called “Coalition for Veterans of America.” The Kentucky Attorney General’s Office says its received multiple reports from Kentuckians—including one from state police—who say they’ve been contacted by the scammers.
          US Vets Offered Free Mental Health Care Through Burgeoning Nonprofit (Military.com)        

By Casey Stegall

July 19, 2017

See Original Post

Jeff Hensley, a former   Navy fighter pilot,

spent 21 years in the military and did multiple deployments before retiring

in 2009 and settling in Texas. 

 

When he found himself in a dark place, the local Veterans Affairs hospital

was unable...

Read more

          Please stop talking about that cake!        
Poor Lud and Marie, can't even say "cake" in their own home.

I had a Lily Tomlin clip yesterday and Rosita e-mailed that her favorite Lily Tomlin sketch on vinyl is from APPEARING NIGHTLY.



That's the sketch she's talking about.

Agnes aka Dracula's Daughter lives with Lud and Marie and sulks and screams if anyone says "cake."

There's another Ernestine sketch, by the way, after the Lud and Marie and Agnes.

Lily Tomlin is probably the best living comedian we have.

In fact, she and Richard Pryor ruled the seventies in a way no one's ever come close to.

He's passed so now it's just Lily.

I'm glad Ellen's going to do a standup tour again.

I had her first album -- and loved it.  But I didn't see her live then.

It was only after she was out and ABC gave her the axe that I saw her in concert.

It was a brave and funny show.

I also saw her on the tour that followed.

Lily?

My friend Maggie is a huge Lily fan.

I've seen Lily more times than I can count.

And when she was doing the Broadway show THE SEARCH FOR SIGNS OF INTELLIGENT LIFE IN THE UNIVERSE, Dak-Ho and I saw it with Maggie -- it was our birthday gift to her -- the flight, the hotel and the show.




Closing with C.I.'s "Iraq snapshot:"


Thursday, July 20, 2017.


Since the discussion of human rights abuses -- War Crimes -- entered the press conversation regarding Mosul last week, there has been silence from the US government.

Turns out not all leaders of government are being silent.  REUTERS reports:

German Chancellor Angela Merkel on Wednesday urged Iraqi Prime Minister Haider al-Abadi to investigate alleged human rights abuses that occurred during military operations to regain control of the city of Mosul from Islamic State militants.
Merkel telephoned al-Abadi to congratulate him on the victory of U.S.-backed Iraqi forces in Mosul, calling it a "big step forward in the fight against Islamic State," her spokesman Steffen Seibert said in a statement.

The German leader also encouraged Abadi to investigate claims of human rights abuses that emerged after the military operations, Seibert said.

Hayder al-Abadi is the prime minister of Iraq.

He has not set a good example and his record is appalling.

This was noted by Human Rights Watch yesterday:


International observers have discovered an execution site in west Mosul, Human Rights Watch said today. That report, combined with new statements about executions in and around Mosul’s Old City and persistent documentation about Iraqi forces extrajudicially killing men fleeing Mosul in the final phase of the battle against the Islamic State (also known as ISIS), are an urgent call to action by the Iraqi government.
Despite repeated promises to investigate wrongdoing by security forces, Prime Minister Haider al-Abadi has yet to demonstrate that Iraqi authorities have held a single soldier accountable for murdering, torturing, and abusing Iraqis in this conflict.

“As Prime Minister Abadi enjoys victory in Mosul, he is ignoring the flood of evidence of his soldiers committing vicious war crimes in the very city he’s promised to liberate,” said Sarah Leah Whitson, Middle East director at Human Rights Watch. “Abadi’s victory will collapse unless he takes concrete steps to end the grotesque abuses by his own security forces.”



Despite repeated promises . . .

That is his record.

The same one as Nouri al-Maliki had before him.

Merkel has called out the abuses.

The US government has not.

Gwynne Dyer (RED DEER ADVOCATE) observes:

The shooting was still going on down by the river last week when Iraq’s Prime Minister Haider al-Abadi dropped by and prematurely declared that the battle for Mosul was over. He was misled by the various Iraqi army, police and militia units who were competing with one another to declare victory first, but now it really is over – and there is little left of Mosul.

The siege began on 17 October of last year, so it lasted nine months – longer than the Battle of Stalingrad. It probably killed more civilians, too, because the US-led air forces were used to compensate for the shortage of trained and motivated Iraqi ground forces.


On the issue of media coverage, Adam Johnson (FAIR) offers an analysis which includes:

Earlier this week, human rights group Amnesty International issued a lengthy report accusing US-backed forces of “repeated violations of international humanitarian law, some of which may amount to war crimes,” in Mosul, Iraq, causing the deaths of at least 3,700 civilians. Neither this report, nor the broader issue of the civilian toll in the US war against ISIS, has come close to penetrating US corporate media.
The only major radio or television outlet to report on Amnesty’s claims was NPR (7/12/17). While traditional print outlets, such as the New York Times and Washington Post, did run Reuters (7/11/17) and AP (7/12/17) articles, respectively, on the report, neither covered it themselves. Neither Amnesty’s charges, nor the broader issue of civilian deaths in Mosul,  garnered any coverage in television news, with no mention on ABC, NBC, CBS, CNN or MSNBC.

The expulsion of ISIS from Mosul by the US-led coalition did receive coverage, but the US role in killing civilians was uniformly ignored.



Amnesty International actually issued the report two weeks ago (this snapshot was the first time we mentioned it).

The silence isn't just over broadcast media, it's also in State Dept press briefings.  Mosul was frequently mentioned

The Amnesty report?

Nope.

The abuses?

Nope.

These are not broadcasts.

No reporter can whine, "My producer wouldn't air it."

This is when reporters can ask anything.

And they chose to ignore the issue.

They refused to press the US government on what was taking place.

It's exactly these moments that go to why the press is not respected.

They are pretending to do so much but they do so little.


Let's not this upcoming event.

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Senator Johnny Isakson is the Chair of the Senate Veterans Affairs Committee.  Yesterday, his office issued the following statement on Senator John McCain:

WASHINGTON â€“ U.S. Senator Johnny Isakson, R-Ga., today released the following statement regarding U.S. Senator John McCain, R-Ariz.:

“John McCain is an American hero and one of the greatest Americans of my generation. He, Cindy and the entire McCain family are in my prayers. God bless John McCain.”

###




The following community sites updated:
















  • iraq iraq iraq iraq iraq iraq

              ScribeAmerica Praises House Passage of H.R. 1848        

    ScribeAmerica commends the House of Representatives for the passage of the Veterans Affairs Medical Scribe Pilot Act of 2017

    (PRWeb July 27, 2017)

    Read the full story at http://www.prweb.com/releases/2017/07/prweb14551552.htm


              206: What Kind of Physician Do You Want to be? Recorded Live!        

    session-206

    Session 206

    Today’s episode is a different one as Ryan presents live recordings of the premed students he got to talk with during the two back-to-back conferences this October, namely, the AMSA (American Medical Student Association) PremedFest at the University of South Florida and the UC Davis Pre-Health Conference in California.

    Soon, we will be launching the Specialty Stories, a podcast where Ryan talks with different specialists and what they're doing in a non clinical role to give you an idea of what the future may hold and of what you can do now to set yourself for success in the future.

    Hear from these amazing students who attended either of these conferences and see if you can relate with them in terms of the specialties they’re interested in and their thought processes.

    David

    Interest: DO

    Specialty in mind: Surgery

    Background: Nontraditional; going to DO due to grades and his holistic idea; working as a surgical technologist at a spine center

    His PremedFest highlights: Physician-Assisted Suicide; The event has helped him shape his views on different things

    Nina

    Specialty in mind: Surgery

    Her PremedFest highlights: Taking advantage of whatever you see even if it's not something you knew existed before

    Rico

    Specialty in mind: Anesthesiology

    Ryan’s Tip: Do some research on CRNA and check out the Texture app, a Netflix for magazines, www.medicalschoolhq.net/texture and sign up for a free one-week trial account. This is the perfect app to get your prepared for your medical school interviews, etc. and get in-depth articles from all the top magazines. Check it out and see what's going on with the Anesthesia world specifically what the Veterans Affairs hospitals are trying to do.

    Kimberly

    Specialty in mind: Pediatrics

    Background: Currently in a postbac program

    Abby

    Specialty in mind: Pediatric emergency medicine or Neonatology

    Reason: Love of kids and the fast pace, spontaneity, and being there in critical times for the patients

    Adrienne

    Specialty in mind: Dermatology

    Reason: Since the skin is the outer layer, you can transform someone's life with your knowledge.

    Gabriel

    Specialty in mind: Cardiology, Neurology, or Internal Medicine

    Why he wants to be a doctor: Helping people and serving the community

    Nikki

    Specialty in mind: DO, family practice

    Daniel

    Specialty in mind: Surgery, Orthopedics

    Background: Worked as a train engineer and now working in Human Resources at the United Nations; started applying to postbac programs

    Anthony

    Specialty in mind: Emergency medicine

    Background: Working as a paramedic in the EMT level and wanting to learn more and more with medicine as the next step

    Andrew

    Specialty in mind: Emergency medicine, Pediatrics, Primary care

    Kevin

    Specialty in mind: MD or DO PhD programs specifically, degenerative medicine

    Background: Current postbac student at UC Berkeley Kevin thinks we won't live forever but we can continue to extend not only lifespan but "health" spans

    Edith

    Specialty in mind: Plastic or reconstructive surgery. Orthopedics, Neurosurgery

    Reason: To help burn victims and her desire to help people

    Radelle

    Specialty in mind: Gastroenterology, Endocrinology

    Why she wants to be a doctor: To make personal connections with people and help them live a better life

    Jordan

    Specialty in mind: Forensic pathology

    Background: Joined the marine corps at 17

    Some pieces of advice for premed students:

    1. Keep an open mind.
    2. You don't need to know what specialty you want when going to medical school. You will figure it out along the way, reason for all these clinical rotations in medical school.
    3. Check out the premed conferences in your area or budget so you can travel to a premed conference to be around like-minded students and witness the collaboration among students.

    Come celebrate with us!

    In celebration of this podcast’s 4th anniversary (which will be Episode 208), Ryan is giving away a 4-pack mock interview prep and a single session of personal statement editing, and some of his mock interview courses. To get a chance to win, simple follow these quick steps:

    Contest Mechanics:

    1. Leave this podcast a review on iTunes.
    2. Take a screenshot of the review. (If you’ve already left one, just take a screenshot of the review you’ve already left.)
    3. Post on your Facebook page the best way of getting this podcast out to more people or go to www.medicalschoolhq.net/contest and have a snippet of what you need to write.
    4. Take a screenshot of your Facebook post and tag MSHQ too if possible.
    5. Fill up a form at www.medicalschoolhq.net/contest and upload your two screenshots.
    6. Deadline will be on November 14, 2016 at 12 midnight (technically the 15th).

    Links and Other Resources:

    Check out the AMSA Convention - February 2017 and use the code: MSHQ17 to save some money on this big event happening in DC.

    UC Davis Pre-Health Conference

    Texture app

    www.mededmedia.com


              13: Interview with Dean of UCF College of Medicine        

    Session 13Session 13

    In today's episode, Ryan talks with Dr. Deborah German, the Dean of The University of Central Florida College of Medicine (UCF COM). UCF COM was the first, built from the ground up, allopathic medical school in the US in almost 30 years.

    Before we dive into the discussion, the show begins with a question we got in the email forum from Laura, a 3rd-year biomedical PhD student, where she asked about how to shadow on weekends if your schedule is too full during the week.

    Ryan answers this by saying that while not ideal, there are opportunities on weekends. Hospitals are open 24/7 so you can probably shadow in a hospital ER if they let you. It's a matter of reaching out to your local hospital. Also look around for doctor's offices that may be open on weekends in your area as well as some walk-in clinics which fill in where other offices are closed. Back to the interview, Ryan talks with Dr. German where they discuss about Lake Nona Medical City, the types of students UCF is looking for, and having that passion to really do what you love to do which Dr. German has reiterated for a number of times.

    Here are the highlights of the conversation with Dr. German:

    Types of students UCF looks for:

    • Strive for excellence
    • Heart for medicine
    • Pioneering entrepreneurial spirit
    • Spirit of inquiry and curiosity about medicine
    • Leadership
    • Professionalism - Willing to put themselves aside for the needs of another

    More about Lake Nona Medical City:

    UCF's current progress:

    • UCF did better than half of the medical schools across the country on USMLE
    • Students doing international trips
    • New online medical journal Cureus
    • UCF won the global competition for student research for medical students, residents, and graduate students
    • Full accreditation https://today.ucf.edu/ucf-college-of-medicine-achieves-full-accreditation/

    Curriculum at UCF:

    • Integrated curriculum
    • Clinical work starts in the first year
    • Basic and clinical science throughout all 4 years
    • Research required of every student (First two years)
    • Use of technology to assist the education for students (simulation, virtual patients, standardized patients, live patient interaction, assessment system)

    UCF Admissions:

    Admitting 120 in the Fall

    Reasons for the rise of new medical schools:

    • To address healthcare nationally
    • Scarcity of physicians
    • Economic driver for communities

    3 Categories of dreamers that lay the foundation of UCF:

    1. Mother Teresa - Taking care of people
    2. Nobel Prize Winners - Curing cancer, eliminating obesity, or eradicating infectious diseases
    3. Sergeants General - Global health, healthcare reform, and health disparities

    Dr. German's advice to those struggling with poor grades:

    You have to show that you're committqed and it has to come across in your grades in your last couple of years. Otherwise, take a Master's degree if you have to to really show that you're committed to it.

    Some pieces of advice for high school seniors and premed students:

    If you love it, give it everything you have. If you can't, then think about that.

    Links and Other Resources:

    Call in and leave a question like Laura did at 617-410-6747 so we can play it here on the podcast and share it with everyone. This is not a competition. We're all in this together!

    University of Central Florida College of Medicine

    Lake Nona Medical City

    Cureus Medical Journal

    PDF showing 8.9% of 3.8+GPA and 39+ MCAT applicants DO NOT get into Medical School

    10,000 people are turning 65 EVERY DAY!

    If you need any help with the medical school interview, go to medschoolinterviewbook.com. Sign up and you will receive parts of the book so you can help shape the future of the book. This book will include over 500 questions that may be asked during interview day as well as real-life questions, answers, and feedback from all of the mock interviews Ryan has been doing with students.

    Are you a nontraditional student? Go check out oldpremeds.org.

    For more great content, check out www.mededmedia.com for more of the shows produced by the Medical School Headquarters including the OldPremeds Podcast and watch out for more shows in the future!

    Free MCAT Gift: Free 30+ page guide with tips to help you maximize your MCAT score and which includes discount codes for MCAT prep as well.

    Hang out with us over at medicalschoolhq.net/group. Click join and we'll add you up to our private Facebook group. Share your successes and miseries with the rest of us.

    Check out our partner magazine, www.premedlife.com to learn more about awesome premed information.

    Next Step Test Prep: Get one-on-one tutoring for the MCAT and maximize your score. Get $50 off their tutoring program when you mention that you heard about this on the podcast or through the MSHQ website.

    Check out their 10-full length practice tests that you can take.

    Listen to our podcast for free at iTunes: medicalschoolhq.net/itunes and leave us a review there!

    Email Ryan at ryan@medicalschoolhq.net or connect with him on Twitter @medicalschoolhq


              NO MERCY        



    IN RESPECT AND HONOR FOR ALL OF OUR SOLDIERS.





    I find this gross corruption/scandal disturbing and disgusting which made me absolutely
    sick to my stomach.  For those men and women who have sacrifice so much of their lives
    to protect and serve our great country.  For veterans not receiving proper healthcare and
    their respectable burial, this is absolutely despicable and deplorable.  For the Department
    of Veterans Affairs allowing this to happen has ultimately come down to this, people with
    no mercy whatsoever for other human beings.

    Our veterans both men and women who sacrifice so much for our country deserve much
    more, both in life and death.  The gross corruption and lazy negligence of others towards
    our soldiers touches our hearts.  Beginning Today! we must voice and fight to assure that
    all of our precious honorable soldiers life or death receive all their proper care, shelter and
    burial rights that they have rightfully earned and for those who have allowed this to happen
    must be held accountable for their actions.





    Lord Forgive Them

    Angela    
              Study Finds Small Risk Of Guillain-Barre Syndrome From H1N1 Vaccine        
    The link between the H1N1 vaccine and Guillain-Barré first emerged in 1976, during the U.S.’s last urgent national campaign to immunize citizens against a fast-acting flu. At that time, the risk of the disease, which is a rare but serious immune disorder in which the body’s own immune cells start to attack nerves, leading to muscle weakness, paralysis and even death, was concerning enough that the vaccination program was halted. H1N1 immunization was called for again in 2009, however, when threat of a related pandemic strain of influenza against which most of the population wasn’t immunized, called for a massive vaccination campaign to avoid a pandemic. Now the latest study on adverse events reported from those vaccinations, published in the Lancet, shows that the risk of Guillain-Barré remained. The data included adverse events reported to six different systems, including the core vaccine safety datalink, new surveillance systems established by Medicare and the U.S. Department of Defense and Veterans Affairs, as well as a monitoring system specifically created to track adverse events related to the 2009 H1N1 immunization campaign. Researchers from the National Vaccine Program Office of the U.S. Department of Health and Human Services analyzed the data from 23 million people who were vaccinated as part of that effort and found 61 million cases of H1N1, 274,000 hospitalizations and 12,470 deaths related to the pandemic flu. Of those who were immunized, 77 developed Guillain-Barré, some as long as 91 days after getting their shot. Since the disorder normally affects about one person in 100,000, this results in an additional 1.6 cases of Guillain-Barré syndrome per one million people vaccinated — still a small risk. (SPECIAL: What You Need to Know About the H1N1 Vaccine) This rate is similar to that found in other studies that have studied the link between the vaccine and the autoimmune disorder. Last summer, a group of scientists in Quebec analyzed the risk of Guillain-Barré syndrome in millions of people given the vaccine in Canada between 2009 and 2010 and reported 83 confirmed cases of Guillain-Barré, including 25 cases
              Weed For Vets Now Possible With New Amendment        

    U.S. veterans may finally have access to medical marijuana thanks to an amendment by the The U.S. Senate Appropriations Committee on Thursday which would allow weed for Vets and a process to obtain medical marijuana recommendations through the Department of Veterans Affairs. As it stands today, even veterans in legal states like Colorado and Oregon [...]

    The post Weed For Vets Now Possible With New Amendment appeared first on The Weed Blog.


              Nov 13: Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades, and Veteran Cultural Competency 2017        
    San Francisco, Live Webcast and www.pli.edu,* November 13, 2017 IMPORTANT! If you get accredited by the VA before you attend this training, the first three hours will satisfy the VA’s CLE requirement. 1. Attorneys and other advocates must be accredited to practice before the VA. To obtain accreditation you must complete this form: www.va.gov/vaforms/va/pdf/VA21a.pdf. 2. Accreditation by the VA may take several weeks, so do not delay filing your application. You can speed up the process by emailing the form to: OGCAccreditationMailbox@va.gov. 3. Within 12 months after accreditation you are required to complete three hours of qualifying CLE. The morning session of this program satisfies that requirement, but only if you have already received your accreditation from the VA. If you have not received it, you should still watch this program, but keep in mind that you will need to complete three additional hours of CLE within 12 months after receiving your accreditation. 4. Attorneys and other advocates who become accredited will be listed on a national VA list, and are entitled to represent veterans in their claims for benefits, on a pro bono basis, and for attorney’s fees on appeals, where they are available. Why You Should Attend There are over 21 million veterans in the U.S.; many of them are not aware of the benefits to which they are entitled. Medical and financial assistance are available to those who have served in the military, but many veterans most in need are not receiving VA benefits. Navigating the VA claims system and applying for discharge upgrades before the Department of Defense are difficult and complex processes. Attorneys play an essential role in removing barriers to VA benefits, such as: • Lack of evidence to “service-connect” their injuries or disabilities. • Lack of current medical or mental health evidence documenting severity of symptoms for accurate disability ratings. • VA eligibility determinations for those given less than fully honorable discharges for behaviors that were related to minor disciplinary infractions or symptoms of Post- Traumatic Stress or other service-related disabilities. What You Will Learn Nearly 45% of veterans returning from Iraq and Afghanistan seek compensation from the Department of Veterans Affairs (VA) for service related injuries; 30% of these veterans who file for VA benefits include claims for Post-Traumatic Stress. Many of those who should receive benefits will be denied. Many service members who may be VA eligible are unaware of their legal right to pursue VA benefits, and of those who do apply, more than 90% will be denied. All of them will wait months or years for the VA to issue decisions on their claims. Learn how to navigate the VA claims process and to become an effective advocate for veterans in need. This all-day program will provide an overview of VA disability law and military discharge review law. You will gain an understanding of different types of military discharges, why they are important, and how you can help veterans with less than Honorable discharges. • The three one-hour morning sessions provide the basics you need to represent veterans before the VA. It will also cover the interactions between VA benefits and other public benefits, such as SSI and SSDI. The morning session fulfills the VA’s requirement for qualifying CLE within the first 12 months of your VA accreditation. • The 1:45 session, Veteran Cultural Competency: Combat to Community will help veterans’ advocates to understand the challenges that veterans face in their transition to a noncombat community, and provide tips on interviewing and providing legal services to veterans with disabilities. • The 2:45 to 5:00 sessions will provide attorneys with the tools that they need to assist veterans in upgrading their discharge status and removing stigmatizing information from their discharge documents. Who Should Attend Attorneys seeking meaningful pro bono opportunities and any advocate who wants to help change the life of a veteran with a disability. Attorneys seeking to meet VA’s CLE requirements for new and continuing VA accreditation should also attend. Finally, attorneys who hope to expand their practice areas to include veterans’ cases where fees are available should register for one or more of the sessions.
              HUD Secretary Announces New Round Of Funding For Housing For Homeless Vets        
    A new initiative from the U.S. Housing and Urban Development department will help homeless veterans with mental health issues find housing. HUD Secretary Julián Castro made the announcement in Seattle today. HUD is partnering with the department of Veterans Affairs to help get veterans connected to housing and to VA services. This new round of money will help about 9-thousand veterans across the country. That's about a fifth of the overall population of homeless veterans in the U.S. HUD will provide them with vouchers that can go towards rent. The VA will give them case management and clinical services. Veterans in Washington state will get a million dollars towards vouchers. Copyright 2015 KUOW
              In Remote Washington, Veterans Services Are Ferry Ride Away         
    NPR — along with seven public radio stations around the country — is chronicling the lives of America's troops where they live. We're calling the project " Back at Base ." This story is part of a three-part series about veteran benefits ( Part 1 / Part 2 ) . For veterans in San Juan County, Wash., getting health care from the U.S. Department of Veterans Affairs almost always begins with an hourlong ferry ride. Even routine bloodwork requires a three-hour one-way trip. Friday Harbor, Wash., is one of four island stops on this ferry ride, and the only incorporated city in San Juan County. Travel to the west side of the island, and your cellphone pings you that you're in Canada, even though you're still in the U.S. Just a short walk from the ferry terminal is American Legion Post 163, where Peter DeLorenzi, a veterans service officer, helps area vets. "Because I get veterans from Orcas and Lopez and besides San Juan Island, and so it's a really convenient place to meet," he says. "If a
              5 Tips On How To Interact With A Depressed Loved One        
      WASHINGTON - JANUARY 11: U.S. Secretary of Veterans Affairs Eric Shinseki speaks about suicide prevention in the military a during the 2010 Department of Defense and Veterans Affairs Suicide prevention conference at the Hyatt Regency on Capitol Hill on January 11, 2010 in Washington, DC. The Defense Centers of [...]
              Boiler Plant Operator - Veterans Affairs, Veterans Health Administration - Manchester, NH        
    Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 ... $23.27 - $27.08 an hour
    From Department of Veterans Affairs - Sat, 05 Aug 2017 02:57:20 GMT - View all Manchester, NH jobs
              Despite Claims To Contrary, Trump Has Signed No Major Laws 5 Months In        
    Updated 12:30 p.m. ET President Trump kept one of his campaign promises, signing a bill Friday to make it easier for the secretary of veterans affairs to fire and discipline employees. It came in response to the 2014 VA scandal in which employees covered up long wait times while collecting bonuses. The bill, which passed earlier this month with strong bipartisan support, also gives the secretary authority to revoke bonuses and protects whistleblowers who report wrongdoing. "What happened was a national disgrace and yet some of the employees involved in these scandals remained on the payrolls," Trump said just before signing the bill. "Outdated laws kept the government from holding those who failed our veterans accountable. Today we are finally changing those laws." The Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 marks Trump's 40th law signed. Sounds like a lot. And in recent days, Trump has boasted about all the legislation he has signed. "We
              White House Touts 'Historic' 28 Laws Signed By Trump, But What Are They?        
    Even though President Trump calls the 100-days measure "ridiculous," the White House is still touting what one press release called the president's " historic accomplishments " — including 28 laws he has signed since taking office. But when it comes to legislation, political scientists say it is better to measure significance than to simply add up the number of bills. It is better, they argue, to ask whether a law changes the status quo or introduces a new policy idea. By that measure, there is not as much to show legislation-wise for Trump's first 100 days. Of the 28 new laws signed by Trump, two name Veterans Affairs clinics in honor of people, one adds National Vietnam War Veterans Day to the list of days people and businesses are encouraged to fly American flags, five are related to personnel matters (including the waiver allowing James Mattis to become secretary of defense), and one extends an Obama-era policy allowing veterans in some circumstances to get health care outside of
              High-Risk Pools Pose a Dilemma for Conservatives        
    High-risk pools have played a prominent role in the debate over U.S. health care policy, especially on the conservative side. In contrast to liberals, who lean toward a single-payer system or public option, conservatives would like to limit the government’s role to the very sick and the very poor. For the poor, they seem ready (grudgingly) to accepted Medicaid, or something like it, as long as coverage is limited to the “truly needy.” What to do about the very sick is a more complicated problem. High-risk pools, which both HHS Secretary Tom Price and House Speaker Paul Ryan have endorsed, offer a possible solution, but one that comes with issues of its own.

    High-risk pools in theory

    High-risk pools are a response to the inability of private companies to offer insurance at an affordable premium unless their pool of customers has enough healthy individuals to keep average  claims low. If too many sick people join the pool, claims and premiums, begin to rise. Rising premiums cause healthy people to drop out of the pool and take their chances on life without coverage. The dropouts push premiums higher still for those who remain in the pool until, eventually, no one can afford coverage. Economists call this phenomenon adverse selection. It is popularly known as a “death spiral.”

    The traditional way of dealing with adverse selection was to practice medical underwriting, which means dividing the population into separate pools according to health status. If medical underwriting is permitted, insurers quote premiums that reflect the actuarial risk of each pool. They may refuse altogether to cover people with pre-existing conditions, cover them only at very high rates, or place caps on annual or lifetime benefits.

    Although it keeps premiums affordable for the relatively healthy, medical underwriting inevitably means that some people cannot obtain coverage at an affordable premium, or have exhausted their coverage by reaching their spending caps. Before the Affordable Care Act (ACA or “Obamacare”) limited medical underwriting, many states created high-risk pools to meet their needs. Such pools were not intended to be profitable and were supported by government subsidies.
    Described in this way, high-risk pools sound like a good compromise between the comprehensive government health care found in the rest of the developed world, and a purely market-based system that would make health care unaffordable for any but the healthy and the wealthy. What could go wrong? Several things, it turns out.


    Problem No. 1: The skewed distribution of health care spending

    The first problem stems from a nasty reality that proponents of high-risk pools often gloss over. Although such pools would need to cover only a minority of individuals, that small group accounts for the vast majority of health care spending. Consider the following chart, based on data from the National Institute of Health Care Management Foundation:



    As the chart shows, the top 1 percent of health care spenders account for almost a quarter of total spending, the top 5 percent for half of all spending, and the top 10 percent for two-thirds of the total. A majority of people in the top spending groups suffer from chronic conditions or functional limitations that put them in the high-spending category year after year. Those near the top of the curve are uninsurable by the standards of conventional medical underwriting. They are the ones who are candidates for a high-risk pool.

    People who fall into the eightieth and ninetieth percentiles of spending units account for about 16 percent of total health care spending. Before the ACA, people in this group would have been only marginally insurable. Some would have been able to obtain insurance through a job. If they had high enough incomes, some would have been able to buy individual insurance at higher than average premiums and deductibles. Others would either have been unable to afford the high premiums quoted by private insurers or would have been rejected outright because of pre-existing conditions.

    Health care consumers in the lowest two-thirds of spenders account for less than 10 percent of total spending, and those in the lowest half for just three percent of spending. If the highest risk individuals were taken out of the private insurance pool, it is likely that most of these people, except perhaps for the very poor, would be able to buy private individual insurance at premiums they could afford.

    Problem No. 2: Government budgets

    Some reformers speak as if it would be easy to offer subsidized high-risk pools to a small sliver of the population — just 5 or 10 percent — and let everyone else pay their own way. Unfortunately, given the distribution of spending, it would not be easy at all.

    In a study for the Commonwealth Foundation, Jean P. Hall of the University of Kansas calculates that the net cost to the federal budget of a national high-risk pool would be $178 billion per year. That assumes the pools would cover 13.7 million people with chronic conditions, which is less than 5 percent of the population. Each of them would pay a premium of $7,000 per year and have average medical costs of $20,000 per year, requiring a subsidy of $13,000.

    Republican proposals to date do not come close to providing that kind of money. Tom Price, while still a Congressman, suggested a budget of $1 billion per year for subsidies to state high-risk pools. A preliminary proposal endorsed by Rep. Paul Ryan was a little more generous, at $2.5 billion per year.

    The American Health Care Act (AHCA) that failed to gain Congressional approval in March treated high-risk pools as an afterthought. Its proposed Patient and State Stability Fund would have allowed states to experiment with high-risk pools (among other options), but it was funded at a level of only $10 billion per year, plus a little start-up money. That would have come to just $728 a year for each of 13.7 million medically eligible individuals, or enough to cover Hall’s estimated $13,000 per year average subsidy for fewer than 750,000 out of 13.7 million medically eligible candidates.

    In April, the House Rules Committee approved an amendment to the AHCA in an attempt to revive the measure, however it did not reach the floor for a vote. The amendment authorized an additional $15 billion to fund a federal high risk pools. The effort showed that some conservative House members continue to favor high-risk pools. However, the amount they are willing to spend appears to fall far short of the full costs of a comprehensive program for high-risk individuals.

    Problem No. 3: Affordability and accessibility

    The clash between the real-world expenses of high-risk pools and the amount reformers are willing to budget sets up a tension between affordability and accessibility. GOP reformers promise both — “a step-by-step approach to give every American access to quality, affordable health care,” in the words of a policy brief released by House Republicans in early 2017.

    The experience of high-risk pools that existed before the ACA gives an idea of what happens when the goal of affordable, accessible coverage meets budget realities. In an issue brief for the Kaiser Family Foundation, Karen Politz reports that at their peak in 2011, 35 states had some kind of high-risk pool. Total enrollment in the pools, however, was just 223,000 people — fewer than 2 percent of the number of people estimated to be medically eligible today. States discouraged participation in a number of ways that undermined affordability and accessibility:
    • Most states charged premiums well above market rate, typically 150 to 200 percent of the prevailing average. Today the cost of an average silver plan for a family of four on the ACA exchanges is $923 per month, according to a Kaiser Family Foundation calculator. Applying the 2011 high-risk markups to that amount would give a range of $16,614 to $22,152 per year, equal to approximately 30 to 40 percent of median household income.
    • Deductibles further limited affordability. In 29 states, the deductible was $1,000 or more, and it was $5,000 or more in ten states.
    • Most states had lifetime coverage limits, typically $1 million or $2 million. Several states also had annual limits.
    • Limits on enrollment were another tool used to control the cost of high-risk pools. Some states closed enrollment altogether when funds ran out. Others had waiting periods or excluded treatment of pre-existing conditions for a period after initial enrollment in the pool.
    On balance, then, the high-risk pools of the past fell far short of universal accessibility and affordability. Pools that covered the full needs of all medically eligible individuals at an affordable cost would require much larger budgets than either the federal government or most states seem willing to appropriate.

    The High-Risk Dilemma

    Taking all of the above into account, high-risk pools, attractive as they are in theory, pose a practical dilemma for conservatives. On the one hand, they offer a possible lifeline to market-based, insurance-driven health care for the majority of households who are neither very poor nor very sick. On the other hand, a full commitment to high-risk pools would not be cheap.

    The price tag to combined federal and state budgets of fully-funded high-risk pools would exceed $100 billion per year — $40 billion more than the federal government spends on health care through Veterans Affairs, and an order of magnitude more than envisioned budgeted by any conservative ACA replacement offered to date. To keep the cost close to $100 billion would require that participants in the high-risk pools who had the ability to do so paid premiums and deductibles at or moderately above those prevailing in the individual market.

    Introducing high-risk pools without adequate funding would have negative unintended consequences:
    • Quantitative limits on admission to the pools or long waiting periods would mean loss of coverage for many people with pre-existing conditions, breaking the promise of universal access.
    • Trying to save money by lowering reimbursement rates would discourage providers from accepting high-risk patients, leaving them with coverage on paper, but no actual care—a criticism that conservatives often make regarding Medicaid.
    • Moving the threshold for high-risk pool eligibility farther up the cost curve would leave more high-cost households in the individual or employer-based market. That, in turn, would push up premiums at the risk of an adverse selection death spiral.
    The next round of conservative health care reform will have to face this dilemma just as the first round did. Unless high-risk pools get a more serious treatment and better funding than the AHCA offered, they will have no future.


    Earlier versions of this post appeared on the websites of the Milken Institute Review
    and the Niskanen Center.
              Gabby Giffords’ Gun Control Group Urges Opposition to Repeal of Gun Ban for Military Vets        
    Gabby Giffords’ gun control group Americans for Responsible Solutions (ARS) is urging opposition to a repeal of the gun ban for military veterans. On March 16 Breitbart News reported that the House voted to repeal the gun ban for military veterans and ARS is asking gun controllers to convince their Senators not to follow suit. ARS posted a link that helps gun controllers write a letter to their Senators. The text of the link says, “Write a letter to your Senators saying that you OPPOSE legislation that would prevent the Department of Veterans Affairs from submitting mental health records to...
              Stop the presses! The VA is doing something to make life easier for veterans' families        
    The U.S. Department of Veterans Affairs has a lot of problems, and I've shared many of them with you. When it does something right it's only fair that I also pass that along, and it's making a change that will...
              VA health care scandal update: See the latest patient wait-time data        
    The uproar over the Department of Veterans Affairs health care scandal has quieted some in recent weeks, but the pressure still is on for medical centers and outpatient clinics to ensure patients are seen in a timely manner. Data released...
              Rehabilitation Consultant - part time with a home office base- DVA client base        
    ACT-Canberra, Great role with flexible, family-friendly hours available for an experienced Rehabilitation Counsellor or Occupational Therapist; DVA portfolio with this specialist boutique employer Flexible hours - Part time, school hours and home office base to suit you Highly competitive salary- $75K - $82K Boutique specialist employer servicing the Department of Veterans Affairs Due to significant business su
              USAA Tapping EHR To Gather Data From Life Insurance Applicants        
    I can’t believe I missed this. Apparently, financial giant USAA announced earlier this year that it’s collecting health data from life insurance applicants by interfacing with patient portals. While it may not be the first life insurer to do so, I haven’t been able to find any others, which makes this pretty interesting.
    Usually, when someone applies for life insurance, they have to produce medical records which support their application. (We wouldn’t want someone to buy a policy and pop off the next day, would we?) In the past, applicants have had to push their providers to send medical records to the insurer. As anyone who’s tried to get health records for themselves knows, getting this done can be challenging and is likely to slow down policy approvals.
    Thanks to USAA’s new technology implementation, however, the process is much simpler. The new offering, which is available to applicants at the Department of Veterans Affairs and Department of Defense, allows consumers to deliver their health data directly to the insurer via their patient portal.
    To make this possible, USAA worked with Cerner on EHR retrieval technology. The technology, known as HealtheHistory, supports health data collection,  encrypts data transmission and limits access to EHR data to approved persons. No word yet as to whether Cerner has struck similar deals elsewhere but it wouldn’t surprise me.
    Read more
              Therapeutic Medical Physicist - Veterans Affairs, Veterans Health Administration - Jackson, MS        
    Master's degree or higher in a physics, science, or engineering discipline recognized by an accredited college or university with at least 30 semester hours in... $101,409 - $131,833 a year
    From Department of Veterans Affairs - Thu, 18 May 2017 08:54:22 GMT - View all Jackson, MS jobs
              qotd: Government pays for 71 percent of health care in California        
    UCLA Center for Health Policy Research
    Health Policy Brief
    August 2016
    Public Funds Account for Over 70 Percent of Health Care Spending in California
    By Andrea Sorensen, Narissa J. Nonzee, and Gerald F. Kominski

    Summary 

    In California, personal health care expenditures are estimated to total more than $367 billion in 2016. Approximately 71 percent of these expenditures will be paid for with public funds (i.e., taxpayer dollars). This estimated contribution of public funds to health care expenditures is much higher than estimates that include only major health insurance programs such as Medicare and Medicaid. Several additional public funding sources also contribute to health care expenditures in the state, including government spending for public employee health benefits, tax subsidies for employer-sponsored insurance and the Affordable Care Act (ACA) insurance exchange, and county health care expenditures. As health care reform continues to take effect, it will be important to monitor the public versus private contributions to state health care expenditures to ensure that funds are being distributed both efficiently and equitably.

    Health Care Expenditures in California

    In California, health care expenditures in 2016 are estimated to total more than $367 billion; our estimates suggest that 71 percent of these expenditures will be paid for with public funds. Medi-Cal/Healthy Families will comprise the largest proportion of total spending (27 percent), followed by Medicare (20 percent). Tax subsidies for ESI (12 percent); government spending for public employee insurance (4 percent); county health expenditures (3 percent); other government programs—Veterans Affairs (VA) health care, Indian Health Services, and Maternal and Child Health (3 percent altogether); and ACA marketplace exchange subsidies (2 percent) will account for the remainder of total expenditures. Private expenditures for covered benefits will comprise approximately 29 percent of total health care spending in California in 2016. These expenditures include employer share of premiums (16 percent), employee share of premiums (6 percent), out-of-pocket expenditures for covered benefits (4 percent), and premium contributions for individually purchased insurance (3 percent).

    Conclusion and Recommendations

    Public funds in California contribute to approximately 71 percent of total state health care expenditures. As an increasing number of individuals gain health insurance coverage under the ACA, as health care expenditure growth rates continue to increase, and as policy debates continue to mount around introducing a public insurance option, it is important that public funding for health care expenditures be monitored. Comparable to national-level analyses, these findings run contrary to the assumption that U.S. health care expenditures are funded primarily by private payers. If public funds continue to comprise the majority of total health care expenditures, it will be increasingly important for policymakers to consider whether these public funds are being distributed efficiently and effectively, and whether alternatives such as a state single-payer system would be a more effective use of public and private health spending.


    ===

    UCLA Center for Health Policy Research
    Newsroom
    August 31, 2016
    Public money accounts for more than two-thirds of health care spending in California
    By Gwendolyn Driscoll

    Contrary to the notion that the country's health care is primarily a privately funded system, 71 percent of health care expenditures in California are paid for with public funds, according to a new analysis by the UCLA Center for Health Policy Research.

    In California, public funds will pay for 71 percent ($260.9 billion) of a projected $367.5 billion spent on health care in 2016, according to the study.

    "The public sector is the primary player in health care spending," said Gerald Kominski, director of the UCLA Center for Health Policy Research who led the study. "But monies are disbursed in a fragmented way through numerous different entities, each of which has their own system and way of doing things. The question for policy makers is, 'does this fragmented approach make sense?'"

    "For a majority of Californians, a public-run system is already the reality," said Andrea Sorensen, a graduate student at the UCLA Fielding School of Public Health, who co-authored the study. "A single-payer system could unite all these various programs and expand them to the entire population, resulting in a more streamlined and cost-effective approach to health care spending."


    David Himmelstein and Steffie Woolhandler on the national taxpayer share of health costs:

    ===


    Comment by Don McCanne

    Over two-thirds of health care in California - 71 percent -  is paid for by the government, using our taxes. That is even greater than the national taxpayer share of health care - 64 percent (increasing to 67 percent in 2024) - as demonstrated by Himmelstein and Woolhandler.

    As Himmelstein and Woolhandler have stated previously, U.S. taxpayers are already paying for a national health program, but not getting it. And that is even more true for Californians.

    California has previously made efforts to adopt a single payer program, but they have failed - in the election booth, in the state legislature, and on the governor's desk. As we continue to shift more of health care costs to the government, we have brought along our terribly wasteful, fragmented health care financing system. The California taxpayers are getting a bad deal, and a very expensive one at that ($261 billion for 2016 in public spending alone).

    Without enabling federal legislation, states are limited in how close they can come to a much more efficient single payer system, but that does not mean that we should not proceed with whatever is possible now.

    California, and every other state for that matter, should do two things simultaneously: 1) Advocate vigorously for a national single payer program - an improved Medicare for all, and 2) Move forward on a state level with improving the health care financing system so that eventual transition to a national program will be that much simpler, not to mention providing some limited interim relief.


              Rob Portman Veterans Missing        
    Sen. Rob Portman Veterans Missing in America Act was introduced and passed in 2012. The goal of the act is to link Veterans Affairs up with the finders of abandoned remains of veterans and have those remains interred in a national cemetery. He is a Missouri native and his full name is Stan Enos Kroenke. […]
              Real Innovation for Homeless Vets        
    Hey, this here is some real innovation reaching out to homeless veterans, sponsored by the Department of Veterans Affairs, the JBJ Soul Foundation Chairman, and Jon Bon Jovi.  (I think the latter is a rocker, right?) It’s about Project REACH (Real-time Electronic Access for Caregivers and the Homeless) and five finalists have just been announced.
              Agency Inspector General Reports and Investigations        

    Background Agencies periodically conduct their own special investigations and produce reports about certain allegations against their respective departments. For example, the CIA Inspector General produced a report regarding the allegations of the connection between the CIA and drug trafficking.  Each agency will do the same types of investigations. Below, you will find reports and indexes that are relevant.  I decided to compile them here in one archive, as it is interesting to show a complete set of allegations/investigations. Declassified Documents AMTRAK  AMTRAK/OIG Closed Investigations, 2016 [5 Pages, 2.3MB]   Central Intelligence Agency (CIA) Inspector General CIA Inspector General Report of Investigation: Improper Handling of Classified Information by John M. Deutch, February 18, 2000 [84 Pages, 266kb]  CIA Inspector General Report of Dumping Hazardous Material into Potomac at CIA HQ, February 2, 2000 [33 Pages, 4.14MB] List of CIA/IG Closed Investigations, January 1, 2005 – May 2014 [33 Pages, 4.4MB] List of CIA/IG Closed Investigations, January 1, 1997 – October 5, 2004 [57 Pages, 15.1MB] List of CIA Inspections and Special Studies, 1994-1997 [26 Pages, 2.49MB] List of CIA Inspections and Special Studies, 1990-1994 [16 Pages, 4.2MB]   Defense Intelligence Agency (DIA)  DIA/IG Closed Investigations, 2014-2015 [5 Pages, 1.3MB]  DIA/IG Closed Investigations, 2005-2008 [12 Pages, 4.6MB]   Department of Agriculture Inspector General (USDA)  Department of Agriculture Closed Investigation Logs, 2016 [13 Pages, 1.8MB]  Department of Agriculture Closed Investigation Logs, 2014-2015 [22 Pages, 7.7MB]   Department of the Army (ARMY)  Department of the Army Closed Investigation Logs, January 2010 – September 2016 [100 Pages, 21.9MB]   Department of Commerce Inspector General  Department of Commerce Closed Investigation Logs, 2016 [21 Pages, 4.2MB]  Department of Commerce Closed Investigation Logs, 2014-2015 [17 Pages, 2.3MB]  Department of Commerce Closed Investigation Logs, 2000-2005 [28 Pages, 1.1MB]   Department of Defense (DOD) Inspector General  Department of Defense Closed Investigation Logs, 2016 [21 Pages, 4.2MB]   Department of Energy (DOE) Inspector General  Department of Energy Closed Investigation Logs, 2014-2015 [11 Pages, 1.7MB]  DOE/IG Investigation into Fisker Automotive, 2012 [32 Pages, 1.96MB] – On 26 March 2012, the DOE was notified about a misuse of funds and questionable business practices by Fisker Automotive.  They previously had received DOE Loan Program Office financing.  These files are the first release relating to their investigation.  National Nuclear Security Administration Nuclear Weapons Systems Configuration Management, March 2014 [30 Pages, 0.8MB] – The Office of Inspector General received multiple allegations regarding the National Nuclear Security Administration’s (NNSA) management of configuration management (CM) information.  The allegations related to incomplete product definitions for NNSA nuclear weapons, and ineffective management of classified nuclear weapons drawings, a situation that could lead to unauthorized changes to the drawings.  In response, we initiated this audit to determine whether NNSA had maintained accurate and complete CM information for nuclear weapons and nuclear weapons components to support safe, sound and timely decisions related to these devices. The review substantiated the allegations and identified instances in which NNSA had not maintained accurate and complete CM information for its nuclear weapons and components.  DOE/IG Finds 6 BILLION U.S. Dollars MISSING, March 20, 2014 [9 Pages, 1.78MB] – The Office of Inspector General (OIG), in recent audits, investigations, and inspections, has identified significant vulnerabilities in the management of contract file documentation that could expose the Department to substantial financial losses. Specifically, over the past 6 years, OIG has identified Department of State (Department) contracts with a total value of more than $6 billion in which contract files were incomplete or could not be located at all. The failure to maintain contract files adequately creates significant financial risk and demonstrates a lack of internal control over the Department’s contract actions.     Department of Homeland Security (DHS) Inspector General 2016 [87 Pages – 1.87MB] April 1, 2009 – September 30, 2009 [87 Pages – 1.87MB] October 1, 2008 – March 31, 2009 [71 Pages – 2.66MB] April 1, 2008 – September 30, 2008 [72 Pages – 2.70MB] October 1, 2007 – March 31, 2008 [56 Pages – 3.5MB] April 1, 2007 – September 30, 2007 [56 Pages – 2.8MB] October 1, 2006 – March 31, 2007 [104 Pages – 2MB] April 1, 2006 – September 30, 2006 [102 Pages – 8.76MB] October 1, 2005 – March 31, 2006 [88 Pages – 413kb] April 1, 2005 to September 30, 2005 [74 Pages – 62MB] October 1, 2004 to March 31, 2005 [60 Pages – 1.32MB] April 1, 2004 to September 30, 2004 [86 Pages – 3.53MB] October 1, 2003 to March 31, 2004 [86 Pages – 3.53MB] April 1, 2003 to September 30, 2003 [62 Pages – 1.24MB] October 1, 2002 to March 31, 2003 [54 Pages – 963kb]   Department of Housing and Urban Development HUD/OIG Congressional Response – 2015-2016 [121 Pages – 1.4MB] – HUD OIG response to a Congressional Request for a list of closed investigations not disclosed to the public – 2015-2016. HUD/OIG Investigations Regarding HUD Employees – 2015 [3 Pages – 1.1MB] – This is an interim release, and is an index of potentially responsive records. The actual case files will be sent to me in the future, and once received, I will add them here.     Department of Interior (DOI) Inspector General  DOI/IG Closed Investigation Logs, 2016 [6 Pages, 1.2MB]  DOI/IG Closed Investigation Logs, 2014-2015 [32 Pages, 1.96MB]   Department of State  DOS/IG Closed Investigations, 2013-2015 [8 Pages, 3.6MB]   Department of Transportation (DOT)  DOT/IG Closed Investigations, 2016 [8 Pages, 0.7MB]   Department of Treasury Inspector General (TOIG)  DOT/IG Closed Investigations, 2016 [7 Pages, 0.8MB]   Department of Veterans Affairs (VA)  VA/IG Closed Investigations, 2014-2015 [111 Pages, 17.4MB]   Director of National Intelligence Inspector General  ODNI OIG Semi-Annual Reports, published in 2013 [98 Pages – 8.82MB]   Environmental Protection Agency (EPA)  EPA/IG Closed Investigations, 2016 [3 Pages, 1.1MB]   The Export-Import Bank of the United States (EXIM) EXIM OIG IG Investigations, 2016 [4 Pages – 2.8MB] EXIM OIG IG Investigations, 2014-2015 [6 Pages – 2.8MB]   Farm Credit Administration (FCA) Inspector General  FCA/IG Investigations Closed 2015-2016 [3 Pages, 0.5MB]   Federal Communications Commission (FCC) Inspector General  FCC/IG Investigations Closed 2016 [6 Pages, 0.6MB]  FCC/IG Investigations Closed 2014-2015 [4 Pages, 0.9MB]  FCC/IG Investigations Closed 2005-2013 [11 Pages, 1.8MB]   Federal Election Commission (FEC) Inspector General  FEC/IG Investigations Closed 2014-2015 [1 Page, 0.4MB] – I did confirm – the FEC only did one IG investigation during this time period.   Federal Housing Finance Agency (FHFA) Inspector General  FHFA/IG Investigations Closed 2016 [18 Pages, 7.5MB]...

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              Premium Travel Expenditure Reports        

    Background Travel is an important and necessary component of government to accomplish agencies’ mission. In today’s climate of increased transparency, budget reductions, and accountability, agencies’ travel expenditures are closely evaluated to ensure taxpayer dollars are spent wisely. Government travelers are required to exercise the same care in incurring expenses that a prudent person would exercise if traveling on personal business . Therefore, when making official travel arrangements, agencies and employees must consider the most cost-effective class of transportation that meets their needs. Government travelers are required to use coach-class for official travel. Other than coach-class airline accommodations may be used only when their agency specifically authorizes/approves such transportation. Travel in any class above coach class is also known as premium-class travel. To achieve the goals of greater accountability and transparency for the premium-class transportation, Chapter 300-70.100 of the Federal Travel Regulation (FTR) requires Federal agencies to annually submit premium-class travel data to the General Services Administration (GSA). Agencies are required to report their usage of other than coach class (first and business-class) transportation accommodation acquired while on official business which has a cost to the government greater than coach-class travel. The information is submitted annually via the GSA Travel Reporting Tool, a web-based reporting tool. The annual Premium-Class Travel Report presents the analysis of the data as a report from these annual submissions. This report provides an objective view of the data collected by GSA’s Office of Government-wide Policy (OGP) as required by the FTR . Premium Travel Expenditure Reports Below, you will find a growing list of agencies, and their respective Premium Travel Expenditure Reports. Broadcasting Board of Governors (BBG)  2016 [2 Pages, 1.0MB] U.S. General Services Administration (GSA)  FY 2015 [10 Pages, 0.5MB] Internal Revenue Services (IRS)  CY 2015 [2 Pages, 0.5MB] Department of Veterans Affairs (VA)  FY 2016 [5 Pages, 0.8MB] National Reconnaissance Office (NRO)  CY 2016 [8 Pages, 4.5MB] United States Secret Service (USSS)  CY 2016 [19 Pages, 9.3MB]

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              Nov 13: Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades and Veteran Cultural Competency 2017 (Free Webcast)        
    The Practising Law Institute is offering a free webcast of a live presentation from San Francisco entitled Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades and Veteran Cultural Competency 2017 on November 13, 2017 from 12:00 pm to 8:00 pm. IMPORTANT! If you get accredited by the VA before you attend this training, the first three hours will satisfy the VA’s CLE requirement. Attorneys and other advocates must be accredited to practice before the VA.To obtain accreditation you must complete this form:www.va.gov/vaforms/va/pdf/VA21a.pdf. Accreditation by the VA may take several weeks, so do not delay filing your application.You can speed up the process by emailing the form to: OGCAccreditationMailbox@va.gov. Within 12 months after accreditation you are required to complete three hours of qualifying CLE. The morning session of this program satisfies that requirement, but only if you have already received your accreditation from the VA. If you have not received it, you should still watch this program, but keep in mind that you will need to complete three additional hours of CLE within 12 months after receiving your accreditation. Attorneys and other advocates who become accredited will be listed on a national VA list, and are entitled to represent veterans in their claims for benefits, on a pro bono basis, and for attorney’s fees on appeals, where they are available. Why You Should Attend There are over 21 million veterans in the U.S.; many of them are not aware of the benefits to which they are entitled. Medical and financial assistance are available to those who have served in the military, but many veterans most in need are not receiving VA benefits. Navigating the VA claims system and applying for discharge upgrades before the Department of Defense are difficult and complex processes. Attorneys play an essential role in removing barriers to VA benefits, such as: Lack of evidence to “service-connect” their injuries or disabilities. Lack of current medical or mental health evidence documenting severity of symptoms for accurate disability ratings. VA eligibility determinations for those given less than fully honorable discharges for behaviors that were related to minor disciplinary infractions or symptoms of Post- Traumatic Stress or other service-related disabilities. What You Will Learn Nearly 45% of veterans returning from Iraq and Afghanistan seek compensation from the Department of Veterans Affairs (VA) for service related injuries; 30% of these veterans who file for VA benefits include claims for Post-Traumatic Stress. Many of those who should receive benefits will be denied. Many service members who may be VA eligible are unaware of their legal right to pursue VA benefits, and of those who do apply, more than 90% will be denied. All of them will wait months or years for the VA to issue decisions on their claims. Learn how to navigate the VA claims process and to become an effective advocate for veterans in need. This all-day program will provide an overview of VA disability law and military discharge review law. You will gain an understanding of different types of military discharges, why they are important, and how you can help veterans with less than Honorable discharges. The first three one-hour sessions provide the basics you need to represent veterans before the VA. It will also cover the interactions between VA benefits and other public benefits, such as SSI and SSDI. The morning session fulfills the VA’s requirement for qualifying CLE within the first 12 months of your VA accreditation. The 4:45 session, Veteran Cultural Competency: Combat to Community will help veterans’ advocates to understand the challenges that veterans face in their transition to a noncombat community, and provide tips on interviewing and providing legal services to veterans with disabilities. The 5:45 to 8:00 sessions will provide attorneys with the tools that they need to assist veterans in upgrading their discharge status and removing stigmatizing information from their discharge documents. Who Should Attend Attorneys seeking meaningful pro bono opportunities and any advocate who wants to help change the life of a veteran with a disability. Attorneys seeking to meet VA’s CLE requirements for new and continuing VA accreditation should also attend. Finally, attorneys who hope to expand their practice areas to include veterans’ cases where fees are available should register for one or more of the sessions. More Information and Registration
              Nov 13: Advocating for Veterans: The Basics on VA Benefits, Discharge Upgrades, and Veteran Cultural Competency 2017        
    San Francisco, Live Webcast and www.pli.edu,* November 13, 2017 IMPORTANT! If you get accredited by the VA before you attend this training, the first three hours will satisfy the VA’s CLE requirement. 1. Attorneys and other advocates must be accredited to practice before the VA. To obtain accreditation you must complete this form: www.va.gov/vaforms/va/pdf/VA21a.pdf. 2. Accreditation by the VA may take several weeks, so do not delay filing your application. You can speed up the process by emailing the form to: OGCAccreditationMailbox@va.gov. 3. Within 12 months after accreditation you are required to complete three hours of qualifying CLE. The morning session of this program satisfies that requirement, but only if you have already received your accreditation from the VA. If you have not received it, you should still watch this program, but keep in mind that you will need to complete three additional hours of CLE within 12 months after receiving your accreditation. 4. Attorneys and other advocates who become accredited will be listed on a national VA list, and are entitled to represent veterans in their claims for benefits, on a pro bono basis, and for attorney’s fees on appeals, where they are available. Why You Should Attend There are over 21 million veterans in the U.S.; many of them are not aware of the benefits to which they are entitled. Medical and financial assistance are available to those who have served in the military, but many veterans most in need are not receiving VA benefits. Navigating the VA claims system and applying for discharge upgrades before the Department of Defense are difficult and complex processes. Attorneys play an essential role in removing barriers to VA benefits, such as: • Lack of evidence to “service-connect” their injuries or disabilities. • Lack of current medical or mental health evidence documenting severity of symptoms for accurate disability ratings. • VA eligibility determinations for those given less than fully honorable discharges for behaviors that were related to minor disciplinary infractions or symptoms of Post- Traumatic Stress or other service-related disabilities. What You Will Learn Nearly 45% of veterans returning from Iraq and Afghanistan seek compensation from the Department of Veterans Affairs (VA) for service related injuries; 30% of these veterans who file for VA benefits include claims for Post-Traumatic Stress. Many of those who should receive benefits will be denied. Many service members who may be VA eligible are unaware of their legal right to pursue VA benefits, and of those who do apply, more than 90% will be denied. All of them will wait months or years for the VA to issue decisions on their claims. Learn how to navigate the VA claims process and to become an effective advocate for veterans in need. This all-day program will provide an overview of VA disability law and military discharge review law. You will gain an understanding of different types of military discharges, why they are important, and how you can help veterans with less than Honorable discharges. • The three one-hour morning sessions provide the basics you need to represent veterans before the VA. It will also cover the interactions between VA benefits and other public benefits, such as SSI and SSDI. The morning session fulfills the VA’s requirement for qualifying CLE within the first 12 months of your VA accreditation. • The 1:45 session, Veteran Cultural Competency: Combat to Community will help veterans’ advocates to understand the challenges that veterans face in their transition to a noncombat community, and provide tips on interviewing and providing legal services to veterans with disabilities. • The 2:45 to 5:00 sessions will provide attorneys with the tools that they need to assist veterans in upgrading their discharge status and removing stigmatizing information from their discharge documents. Who Should Attend Attorneys seeking meaningful pro bono opportunities and any advocate who wants to help change the life of a veteran with a disability. Attorneys seeking to meet VA’s CLE requirements for new and continuing VA accreditation should also attend. Finally, attorneys who hope to expand their practice areas to include veterans’ cases where fees are available should register for one or more of the sessions.
              US Department of Veterans Affairs Collaboration        

    Counseling Services has been working with Accenture Federal Services – Suicide Prevention Program,  US Army – Resilience Program, The Vet Center – Military Mental Health,…  

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              Ayotte, Bass, Shaheen: Vets Should Get Colebrook Med Center        

    Veterans in Coos County deserve a medical clinic in Colebrook, according to a letter sent to the Department of Veterans Affairs by Senators Kelly Ayotte and Jeanne Shaheen and Rep. Charlie Bass.

    “While Coos County’s population is small compared to the area covered, there are some 3,605 veterans in New Hampshire’s North Country, of which 1,821 are in the VA medical system,” the letter says. 


              The Disabled Veteran's Story        
    The December 4, 2014, episode of American Heroes Radio features a conversation with former Major Miguel Reece, USAF (ret.) the author of The Disabled Veteran's Story: The Sacrifices of our Veterans and Their Families. Major Miguel Reece, United States Air Force, (ret.) "is a military veteran with more than thirty years of service as both an enlisted member and an officer in the U.S. Air Force. He served in Vietnam and the Middle East, as well as a member of Stabilization Forces in the Balkans. Major Reece was born in the Panama Canal Zone. He has a bachelor’s degree from Southern Illinois University and a master’s degree from Webster University, St. Louis, Missouri. After thirty years in the Air Force, he served for ten years with the Department of Veterans Affairs. Major Reece enjoyed working with veterans and making a difference in the lives of the beneficiaries. He often visited veterans with their families in their homes, nursing homes, assisted-living facilities, relative’s homes, under bridges, in parks, or even in a tree house. He aspires to share these stories with the world and educate a new generation or remind society of the sacrifices the American veterans endured for the freedom of this nation and not to allow their stories to be forgotten."  Major Miguel Reece is the author of The Disabled Veteran's Story: The Sacrifices of our Veterans and Their Families.
              Still Standing: The Story of Staff Sergeant John Kriesel        
    Staff Sergeant John Kriesel, USA (ret.) “was nearly blown to shreds by a 200 pound roadside bomb in Iraq, but battlefield angels in Army uniforms kept him breathing long enough to reach a field hospital.  He died 3 times & was shocked back to life.  Somehow he survived through 4 hospitals, 35 surgeries & months of recovery.  He lost both legs and suffered numerous other major injuries, but it was the loss of two close friends that hurt the most. Four years after his near-death experience in Iraq Kriesel became a civilian marketing employee with the Minnesota Army National Guard and in 2012 was named Director of Veterans Affairs for Anoka County. He also is a former member of the Minnesota House of Representatives.  After tours of duty in Kosovo and Iraq and a lengthy medical recovery Kriesel’s two sons wanted to spend more time with him and he chose not to run for re-election.”  According to the book description of Still Standing: The Story of SSG John Kriesel, “When SSG John Kriesel lost his legs and two buddies in a roadside bomb explosion, no one expected him to survive. He died three times on the operating table. Miracles, a lot of miracles, starting with a few grunts who refused to let him die in Iraq, ripped the young warrior from the grip of death and sent him on to four hospitals, thirty-five surgeries, and months of recovery and rehabilitation. Medical miracles put his body back together, but it was an incredible confluence of angels at every step along the way that breathed life into his shattered body. This is not just another war story. This is the story of an ordinary young man who overcame extraordinary challenges with a lot of help from others, including many strangers and he emerged stronger and more in love with his country, his wife, his children, and ultimately, his own life.”
              Thirty Days with My Father: Finding Peace from Wartime PTSD        
    The November 15, 2012, Episode of American Heroes Radio features a conversation with Dr. Christal Presley, Ph.D., the author of Thirty Days with My Father: Finding Peace from Wartime PTSD. Christal Presley, PhD, is the founder of United Children of Veterans (www.unitedchildrenofveterans.com), a website that provides resources about post-traumatic stress disorder (PTSD) in children of war veterans. She obtained her PhD in education in 2009, and is an instructional mentor teacher in Atlanta Public Schools.   Publisher’s Weekly said of Thirty Days with My Father: Finding Peace from Wartime PTSD, “A soldier's return home from war is often just the beginning of another, more internalized battle. In her memoir, Presley recounts 30 days of interviews with her Vietnam veteran father—conversations in which she attempts to understand her father, his PTSD, and her own lifetime of vicarious traumas. Each day is given a chapter, and each chapter concludes with a "Journal" entry that revisits Presley's tumultuous childhood memories. What emerges from this format is a harrowing portrait of the past's ability to haunt the present; Presley's descriptions of the troubled child she was blend all too easily into the confused and searching adult she becomes. In some cases, she is compelled to go to a Veterans Affairs hospital and even to Vietnam. The book's division into 30 days feels increasingly forced and fragmented with the passing of each chapter. Such a story is, by its very nature, fractured, and by the end of the book Presley's father is no less tormented than he was at Day One. Yet Presley has found stability in her father's story, and her willingness to share it—and her own revelations—will be appreciated by readers who deal with any form of wartime PTSD.”
              VA's War Against the US Navy's Agent Orange Survivors        
    Our Guest, Bob Ford is a former US Marine & author of War Against the Navy.  According to the book description, "Agent Orange is a term used to describe a combination of deadly dioxins which were repeatedly sprayed over Vietnam for the purpose of defoliating the jungles. The term originated from the Orange stripe around the barrels of chemicals that were used. Dumped by the tons from the skies from large multi-engine aircraft, often 3 & 4 abreast, & it did indeed transform much of Vietnam into a deadly wasteland. It also exposed American servicemen & women to the origins of numerous cancers that now have them dying at a rate of 13 years earlier than their counterparts who did not serve in Vietnam. When all this was taking place, the military was told there was nothing to fear from Agent Orange. After years of denial in a prolonged battle by Vietnam veterans, the government finally acknowledged the disabilities caused by Agent Orange, and a system was established to process claims for those who now have one or more of the related diseases recognized by VA as caused by exposure to these chemicals. The legislation was clear in that anyone who served, whether on land or sea, was presumed to have been exposed to Agent Orange. Obviously, the one claim no veteran would ever hope to file with VA would be for Agent Orange benefits. The stark reality is that you must already have cancer to qualify. The main conclusion of this story is there is a controlling group of senior bureaucrats within the United States Department of Veterans Affairs who are relentlessly determined to prevent United States Navy veterans of the Vietnam War from receiving benefits that are automatically granted to all other Vietnam veterans.  
              Ð¢Ð¸Ð°Ð·Ð¸Ð´Ð½Ñ‹Ðµ диуретики снижают риск переломов        
    Высокое артериальное давление и слабые кости – две серьезные угрозы для пожилых людей. Новое исследование показало, как одна группа препаратов способна защитить стариков от обеих угроз. Анализ историй болезни тысяч пациентов Veterans Affairs (VA) и Medicare подтверждает, что назначаемые при…
               Monitoring VA's Clinical Productivity and Efficiency         
    The Department of Veterans Affairs has faced challenges managing its budget and ensuring that veterans have access to health care. So, how can the VA accurately measure whether it's providing quality health care?
              Can We Break the Cycle of Military Sexual Violence Scandals?        
    Jan. 31, 2013 Huffington Post

    Last week, Defense Secretary Leon Panetta lifted the ban preventing female soldiers from officially serving in combat -- a decision that raised the urgency on efforts to address the festering crisis of sexual assault within the U.S. military. That crisis -- which claimed more than 50 victims of sexual assault a day in the latest year of Defense Department data -- is the subject of the Oscar-nominated 2012 documentary Invisible War. In this series, The Huffington Post invites victims and advocates to speak out about sexual assault in the military.

    "When someone in the military is injured on duty, they're a hero and people shake their hands. I was injured too, but I'm treated like it was my fault. I didn't join the military to get raped, I wanted to serve my country too and I did for nearly two years," Kori Cioca told me during an interview.

    Cioca is a survivor of an alleged military sexual assault, the lead plaintiff of a class-action lawsuit against the military, and a film subject in the award-winning, Oscar-nominated documentary The Invisible War.

    She's faced intense retaliation and upheaval in her life for exposing a crime that affects as many as one third of women and 1 percent of men in the armed forces. A recent study by the Department of Veterans Affairs found that about half of women sent to Iraq or Afghanistan report being sexually harassed, and nearly one in four say they were sexually assaulted.

    Most incidents are never reported, in part because soldiers have to report to their chain of command and that could include the rapist or his friends. In Cioca's case, the person she reported initial harassment to was a drinking buddy of the alleged rapists, so he did not help her. Soon the harasser allegedly escalated to rape. Afterward, he claimed it was consensual sex and his punishment was only a minor loss of pay and being forced to stay on the base for 30 days. For her punishment, Cioca was given janitorial duties. Because she was upset and afraid, she was also forced to undergo a mental evaluation.

    She said, "The tests showed I was mentally sound and one of the women who saw me and found out what happened got me out of there. Just shy of two years of service, I was discharged with honorable misconduct in 2007 and I didn't make the GI Bill qualifications."

    That same woman told her about the 1991 Tailhook scandal and suggested she find a lawyer. Fortunately, lawyer Susan Burke found her, and when Cioca discovered she was just one of tens of thousands of soldiers who have been raped by their comrades, she agreed to join a class action lawsuit to hold the military responsible.

    "In the Coast Guard, you learn to fight for just causes and to stand up and be proud," she told me. "I want to try to be strong enough for other people. It's awful thinking about people in the military who are currently going through what I went through. I want to change that."

    Nearly two years ago, the American Association of University Women (AAUW), where I work, began providing support to the lawsuit through our Legal Advocacy Fund case support program. Since then, Burke has filed two more class-action lawsuits against the military on behalf of female and male survivors of military sexual assault. AAUW also supports those cases.

    Congress is addressing the issue, too. In November of 2011, Rep. Jackie Speier (D-CA) introduced the Sexual Assault Training Oversight and Prevention Act (STOP Act) to create an independent review process for rape reports.

    This month, the U.S. Commission on Civil Rights held a hearing on military sexual assault and Congress held a hearing on the sexual misconduct at Lackland Air Force Base in San Antonio.

    At the hearings, the military said they have instituted many new training and prevention programs. Good. They also said they do not want to change the reporting or prosecuting process, which means commanders continue to have all the power, even though they are not impartial judges, and they may even be the assailants. Bad.

    If survivors still face barriers to reporting, if alleged rapists likely face little punishment, and if commanders have so much power, what changes?

    In the 22 years since the Tailhook scandal, we have witnessed a cycle: scandals of sexual violence within the military, the revelation of abuse of power, and then congressional hearings during which the military promises to do better. Rinse and repeat.

    How many more years will this continue? Our military members deserve so much better.

    For now, I am proud to stand by veterans like Cioca who are pressuring the military to improve. You can stand by them too by helping support their cases, donating to support the work of groups that work with survivors like Protect our Defenders and Service Women's Action Network, and taking online action. Make sure your Congressional representatives know you want them to act to change the military reporting structure.

    Last, if you meet a survivor of military sexual assault, thank them for their service and for their courage.

    Forums: 

              Los nuevos fármacos antidiabéticos y el riesgo cardiovascular.        
    Los nuevos fármacos antidiabéticos y el riesgo cardiovascular.

    Es interesante leer un artículo que haga una puesta a punto de las evidencias actuales sobre el riesgo cardiovascular (RCV) en el paciente con diabetes tipo 2 (DM2) que toma fármacos antidiabéticos no insulínicos (ADNI).
    Clásicamente la metformina (MET) ha sido el único fármaco al que se le han achacado estas propiedades, en buena medida inmerecidas pues los resultados provenían del estudio United Kingdom Prospective Diabetes Study  (UKPDS) de un pequeño subgrupo de pacientes obesos o con sobrepeso. La reducción de eventos cardiovasculares (ECV) en el UKPDS hubiera sido demasiado reducidos para los estándares actuales en el diseño de ensayos clínicos (ECA) que en este aspecto propugna la American Diabetes Association (ADA). Si bien, es cierto que este estudio como el del Veterans Affairs Diabetes Trial (VADT) debieron transcurrir hasta 10 años para poder observar beneficios cardiovasculare (CV) relacionados con el control glucémico.
    En general, la DM2 duplica el RCV de presentar infarto agudo de miocardio (IAM), accidente vásculo-cerebral (AVC) o enfermedad arterial periférica (EAP), siendo la enfermedad cardiovascular (ECV) la principal causa de muerte (80%) en los pacientes con DM2. Sin embargo, la contribución del control metabólico en forma  HbA1c contribuye de forma muy modesta en este riesgo, no así, sin embargo, otros factores de riesgo cardiovascular (FRCV) como la presión arterial (PA), o el colesterol que su reducción se traduce en disminuciones en la mortalidad por esta causa en estos pacientes.
    Al margen de la MET, el PROactive (PROspective pioglitAzone Clinical Trial In macroVascular Events) con la pioglitazona,  mostró ya hace algunos años, una reducción del 16%  en los ECV en un objetivo compuesto  cardiovascular (IAM, AVC, muerte cardiovascular -MCV).
    Sin embargo, no ha sido hasta hace poco tiempo en que estudios, que ya hemos comentado, como el LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) o el  SUSTAIN (Trial to Evaluate Cardiovascular and Other Long-term Outcomes with Semaglutide in Subjects with Type 2 Diabetes) hayan mostrado como el grupo de los agonistas de los receptores  glucagon-like peptide 1(GLP-1) se reducía el RCV al tiempo que mejoraban otros FRCV al margen de la glucemia en pacientes con ECV ya establecida. 
    En el  LEADER, el liraglutide redujo un 13% los ECV y un 22% de la MCV (p 0,007). El IAM se redujo un 12% y el AVC un 11%.
    En el  SUSTAIN la semaglutida   redujo el objetivo primario un 26%, fundamentalmente por disminución del AVC un 39% y un 26% del IAM, aunque la MCV apenas se modificó (HR 0,98).
    El EMPA-REG OUTCOME (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), como el   PROactive o el IRIS (Insulin Resistance Intervention After Stroke Trial)  inaguraron una nueva era en donde, independientemente de los niveles de glucemia y de otros FRCV, la utilización de ADNI eran capaces de reducir el RCV. En estos últimos, el mecanismo subyacente, la insulinorresistencia, se identificó como la causa de diversos FRCV, fueran dislipemia, HTA, disfunción endotelial o estado procoagulante. En el IRIS la pioglitazona redujo la incidencia de AVC recurrente y del IAM en un 24% en pacientes con insulinoresistencia pero sin DM2, aunque con antecedentes de AVC o AIT.
    En el estudio  PROactive el objetivo principal secundario se redujo significativamente HR 0,84 (p  = 0,027), previniendo el IAM, AVC y la mortalidad. La pioglitazona en el IRIS a los 4,8 años en individuos resistentes a la insulina, pero no DM2,  y AIT reciente redujo en un 24% el AVC junto con el IAM -HR 0,76 (p= 0,007)- con una ligera reducción de la mortalidad (7%), no significativa.
    En el  EMPA-REG OUTCOME, como comentamos, la empagliflozina produjo una reducción del 14% (p = 0,004 para superioridad) en los tres ECV incluidos en el objetivo primario en pacientes con DM2 y enfermedad CV establecida  durante 3,1 años.  Sus beneficios tempranos en la reducción de la mortalidad se debieron a la disminución en la hospitalización por insuficiencia cardíaca (IC).
    Sí que es cierto, sin embargo, que las diferencias entre  LEADER, SUSTAIN, y el PROactive con respecto al  EMPA-REG OUTCOME se debieron a que la separación de las curvas de la empagliflozina frente al placebo se produjo muy precozmente (a los tres meses) en la reducción de los objetivos primarios. 
    Si se busca una explicación metabólica todos estos estudios generaron  beneficios glucémicos dispares, reducciones de un 0,3% en el EMPA-REG OUTCOME, del 1,0% en el SUSTAIN-
    del 0,4% en el  LEADER, y de 0,5% en el  PROactive, por lo que no sería una explicación de los resultados CV. Y por otro lado, los beneficios CV del buen control glucémico, aunque pequeños, no se manifestaron hasta muchos años como se vio en el UKPDS y el VADT. La misma razón (escaso tiempo en alcanzarse los objetivos) sería la que rechazaría la explicación de la prevención de la arteriosclerosis en estos ECA.
    En este documento, se muestran los efectos cardioprotectores de los GLP-1 en animales y en seres humanos, que aunque no del todo comprendidos, sus mecanismos a nivel molecular serían parecidos en todo el grupo.
    En los inhibidores de los cotransportadores 2 de la bomba de sodio-glucosa  (inh SGLT-2)  la rápida reducción de la PA (postcarga), del volumen intravascular (precarga) y de la rigidez arterial, y otros efectos hemodinámicos explicarían la reducción de la mortalidad y de la IC. La empagliflocina ha demostrado que a los 3 meses ya actúa sobre el ventrículo izquierdo y mejora la función diastólica. Otros factores para explicar estos resultados se han relacionado con el incremento en la circulación de cuerpos cetónicos, reducciones del ácido úrico, aumentos de la angiotensina y de la actividad del receptor 2 de la angiotensina...
    En fin, un tema de rabiosa actualidad en un documento que resume perfectamente el estado de la cuestión.


    Abdul-Ghani M, DeFronzo RA Del Prato S, Chilton R, Singh R Ryder REJ. Cardiovascular Disease and Type 2 Diabetes: Has the Dawn of a New Era Arrived?. Diabetes Care. 2017 Jul;40(7):813-820. doi: 10.2337/dc16-2736.



              La inercia terapéutica condicionaría no alcanzar los objetivos glucémicos         
    La inercia terapéutica condicionaría no alcanzar los objetivos glucémicos

    Desde que los dos grandes estudios, el UKPDS (United Kingdom Prospective Diabetes Study) en la diabetes tipo 2 (DM2) y el DCCT (Diabetes Control and Complications Trial) pero en pacientes con diabetes tipo 1 (DM1) mostraron como el control estricto glucémico retrasaba el inicio y la progresión de la albuminuria y la retinopatía, y más recientemente los eventos cardiovasculares (ECV) tipo infarto agudo de miocardio (IAM), quedo claro que el buen control metabólico es un objetivo a alcanzar en el paciente con DM. Sin embargo, a partir del  estudio ACCORD (Action to Control Cardiovascular Risk in Diabetes), que tuvo que suspenderse precozmente -3,5 años- al aumentar la mortalidad  por ECV  y no cumplir con  el objetivo primario (IAM,  accidente vásculo cerebral -AVC- y muerte cardiovascular -MCV), el ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-release Control Evaluation) y el VADT (Veterans Affairs Diabetes Trial) que no mostraron mejorías cardiovasculares -CV- en el control glucémico estricto, aunque si a nivel microvascular (microalbuminuria), condicionó que las Guías de Práctica Clínica (GPC) recomendaran la   la individualización de los objetivos glucémicos.
    Con todo, la importancia del control intensivo en estos estudios queda patente en las complicaciones microvasculares a largo plazo. Sin embargo, a pesar de las GPC muchas personas con DM2 no cumplen con los objetivos glucémicos. El trabajo que comentamos intenta identificar los factores, actitudes y práctica de los profesionales sanitarios a partir de la literatura reciente, que puedan explicar que existan unas bajas tasas de buen control glucémico.
    Para ello se hizo una búsqueda a partir de la base de datos médica de PubMed entre enero del 2011 y julio del 2015, complementado con búsquedas de resúmenes de congresos médicos en DM entre 2014-15 y disponibles por vía electrónica. 
    Según ésta bibliografía, y un poco en la línea de los estudios que hemos comentado en este blog, el control glucémico inadecuado se encuentra entre el 40-60% de los pacientes con DM.
    Según este análisis la inercia terapéutica es uno de los condicionantes más importantes del mal control glucémico en la mitad de los pacientes con DM2, como hemos comentado en otros posts.  Los médicos con frecuencia toleran largos períodos de una hiperglucemia moderada asi como trasmiten bajas expectativas a sus pacientes, lo que hace que existen retrasos de hasta 3 años o más en la intensificación del tratamiento con fármacos hipoglucemiantes.
    Se concluye que  la mitad de los pacientes con DM2 no alcanzan los objetivos glucémicos aumentando con ello el riesgo de complicaciones relacionadas con su enfermedad y que parte de ello se relaciona con una inercia terapéutica que retrasa la intensificación del tratamiento durante largo tiempo. 


    Blonde L, Aschner P, Bailey C, Ji L, Leiter LA, Matthaei S; Global Partnership for Effective Diabetes Management. Gaps and barriers in the control of blood glucose in people with type 2 diabetes. Diab Vasc Dis Res. 2017 May;14(3):172-183. doi: 10.1177/1479164116679775. Epub 2017 Feb 1.






              La desintensificación terapéutica, una asignatura pendiente        
    La desintensificación terapéutica, una asignatura pendiente

    En alguna ocasión hemos hablado de la desintensificación del tratamiento antidiabético. La realidad es que el sobretratamiento es causa de morbimortalidad en el paciente con diabetes mellitus (DM) a consecuencia de  la misma intensificación y/o de los efectos secundarios provenientes de los fármacos utilizados para alcanzar esos objetivos tan estrictos. Este hecho se demostró en el estudio Action to Control Cardiovascular Risk in Diabetes (ACCORD), en el que en el grupo del control estricto de la HbA1c inferior a 6%, se aumentó la mortalidad y obligó a la suspensión del estudio. La personalización de los objetivos se ha manifestado en la mayoría de Guías de Práctica Clínica (GPC) y en movimientos como de "elegir sabiamente" (“Choosing Wisely”) en EEUU,  aconsejando ser menos estrictos en los tratamientos de los ancianos, o aquellos con una esperanza de vida corta,…En la presión arterial (PA) también los objetivos se han suavizado según la edad del paciente (150 mm Hg), como ya mostró el Eighth Joint National Committee. En ambas situaciones la relajación en los objetivos obliga a desintensificar el tratamiento evitando los riesgos inherentes a  la sobremedicación.
    En el estudio de Sussman JB et al, que comentamos, sobre datos del “Department of Veterans Affairs (VAD)” en 211.667 pacientes de 70 o más años con DM atendidos en Atención Primaria (AP) entre enero y diciembre del 2012, se observó que en pacientes ancianos en los que los niveles de PA o de HbA1c se encontraban en un rango muy bajo solo hubo un 18,8% y un 27%  de desintensificación de su medicación antihipertensiva o antidiabética respectivamente. Lo que se vio que era realmente insuficiente.
    El propósito del estudio, que comentamos, es examinar la frecuencia en la desintensificación del tratamiento en pacientes de EEUU con DM pero fuera del sistema VAD y explorar si estos varían según el control glucémico o el nivel de salud; y sobre todo, con la fecha en la que fue publicado el estudio ACCORD (febrero del 2008) a partir del cual se debería haber tomado conciencia de los riesgos de control glucémico intensivo.
    Se trata de un estudio retrospectivo de base poblacional utilizando una cohorte a partir de la base de datos Clinformatics Data Mart Database (Optum Insight, Eden Prairie, MN) en el cual se incluyen los registros de los encuentros ambulatorios y hospitalarios, farmacéuticos y de laboratorio de trabajadores, asegurados y dependientes de éstos…de 50 estados de EEUU.
    Se definió como desintensificación  la interrupción o disminución de la dosis de al menos una medicación antidiabética sin que se añadiera o se ajustara otra en 120 días y tras determinar el nivel de HbA1c.
    De las 99.694 personas (54 años de media) identificadas retrospectivamente y que habían sido tratadas con fármacos antidiabéticos tras el diagnóstico de DM, el 50% utilizaban un fármaco, 33% dos fármacos y 17% ≥3 fármacos. De estos, 12.921 (13,0%) su HbA1c era inferior a 6% tras un año de tratamiento, 19.670 (19,7%) tuvieron una  HbA1c entre 6,0 y 6,4%, 35.012 (35,1%) una  HbA1c entre 6,5 y 7,5%, y  32.091 (32,2%) una  HbA1c mayor de  7,5%. 
    Según el patrón de desintensificación, éste se produjo en el 18,3% de los pacientes: el 21,2% en pacientes frágiles, el 19,4% en aquellos con comorbilidades múltiples y 17,7% en otros pacientes sanos. Según los niveles de HbA1c, en el 20,6% de aquellos con una  HbA1c inferior a 6%, un 17,3% de los que tuvieron una HbA1c 6,0-6,4%, un  17,7%  en aquellos con una HbA1c entre 6,5-7,5%, y un 18,6% en los que su HbA1c fue superior al 7,5%. Las proporciones se mantuvieron tras excluir a los 26.985 que se trataban con metformina exclusivamente en monoterapia: 23,3%, 20,4%, 20,3%, y un  20% según el nivel de HbA1c.
    Globalmente la terapia hipoglucemiante se desintensificó en un 22,5% de los pacientes DM con una HbA1c inferior al 6,0% antes de febrero del 2008 (publicación del ACCORD) en comparación con un 19,5% tras ésta (p inferior a 0,001).
    Se concluye que solo a un 1 de cada 5 pacientes con DM se procede a desintensificar el tratamiento antidiabético, que en solo el  Â¾ de los pacientes con HbA1c baja, y que en los pacientes frágiles (21%) o con comorbilidades (19%) tampoco se desintensificó el tratamiento, cuando era necesario, incluso tras las conclusiones del ACCORD. Algo, que confirma los resultados de Sussman JB et al, que ya comentamos, y  que da que pensar como la inercia terapéutica es difícil de cambiar en los médicos.

    McAlister FA, Youngson E, Eurich DT. Treatment Deintensification Is Uncommon in Adults With Type 2 Diabetes Mellitus: A Retrospective Cohort Study. Circ Cardiovasc Qual Outcomes. 2017 Apr;10(4). pii: e003514. doi: 10.1161/CIRCOUTCOMES.116.003514.


    Sussman JB, Kerr EA, Saini SD, Holleman RG, Klamerus ML, Min LC, Vijan S, Hofer TP1. Rates of Deintensification of Blood Pressure and Glycemic Medication Treatment Based on Levels of Control and Life Expectancy in Older Patients With Diabetes Mellitus. JAMA Intern Med. 2015 Dec 1;175(12):1942-9. doi: 10.1001/jamainternmed.2015.5110.







              Sessions Votes to Bolster National Security        

    WASHINGTON, D.C. - This week the Rules Committee held three meetings, heard testimony from dozens of Members, and made in order 126 amendments on the Make America Secure Appropriations Act – a four-piece national security funding package for Defense Appropriations, Military Construction and Veterans Affairs Appropriations, Energy and Water Appropriations, and Legislative Branch Appropriations. U.S. Congressman Pete Sessions (R-TX), Chairman of the House released a statement regarding the passage of this important package:   “This package responsibly funds our nation’s national security interests, provides necessary resources to care for our  veterans, bolsters our nuclear programs, boosts funding for Capitol Police, and specifically addresses our border security needs.  "Year after year I have gone down to the border and talked with patrol agents, met with law enforcement, and learned about the increasingly difficult challenges that they face on our southern border. That is why I felt it was necessary to ensure that we responsibly allocate resources to protect our southern border where there are frailties and develop a plan for how to move forward in securing our border. I believe this is a critical element in gaining operational control of our border and I will continue to work to bolster these efforts with technology, surveillance, and other measures to secure our borders.”  "In addition to protecting our sovereignty, this package also boosts funding for defense and fully funds the largest military pay increase in eight years. Our men and women in uniform put their lives on the line to protect our interests both at home and abroad. We must show them that we are behind them, and this bill does that.  "This package also supports the brave heroes who valiantly fought and served our great nation. I am pleased that this package cares for our nation’s heroes by providing the highest level of funding ever for the Department of Veterans Affairs and supports medical care for the 7 million VA patients across the country.  "I am proud of the hard work of the Appropriations Committee as well as all of the Members who worked to make this bill better and better with their thoughts and ideas that they brought to the Rules Committee.  I urge my colleagues in the Senate to swiftly consider this important package so we can send it to the President’s desk for his signature."  

    ###


              (USA-MI-Battle Creek) Project Manager        
    Project ManagerDLA Facility, Hart-Dole-Inouye Federal Center, Battle Creek, Michigan. The DOD assigned DLA the responsibility for management and administration of the operations of the Federal Catalog Program (FCP). In support of the FCP mission and the Federal Catalog System (FCS), DLA J62H Portfolio is the organization providing computer systems, applications, resources and processes through which users and other computer systems are able to inquire and access item data; workflow processes to maintain; and processes to update, store, disseminate and retrieve necessary item of supply related data/information. DLA J62H requires contractor support to provide Program Management support services to include, but not limited to, coordination, update and maintenance of various program deliverables including Integrated Master Schedule (IMS), software lists, contract lists, system availability trending, program charts, ProSight, briefing charts, and other program and project associated documentation and tracking of all areas of PM. The support will also entail coordination and information gathering across the portfolio and at times outside the portfolio on PM-related special interest items. uJob Responsibilities:/uulliServe as the Project Manager for a large, complex task order (or a group of task orders affecting the same system)/liliAssist the Program Manager in working with the Government Contracting Officer (KO), the task order-level Task Order Managers, Government management personnel and customer agency representatives. /liliResponsible for the overall management of the specific task order(s) and ensuring that the technical solutions and schedules in the task order are implemented in a timely manner. /li/uluRequired Experience and Skills:/uulliMust hold a Project or Program Management certification (i.e. Project Management Professional (PMP) certification or other equivalent/recognized Project or Program Management certification)ulliProject or Program Management certifications from accredited institutions are required. Examples from government and commercial sources include, but are not limited to the Defense Acquisition University, The Program Management Institute, Department of Veterans Affairs as well as Universities and Colleges./li/ul/liliMust have five (5) years relevant program management experience/liliMust have five (5) years of leadership experience with progressively higher responsibility in the public and/or private sector in the IT and/or consulting fields./liliMinimum Education: BS or BA or four (4) additional years of related program management experience/li/ulemSpectrum is proud of our diverse workforce and diligently committed to remaining an Equal Opportunity Employer. Spectrum governs all employment-related decisions without regard to an individual's race, color, gender, gender identity, sexual orientation, religion, national origin, age, disability, veteran status or any other protected classification./emem[Equal Opportunity/Affirmative Action Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity]/em
              (USA-MI-Battle Creek) Task Order Manager        
    Task Order ManagerDLA Facility, Hart-Dole-Inouye Federal Center, Battle Creek, Michigan. The mission of the Defense Logistics Agency (DLA) Customer Support and Readiness Directorate includes the management of J6 customer relationships and IT customer service to DLA users worldwide. Central to this mission is a focus on customer service to ensure the right services, with the right quality, and the right allocation of costs to achieve broad J6 strategic and operational goals in the most efficient manner. DLA consists of approximately 35,000 users worldwide on classified and unclassified networks. DLA requires contractor support to assist and sustain the implementation of the Enterprise Service Delivery (ESD) program. Requirements for the program include the end-to-end solution resolution for desktop, active directory, local network management and software delivery functions. uJob Responsibilities:/uulliServe as the Project Manager for a large, complex task order (or a group of task orders affecting the same system)./liliAssist the Program Manager in working with the Government Contracting Officer (KO), the task order-level Task Order Managers, Government management personnel and customer agency representatives. /liliUnder the guidance of the Program Manager, responsible for the overall management of the specific task order(s) and ensuring that the technical solutions and schedules in the task order are implemented in a timely manner. /li/uluRequired Experience and Skills:/uulliMust hold a Project or Program Management certification (i.e. Project Management Professional (PMP) certification or other equivalent/recognized Project or Program Management certification)ulliProject or Program Management certifications from accredited institutions are required. Examples from government and commercial sources include, but are not limited to the Defense Acquisition University, The Program Management Institute, Department of Veterans Affairs as well as Universities and Colleges./li/ul/liliMust have five (5) years relevant experience/liliMust have five (5) years of leadership experience with progressively higher responsibility in the public and/or private sector in the IT and/or consulting fields./liliMinimum Education: BS or BA or four (4) additional years of related program management experience./li/ulemSpectrum is proud of our diverse workforce and diligently committed to remaining an Equal Opportunity Employer. Spectrum governs all employment-related decisions without regard to an individual's race, color, gender, gender identity, sexual orientation, religion, national origin, age, disability, veteran status or any other protected classification./emem[Equal Opportunity/Affirmative Action Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity]/em
              (USA-MI-Battle Creek) Lead Business Systems Analyst        
    Lead Business Systems Analyst DLA Facility, Hart-Dole-Inouye Federal Center, Battle Creek, Michigan. The DOD assigned DLA the responsibility for management and administration of the operations of the Federal Catalog Program (FCP). In support of the FCP mission and the Federal Catalog System (FCS), DLA J62H Portfolio is the organization providing computer systems, applications, resources and processes through which users and other computer systems are able to inquire and access item data; workflow processes to maintain; and processes to update, store, disseminate and retrieve necessary item of supply related data/information. DLA J62H requires contractor support to provide Program Management support services to include, but not limited to, coordination, update and maintenance of various program deliverables including Integrated Master Schedule (IMS), software lists, contract lists, system availability trending, program charts, ProSight, briefing charts, and other program and project associated documentation and tracking of all areas of PM. The support will also entail coordination and information gathering across the portfolio and at times outside the portfolio on PM-related special interest items. uJob Responsibilities:/uulliServe as a Top-level technical contributor with expertise in Information Technology cradle to grave processes related to applications and infrastructure. /liliResponsible for documenting existing operations and practices; analyzing those operations and practices against documented best practices and developing a plan of actions and milestones to evolve to the best practices./liliProvide technical guidance concerning the business implications of the application of various systems./li/uluRequired Experience and Skills:/uulliMust hold a Project or Program Management certification (i.e. Project Management Professional (PMP) certification or other equivalent/recognized Project or Program Management certification)ulliProject or Program Management certifications from accredited institutions are required. Examples from government and commercial sources include, but are not limited to the Defense Acquisition University, The Program Management Institute, Department of Veterans Affairs as well as Universities and Colleges./li/ul/liliMust have five (5) years relevant Business Systems Analyst experience/liliMinimum Education: BS or BA degree/li/ulemSpectrum is proud of our diverse workforce and diligently committed to remaining an Equal Opportunity Employer. Spectrum governs all employment-related decisions without regard to an individual's race, color, gender, gender identity, sexual orientation, religion, national origin, age, disability, veteran status or any other protected classification./emem[Equal Opportunity/Affirmative Action Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity]/em
              (USA-MI-Battle Creek) Public Affairs Specialist - Webmaster and Social Media        
    Job Overview ## Job Overview ### Summary Vacancy Identification Number (VIN):1994361 OUR MISSION: To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? As a VA professional, your opportunities are endless. With many openings in the multiple functions of VA, you will have a wide range of opportunities and leadership positions at your fingertips. Not only is it the largest, most technologically advanced integrated health care system in the Nation, but we also provide many other services to Veterans through the Benefits Administration and National Cemeteries. VA professionals feel good about their careers and their ability to balance work and home life. VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities. For more information on the Department of Veterans Affairs, go to http://www.vacareers.va.gov/ Special Employment Consideration: VA encourages persons with disabilities to apply, including those eligible for hiring under 5 CFR 213.3102(u), Schedule A, Appointment of persons with disabilities [i.e., intellectual disabilities, severe physical disabilities, or psychiatric disabilities], and/or Disabled veterans with a compensable service-connected disability of 30% or more. Contact the Agency Contact on the last page of the JOA for information on how to apply under this appointment authority via the Selective Placement Coordinator. For more information on the "Who may apply" eligibility requirements, please refer to the OHRM Status Candidates and Other Candidate Definitionsdocument. **VETERANS PREFERENCE:** Veterans Preference will apply to all applicants. If you are claiming preference, you must submit your Veterans Preference Letter and DD-214 with your application package. **IMPORTANT NOTE: To qualify for consideration for this position, you must FIRST meet the provisions of the Pathways Recent Graduates Program, as established by Executive Order 13562. If you do not meet Pathways provisions, you will not be considered eligible. Please refer carefully to the link http://www.opm.gov/HiringReform/Pathways/.** The Pathways Recent Graduates Program is open to recent graduates who have completed, within the previous two years, an associate, bachelor's, master's, professional, doctorate, vocational or technical degree or certificate from a qualifying educational institution. ### Duties This announcement is for a position being filled under the **Pathways Recent Graduates Program**. The Pathways Recent Graduates Program provides managers a ready source of developmental employees upon completion of the program requirements. It also provides the recent graduate with work experience related to their degree and career goals while offering eligibility for non-competitive conversion to permanent employment upon completion. **Some key provisions of the Recent Graduates Program:** * Recent graduates who have completed, within the previous two years, an associate, bachelor's, master's, professional, doctorate, vocational or technical degree or certificate from a qualifying educational institution. * Preference eligible veterans unable to apply, due to military service obligations, may have up to six years after the completion of their degree and/or certificate to apply. * Recent Graduates may be converted to a permanent position after successful completion of the 1-year Program period or at the end of the 120-day approved extension, unless the agency has an approved longer program based on a rigorous training and development requirement; or, in some limited circumstances a term appointment lasting 1-4 years. **The duties listed below represent the full performance level of this position; if selected as a Pathways Recent Graduate, you will work in a developmental capacity for a year. If you successfully complete the program, you will be promoted to the full performance level.** The Public Affairs Specialist position works under the Office of the Director and reports to the Public Affairs Officer. As the Public Affairs Specialist, you will be responsible for assisting the Organization in the development, implementation, and maintenance of the web based communications activities as well as serving as the SharePoint site-collection administrator and assisting with online learning content development for the Talent Management System (TMS). Your primary duties will include, but not be limited to: * Providing high quality design consultation and solutions to assist in the planning, organizing, and execution of the visual and communication aspects of the public affairs program including intranet, internet, SharePoint, and social media. * Uses Adobe creative Suite and other programs to process graphics files for optimum usability. * Managing, at the domain level, the TMS system which houses employee's official education and training record. * Assures that the web content meets technical compliance with all applicable agency regulations. . * Monitors web traffic data and other relevant metrics. * Assist with the development, coordination, implementation and maintenance of public information and community relations programs. * Utilizes appropriate VA software to edit and update VA websites. * Works with Learning Resources Services (LRS) to analyze Battle Creek VA needs, goals, resources and tailors online learning content to reach target audiences. **Work Schedule:**Monday through Friday 8:00 am to 4:30 pm **Position Description Title/PD#:** Public Affairs Specialist/PD# 10100-O Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. ### Supervisory Status No ### Travel Required * Not Required ### Relocation Authorized * No ### Who May Apply #### This job is open to… US Citizens who are Recent Graduates who have completed a qualifying degree within the previous two years. Note: Veterans who were precluded by their military service obligation from meeting this requirement will have 2 years upon release or discharge from military duty, however eligibility will not extend beyond 6 years from degree completion. Questions? This job is open to 2 groups. Job Requirements ## Job Requirements ### Key Requirements * You must be a U.S. citizen to apply for this job. * Subject to a background/suitability investigation. * Designated and/or random drug testing may be required. * Must meet time in grade requirements * Selective Service Registration is required for males born after 12/31/1959. ### Qualifications **SELECTIVE PLACEMENT FACTOR:** This position has a Selective Placement Factor (SPF). An SPF is skill, knowledge, ability or other characteristic basic to and essential for satisfactory performance of the job; Applicants who do not meet the SPF are not eligible for further consideration. This position acts as the sole Web Master for this Medical Center; therefore knowledge and experience with multiple programming languages is required. Knowledge and/or experience of website architecture and usability, various programming languages such as HTML, HTML 5, CGI-bin, SQL, ColdFusion, JavaScript, and Java is required. **Time-in-grade:** Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements. **Specialized Experience:** **At the GS-5 Grade Level**Successful completion of a full 4-year course of study leading to a bachelor's degree, in an accredited college or university, meets the GS-5 level requirements. General experience is 3 years of progressively responsible experience, 1 year of which was equivalent to at least GS-4, that demonstrates the ability to: 1. Analyze problems to identify significant factors, gather pertinent data, and recognize solutions 2. Plan and organize work 3. Communicate effectively orally and in writing **At the GS-7 Grade Level** applicants must have one year of specialized experience equivalent to at least the next lower grade (GS-5 ) in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: assisting in the creation of websites, knowledge of various programming languages; assisting in domain management. **At the GS-9 Grade Level** applicants must have one year specialized experience equivalent to at least the next lower grade (G-7) in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Skill in evaluating the news value or communication potential of visual material including photographs or illustrations. Applicants may substitute education for the experience required for the GS-7 level. To substitute education for specialized experience, you must have 1 full year of progressively higher level graduate education leading to a master's degree related to the field. –OR- Superior academic achievement (3.0 Grade Point Average (GPA) on a 4.0 GPA scale). Applicants may substitute education for the experience required for the GS-9 level. To substitute experience, you must have 2 full years of progressively high level education leading to a degree or equivalent to a doctoral degree. **[TRANSCRIPTS REQUIRED]** Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. **Note:** Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. **Physical Requirements:** No special physical demands such as above-average ability, dexterity, or strength are required to perform the work. Much of the work is sedentary, and the employee may sit comfortably to do the work. There may be some walking, standing, bending, carrying of light items, driving of an automobile, etc. Some field work may entail traveling to interviews, meetings, and sources of information. **Work Environment:**The work area is adequately lighted, heated and ventilated. The work environment includes every day low risk or discomforts which require normal safety precautions typical of offices, meeting and training rooms, or commercial vehicles. ### Security Clearance Public Trust - Background Investigation Additional Information ## Additional Information ### What To Expect Next After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. During our review, if your résumé and application package do not support your questionnaire answers, we will adjust your rating accordingly. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email (if provided); otherwise, applicants will receive a notification letter via the U.S. Postal Service. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made. You may check the status of your application at any time by logging into your USAJOBS account and clicking on “Application Status.” For a more detailed update of your status, click on “more information.” Information regarding applicant notification points can be found in the USAJobs Resource Center. #### BENEFITS VA offers a comprehensive benefits package. This link provides an overview of the benefits currently offered: http://www.vacareers.va.gov/why-choose-va/benefits/index.asp. ### Other Information **The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan CTAP)**provide eligible displaced Federal competitive service employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit appropriate documentation and be found well-qualified (have a final rating of 85 or more before any Veterans preference points) for this vacancy. Information about ICTAP and CTAP eligibility is on OPM's Career Transition Resources website. **Receiving Service Credit for Earning Annual (Vacation) Leave:**Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. ** ****Placement Policy:** The posting of this announcement does not obligate management to fill a vacancy or vacancies by promotion. The position may be filled by reassignment, change to lower grade, transfer, appointment, or reinstatement. Management may use any one or any combination of these methods to fill the position. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/476234000. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered. *Open & closing dates:* 2017-08-04 to 2017-08-25 *Salary:* $32,844 to $64,697 / per year *Pay scale & grade:* GS 05 - 09 *Series:* 1035 Public Affairs *Appointment type:* Permanent *Work schedule:* Full Time *Job announcement number:* BI-17-118-SEF-1994361-BU *Control number:* 476234000
              (USA-MI-Battle Creek) Registered Nurse-Urgent Care        
    Job Overview ## Job Overview ### Summary Vacancy Identification Number (VIN): 1993340 **OUR MISSION**: To fulfill President Lincoln's promise – "To care for him who shall have borne the battle, and for his widow, and his orphan" – by serving and honoring the men and women who are America's Veterans. How would you like to become a part of a team providing compassionate care to Veterans? **Welcome to our Midwestern Frontier** Also known as "Cereal City," Battle Creek Michigan is strategically located midway between Chicago and Detroit. Battle Creek offers the serenity of country living and the cultural and recreational amenities offered in urban settings. Numerous parks are connected to the Battle Creek and Kalamazoo rivers and lakes and provide opportunities for hiking, fishing, canoeing, picnicking and other recreation. Community sporting, cultural, ethnic, historical, and holiday festivals provide plenty for residents to see and do. As a Battle Creek VA Medical Center professional, your opportunities are endless. With many openings in the multiple functions of VA, you will have a wide range of opportunities and leadership positions at your fingertips. Not only is the Department of Veterans Affairs the largest, most technologically advanced integrated health care system in the Nation, but we also provide many other services to our nations Veterans through the Veterans Benefits Administration and the Veterans National Cemeteries. Battle Creek VA Medical Center professionals not only feel good about their careers, but their ability to balance work as well as home life. The Battle Creek VAMC offers generous paid time off, and a variety of predictable and flexible scheduling opportunities. For more information on the Department of Veterans Affairs, go to http://www.vacareers.va.gov/ VA encourages persons with disabilities to apply. The health related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. ### Duties The Urgent Care Registered Nurse (RN) provides care and counseling of persons or in the promotion and maintenance of health and prevention of illness and injury based upon the nursing process which includes systematic data gathering, assessment, appropriate nursing judgment, and evaluation of human responses to actual or potential health problems through such services as case finding, health teaching, health counseling; provision of care supportive to or restorative of life and well-being; and executing medical regimens incuding administering medications and treatments prescribed by a licensed or otherwise legally authorized provider. The urgent Care RN is utilizing the emergency severity index (ESI) to triage patients for urgent care according to the severity of illnesses and services needed. The primary commitment is to the patient, whether an individual, family, group, or community. Your duties will include but not be limited to: * Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. * Assesses, plans, implements and evaluates care based on age-specific components. * Assumes responsibility for the coordination or care focused on patient transition through the continuum of care, patient and family education, patient self-management after discharge, and supporting factors that impact customer satisfaction. * Considers all characteristics of the individual, including age and life stages, state of health, race and culture, values, and previous experiences. * Administers medications and procedures per established policies and guidelines. * Influences care outcomes by collaborating with members of the interdisciplinary team. **Work Schedule:** The RN will be working six 12.5 hour night shifts (11:30 p.m. to 12:00 a.m.) and one 8.0 or 8.5 hour tour (3:30 to 12:00 a.m.) during each 80 hour pay period. **Functional Statement Title/#:** Registered Nurse-Urgent Care Nurse I/1, Nurse I/2, Nurse I/3, Nurse II, Nurse III. ### Supervisory Status No ### Promotion Potential 00 ### Travel Required * Not Required ### Relocation Authorized * No ### Who May Apply #### This job is open to… United States Citizens Questions? This job is open to 1 group. Job Requirements ## Job Requirements ### Key Requirements * Must pass pre-employment examination. * Designated and/or Random Drug Testing required. * Background and/or Security Investigation required. * Must be proficient in written and spoken English. * Selective Service Registration is required for males born after 12/31/1959. ### Qualifications **BASIC REQUIREMENTS:** * U.S. citizenship. Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. * Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. * The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6) * Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia. **Grade Determinations: **The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: * Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. * Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; **OR** an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; **OR** a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. * Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; **OR** an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; **OR** a BSN with approximately 1-2 years of nursing practice/experience; **OR**a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. * Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; **OR** ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; **OR** a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; **OR**a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. * Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; **OR** a Doctoral degree in nursing or related field and approximately 2-3 year's of nursing practice/experience. **Preferred Experience:** ACLS certification and experience in Urgent Care or ER is preferred. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. **Note:** Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. ****Education/Experience Requirements:****Specialized experience in urgent care or experience working in any emergency department is preferred. Please be sure to include all of your experience on your resume in detail.**** **Physical Requirements:**Registered Nurse Functional Requirements: Heavy Lifting 50 lbs and over (intermittently); Carrying up to 45 lbs (intermittently); Repeated bending; Straight Pulling up to 45 lbs (intermittently); Straight Pushing up to 45 lbs (intermittently); Stooping (intermittently); Squatting (intermittently); Kneeling (occasionally); Use of both arms; Use of both hands; Use of fingers; Overhead work, both arms (intermittently); Prolonged walking (up to 4 hours/day); Prolonged standing (up to 4 hours/day); Sitting (up to 2 hours/day); Far Vision - correctable in one eye to 20/20 and 20/40 in the other; Near Vision - correctable to read newsprint at 13-16 inches; Ability to distinguish shades of colors; Hearing - ability to hear and understand the spoken voice from a distance of 8 feet. Ability to effectively utilize a stethoscope and distinguish breath and heart, and bowel sounds; Emotional and mental stability – ability to effectively perform the essential functions of the position and respond appropriately in emergency situations. ### Security Clearance Public Trust - Background Investigation Additional Information ## Additional Information ### What To Expect Next After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. During our review, if your résumé and application package do not support your questionnaire answers, we will adjust your rating accordingly. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email (if provided); otherwise, applicants will receive a notification letter via the U.S. Postal Service. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made. You may check the status of your application at any time by logging into your USAJOBS account and clicking on “Application Status.” For a more detailed update of your status, click on “more information.” Information regarding applicant notification points can be found in the USAJobs Resource Center. #### BENEFITS VA offers a comprehensive benefits package. This link provides an overview of the benefits currently offered: http://www.vacareers.va.gov/why-choose-va/benefits/index.asp. Annual leave shall accrue for full-time Nurses, and Nurse Anesthetists at the rate of 8 hours for each full biweekly pay period. ### Other Information It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/475859100. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered. *Open & closing dates:* 2017-08-03 to 2017-08-14 *Salary:* $52,541 to $90,201 / per year *Pay scale & grade:* VN 00 *Series:* 0610 Nurse *Appointment type:* Permanent *Work schedule:* Full Time *Job announcement number:* BI-17-601-KLH1993340-BU *Control number:* 475859100
              Attorneys generals ask Veterans Administration to restore educational benefits to victims of predatory colleges        
    Eight attorneys general are calling on U.S. Department of Veterans Affairs Secretary Robert McDonald to restore education benefits to veterans who were victims of predatory institutions, such as Corinthian Colleges. “Our veterans earned these benefits by serving our country,” Washington State Attorney General Bob Ferguson said Monday. “These institutions specifically preyed upon them, using false
              Supply Clerk (Non-Expendable), FSN-05/FP-9* at US Embassy        
    The U.S. Consulate General in Lagos, is seeking to employ suitable and qualified candidates for the position below in the General Services Office (GSO):Location: Lagos - General Services Office (GSO) Work Hours: Full-Time; 40 hours/week Basic Function of the Position The incumbent performs clerical functions and data entry to record property transactions in the Non-Expendable (NXP) Supply unit of the Consulate Logistics Center (Warehouse). S/he assists with all property transactions and processes. Position Requirements Note: All applicants MUST address each required qualification listed below with specific information supporting each item. Failure to do so may result in a determination that the applicant is not qualified. Completion of secondary school is required. Minimum of two (2) years of supply related experience of which one (1) year must have been in the supply program or operation is required. Level III (Good working knowledge) Speaking/Writing/Reading in English is required. Language proficiency will be tested. Must have a good working knowledge of instructions and procedures that apply to the supply management. Ability to perform moderately arduous work, including heavy lifting is required. Must be computer literate and able to operate material handling equipment such as hand trucks and pallet jack. Hiring Preference Selection Process: When qualified, applicants in the following hiring preference categories are extended a hiring preference in the order listed below. Therefore, it is essential that these applicants accurately describe their status on the application. Failure to do so may result in a determination that the applicant is not eligible for a hiring preference. Hiring Preference Order: AEFM / USEFM who is a preference-eligible U.S. Veteran* AEFM / USEFM FS on LWOP** Important Information: Applicants who claim status as a preference-eligible U.S. Veteran must submit a copy of the most recent Member Copy Four (4) of the DD-214, Certificate of Release or Discharge from Active Duty, and, if applicable, a letter from the U.S. Department of Veterans Affairs. If claiming conditional eligibility for U.S. Veterans' preference, applicants must submit proof of conditional eligibility. If the written documentation confirming eligibility is not received in the HR office by the closing date of the vacancy announcement, the U.S. Veterans' preference will not be considered in the application process. Mission HR's decision on eligibility for U.S. Veterans' preference after reviewing all required documentation is final. This level of preference applies to all Foreign Service employees on LWOP. Additional Selection Criteria Management will consider nepotism/conflict of interest, budget, and residency status in determining successful candidacy. Current OR employees serving a probationary period are not eligible to apply. Current OR employees with an Overall Summary Rating of Needs Improvement or Unsatisfactory on their most recent Employee Performance Report (EPR) are not eligible to apply Current NOR employees hired on a Family Member Appointment (FMA) or a Personal Service Agreement (PSA) are not eligible to apply within the first 90 calendar days of their employment, unless they have a When Actually Employed (WAE) work schedule The candidate must be able to obtain and hold the local security certification after selection. Candidates who are EFMs, USEFMs, AEFMs, or MOHs must have at least one year remaining on their sponsor's tour of duty to be considered eligible to apply for this position. Salary Or - Ordinarily Resident (OR) - N3,113,911 p.a. (Starting basic salary) Position Grade: FSN-05 In addition to the basic salary, all allowances will be paid in accordance with the Mission Local Compensation Plan. Nor - Not-Ordinarily Resident - AEFM - US$33,700 p.a EFM/MOH - US$28,545 (Full-Time Starting Salary) p.a. Position Grade: FP-9*
              Fort Collins Vet Takes On VA Over Agent Orange Denials        

    UPDATE: The VA has announced Air Force reservists who became ill from Agent Orange exposure should be eligible for disability benefits. Wes Carter is acutely aware of time, its passage and how much he might have left. For four years, Carter has fought to get medical care and benefits from the U.S. Department of Veterans Affairs for […]

    The post Fort Collins Vet Takes On VA Over Agent Orange Denials appeared first on The Constantine Report.


              Pittenger votes to fund border wall, military pay raise        

    FOR IMMEDIATE RELEASE

     

    CONGRESSMAN PITTENGER VOTES TO FUND BORDER WALL, MILITARY PAY RAISE, AND BOOST MILITARY READINESS

     

    WASHINGTON – Today, Congressman Robert Pittenger (NC-09) voted to fund President Trump’s $1.6 billion request for a border wall, provide the largest military pay raise in 8 years, and increase Defense spending by 13% to rebuild America’s military.

    “As Americans, we spend hours debating issues large and small, but too often we forget our freedom to have these debates is paid for by our men and women in uniform,” said Congressman Pittenger.  “Today I voted on common sense legislation to restore military readiness, honor the sacrifices of our troops, and support President Trump’s effort to secure our borders.”

    The Make America Secure Appropriations Act (H.R. 3219) includes:
     

    • $1.6 billion to construct physical barriers along our southern border, fully funding President Trump’s request.
    • A 13% increase ($68.1 billion) to continue rebuilding our military following President Obama’s devastating cuts to military readiness.
    • The largest military pay raise in 8 years.
    • The highest level of funding ever for the Department of Veterans Affairs ($78.3 billion)


    The Make America Secure Appropriations Act also boosts funding for U.S. Capitol Police and continues the pay freeze for Members of Congress.

    H.R. 3219 today passed the U.S. House of Representatives by a bipartisan vote of 235-192.

     

    ###


              Spinal Manipulation Can Alleviate Back Pain, Study Concludes        
    One of the most common reasons people go to the doctor is lower back pain, and one of the most common reasons doctors prescribe powerful, addictive narcotics is lower back pain. Now, research published Tuesday in the Journal of the American Medical Association offers the latest evidence that spinal manipulation can offer a modestly effective alternative. Researchers analyzed 26 studies involving more than 1,700 patients with lower back pain. The analysis found spinal manipulation can reduce lower back pain as measured by patients on a pain scale — like this one — from zero to 10. Spinal manipulation, which is typically done by chiropractors, physical therapists, osteopaths, massage therapists and some other health providers, involves applying pressure and moving joints in the spine. Patients undergoing spinal manipulation experienced a decline of 1 point in their pain rating, says Dr. Paul Shekelle , an internist with the West Los Angeles Veterans Affairs Medical Center and the Rand
              VA Doctors Solve a Medical Mystery        
    As soldiers continue to return from Iraq and Afghanistan, doctors who treat them find themselves at the forefront of scientific research. That's the case at the Veterans Affairs Hospital in Palo Alto, where scientists have made a surprising discovery. Amy Standen reports.
              These Are The New State Laws That Go Into Effect This Month        

    Although the 2016 General Assembly ended back in April, its effects will be felt in mid-July, when a bevy of laws go into effect.

    Most new laws are given a 90-day window for state agencies and other offices to prepare for their implementation. Here’s a rundown of some of the major laws that will take effect on July 15.

    Budget: The $21 billion plan cuts state spending by about 9 percent over the next two years. Several programs are exempted from the cuts, including the Department of Veterans Affairs, public school funding, Medicaid and financial aid for higher education. State troopers get a pay raise under the bill, and funding to state colleges and universities will be cut by 4.5 percent.

    Pension Permanent Fund: Establishes a new fund to save money for future infusions into the state pension systems. The state budget set aside $125 million for the reserve, with plans to add potential surpluses and windfalls from lawsuit settlements as well.

              Marjorie Block Olson and Jack Olson        
    Marjorie W. Block (8/21/1921 – 1/26/1992) was born in Chicago, daughter of George Block ( http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GRid=14... ) and Beatrice Davey Block, and apparently died in Dallas. On 8/5/1943 in Chicago, she married Jack Henry Olson (6/27/1922 – 4/11/1989), son of Henry Darius Olson ( http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GRid=14... ) and Laura Florence Larsen. Marjorie and Jack had three children, Karen, Gail, and George Olson (George, 5/11/1950 – 1993?). Based on a SS application matching that DOB and with his right middle name, I would say George was born in Chicago and died 12/7/1995 and that whichever relative gave me his death year was just guessing.

    I am trying to find out where Marjorie, Jack, and George Olson are buried. I do have Marjorie's obit and death notice from the Chicago Tribune and it does not mention where she is buried. The obit only mentions a church where a local memorial service was held, probably just a memorial service here for people who knew her, rather than an actual funeral, but I imagine her services were done in a Dallas-area funeral home. I have not been able to obtain a Dallas-area obit for Marjorie yet, and I cannot order a death certificate from TX as I am not a direct relative.

    Marjorie apparently died in Dallas county: https://familysearch.org/ark:/61903/1:1:JV26-R4M https://familysearch.org/ark:/61903/1:1:VZFZ-TP8 Jack's full DOD was a little tricky to verify, but it came up in a department of veterans affairs death file.
              Re: Lee, Texas - Manheim, Lee Texas LOWE'S         
    Hi,

    1920 Travis Co. TX
    All African American
    Joe Smith, b. TX, 35, farm laborer
    Marie, b. Tx, 28
    Ottie, b. TX, 10
    Cicero, b. TX, 8
    Rucker, dau, b. TX, 6
    Senie, dau, b. Tx, 4

    1930 Austin, Travis, TX
    Joe Smith, b. Tx, 52, laborer odd jobs
    Maria, b. TX, 39, laundress private family
    Arta M. Lowe, b. TX, 19, stepdau, laundress private family
    Cicero Lowe, stepson, b. TX, 17, laborer odd jobs
    Lina Lowe, stepdau, b. TX, 15
    Willie Lowe, stepson, b. TX, 13
    Janie Smith, b. TX, 7
    Flora Smith, b. TX, 3

    1940 Austin
    Cicera Lowe, b. TX, 26, porter cotton exchange, education-high school 1 yr
    Daisy, b. TX, 21, educ=high school 3 yrs
    Pearl Maria, b. TX, 1

    Cicero Lowe
    Born: 1912, Texas
    Enlisted: 27 Jan 1944, Los Angeles, CA
    Citizen
    Education: Grammar school
    Married
    Source: U. S. World War II Army Enlistment Records 1938-1946

    Cicero Lowe
    Born: 26 oct 1912
    Military: U. S. Army
    Enlisted: 27 Jan 1944
    Released: 27 April 1944
    Died: 27 Sept 2001
    Source: U. S. Dept Veterans Affairs BIRLS Death File 1850-2010

    Cicero Lowe
    Born: Oct 26, 1912
    Died: Sept 27, 2001
    Buried: Cook-Walden Capital Parks Cemetery & Mausoleum, Pflugerville, Travis, TX
    Source: www.findagrave.com
    Successful Searching!

              PHH reaches $75 million settlement with DOJ over False Claims Act violations        
    PHH Corp. announced it settled with the U.S. Department of Justice to resolve issues over alleged False Claims act violations. PHH said it settled with the DOJ on behalf of the Department of Housing and Urban Development and separately with the DOJ on behalf of the U.S. Department of Veterans Affairs and the Federal Housing Finance Agency. The settlement resulted in PHH having to pay a whopping $75 million.
              Treat Sunburns With Tea (and Other Tips)        

    Sipping tea just for its antioxidant punch is so last millennium. Here are some of the best, most unusual, and generally awesome uses for tea that don’t involve sipping.

    Tea Time — Your Action Plan

    Green tea has plenty of skin-protecting benefits — hence its use as a common ingredient in skin creams — but black tea could be the answer to curing a nasty sunburn Green tea prevents non-melanoma skin cancer by enhancing DNA repair. Katiyar, S.K. Birmingham Veterans Affairs Medical Center. Birmingham, AL. Archives of Biochemistry and Biophysics. 2011 Apr 15;508(2):152-8. Epub 2010 Nov 19.. Gently applying chilled black tea to the affected area will help soothe the skin, and the tea’s tannins can help speed the body down its road to recovery. Cooled chamomile tea also has anti-inflammatory properties that can help treat skin affected by sunburns and irritants like poison ivy Chamomile: an anti-inflammatory agent inhibits inducible nitric oxide synthase expression by blocking RelA/p65 activity. Bhaskaran, N., Shukla, S., Srivastava, J.K., et al. Department of Urology, Case Western Reserve University. International Journal of Molecular Medicine. 2010 Dec;26(6):935-40.. For severe cases of skin irritation, though, it’s best to seek medical advice — and avoid these topical solutions altogether if the skin is broken or cracked. Got a pesky mouth sore? Applying a used tea bag to the spot can help relieve the area and reduce inflammation by soaking up excess saliva. Biting down on the bag can also keep a wandering tongue from pestering the wound and causing further irritation (not to mention accidentally biting down on it… ouch). For those who just can’t get enough tea by sipping, adding a few cups of brewed black tea to a marinade will help tenderize beef before cooking (thanks again those tannins!). The jury’s out on whether tea or coffee makes the better marinade, but that’s what experimenting is for, right? And in case those fragrances building up at the gym are less than ideal, throw some dry tea bags in running shoes or a smelly bag when not in use. The tea bags will help absorb the musky scents while imparting some of their own — more pleasant — aroma. (Also Check Out: 54 Unexpected Ways to Hack Your Health)

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              UMHB Hosts Open House for Nurses        
    Thursday, June 1, 2017
    Dr. Sharon Souter, dean of the Scott & White College of Nursing

    Belton, Texas – On Tuesday, June 6, the University of Mary Hardin-Baylor will host an open house from 5:30 to 7:00 p.m. in the Isabelle Rutherford Meyer Nursing Education Center, 401 W. Martin Luther King Jr. Avenue in Belton.  Advanced practice nurses, nurse administrators, and nurse educators are invited to attend the event to learn about the Doctor of Nursing Practice (DNP) degree program at UMHB.

    “We really want to spread the word about our DNP program and the success our students are having,” Dr. Sharon Souter, dean of the Scott & White College of Nursing at UMHB said. “Many nurses in Texas are looking for the opportunity to grow their skills and advance in their careers, and this program is great way to do that.”

    The Doctor of Nursing Practice curriculum helps nurses build on knowledge they gained in a master’s degree program by providing education in data analysis, quality improvement, and systems leadership, as well as other key areas such as ethics, health policy, and the economics of healthcare practice management. The program combines online coursework with on-campus class attendance one weekend per month, to fit the busy schedules of working professionals.

    Forecasters expect nurses with the DNP degree to be in increasing demand in the coming years: the American Association of Colleges of Nursing, the National Institutes of Health, the National Academy of Sciences, the American Organization of Nurse Executives, and the Department of Veterans Affairs have called for the Doctor of Nursing Practice degree to become the industry standard for advanced practice nurses.

    In addition to information about the doctoral program, the open house will feature guided tours of the Isabelle Rutherford Meyer Nursing Education Center, a 77,000 square-foot facility which boasts a simulation hospital wing and state of the art meetings spaces and classrooms. Door prizes will be awarded to visitors throughout the evening.

    For additional information about the open house or the DNP program, contact Stacy Carpenter at UMHB’s Scott & White College of Nursing, 254-295-4662.


              Economic Benefits of Improved Insulin Stability In Insulin Pumps        
    Peer-Reviewed

    Economic Benefits of Improved Insulin Stability In Insulin Pumps

    ABSTRACT

    Purpose: Insulin pump users discard unused medication and infusion sets according to labeling and manufacturer’s instructions. The stability labeling for insulin aspart [rDNA origin] (Novolog) was increased from two days to six. The associated savings was modeled from the perspective of a hypothetical one-million member health plan and the total United States population.

    Design: The discarded insulin volume and the number of infusion sets used under a two-day stability scenario versus six were modeled.

    Methods: A mix of insulin pumps of various reservoir capacities with a range of daily insulin dosages was used. Average daily insulin dose was 65 units ranging from 10 to 150 units. Costs of discarded insulin aspart [rDNA origin] were calculated using WAC (Average Wholesale Price minus 16.67%). The cost of pump supplies was computed for the two-day scenario assuming a complete infusion set change, including reservoirs, every two days. Under the six-day scenario complete infusion sets were discarded every six days while cannulas at the insertion site were changed midway between complete changes. AWP of least expensive supplies was used to compute their costs.

    Principal findings: For the hypothetical health plan (1,182 pump users) the annual reduction in discarded insulin volume between scenarios was 19.8 million units. The corresponding cost reduction for the plan due to drug and supply savings was $3.4 million. From the U.S. population perspective, savings of over $1 billion were estimated.

    Conclusions: Using insulin that is stable for six days in pump reservoirs can yield substantial savings to health plans and other payers, including patients.

    INTRODUCTION

    Diabetes continues to be a critical health issue, both medically and financially. Its incidence in the United States has grown significantly, rising in tandem with the increase in the obesity rate (CDC 2010, Flegel 2010). Currently, almost 18 million people have diabetes in the United States; of these, 90 to 95 percent have type 2 (CDC 2010, American Diabetes Association 2010). As a result, diabetes is a major contributor to morbidity and mortality, driving increased use of a wide variety of medical services. The annual direct medical and pharmacy costs of diabetes, estimated at $116 billion in 2007, are substantial and are expected to continue to rise as the population of patients with diabetes expands (CDC 2010, American Diabetes Association 2010). These costs are largely borne by payers, including private carriers, employers, federal and state governments, and ultimately taxpayers and consumers. This article presents a method with potential to reduce the costs of insulin for individual payers and across the U.S. health care system.

    The U.S. Agency for Healthcare Research and Quality (AHRQ) recognized that diabetes is a difficult and complex disease to manage. AHRQ has identified that intensive therapy and a team approach results in improved care of patients with diabetes. Specifically, the agency recommends the following:

    • More frequent use of 2 oral medications (a hypoglycemic agent and an antihyperglycemic agent) or 1 oral medication plus insulin
    • Greater likelihood of 3 or more daily injections for insulin recipients
    • Four or more visits per year for many patients
    • Visits with both physicians and nurse practitioners alternating with visits with a nurse practitioner
    • Direct telephone availability of nurse practitioners
    • Dietitian visits with patients
    • Screening for complications
    • Self-monitoring

    Using these guidelines, the mean glycosylated hemoglobin (HbA1c) for type 1 patients was 7.1 percent, and the mean for type 2 patients was 6.9 percent (AHRQ).

    An important subset of the diabetic population consists of users of insulin pumps, estimated to be over 360,000 pump users in the United States (JMP Securities, 2009). Insulin pumps offer the advantages of being readily available and may simplify the diabetes treatment regimen.

    The insulin pump has changed diabetes management but has added new complexities to diabetes care. Patients must fill the pump reservoirs, whose capacities differ by pump product, with insulin, discarding unused insulin that has passed the in-use expiration date, as well as changing the needle and the tubing on a regular basis. The insulin and the other disposable parts constitute a significant portion of the pump care costs. Extending the expiration period for insulin potentially decreases drug wastage and reduces the frequency of changing infusion sets. This could lead to lower costs for payers and patients, as well as simplifying the regimen for patients.

    Recently, the labeling for Novolog (insulin aspart [rDNA origin] Injection) has changed to reflect the improved stability in insulin pump reservoirs from two days to six days in three insulin pump devices (Novolog prescribing information). In this study, we used a population-based model to project the potential impact on medical and pharmacy costs, from the payer point of view. We also examined care management issues related to pump use for insulin pump–dependent patients with diabetes. Some of these care management issues included complexity of treatment regimen, patient dosing requirements, and frequency of changing insulin in reservoir and infusion sets.

    METHODS

    The cohort of insulin pump users under each scenario (“two-day” and “six-day”) was distributed among a mix of the three insulin pumps with various reservoir capacities (Minimed Report). These pumps have been evaluated for use with insulin aspart [rDNA origin] and are listed in the insulin aspart product label. Table 1 summarizes reservoir capacity, cost of consumable pump components, and the approximate U.S. market share of three insulin pump types.

    TABLE 1  Characteristics and market share of top three pumps in market
    Pump Reservoir size in units AWP of full infusion set with reservoir AWP of needle and cannula Patient mix
    Accu-Chek Spirit 315 $12.80 $5.75 10.0%
    MiniMed 522 180 $13.80 $5.75 45.0%
    MiniMed 722 300 $13.80 $5.75 45.0%
    Source: MediSpan 2009

    In the two-day scenario, the entire infusion set, including the reservoir, is discarded at the end of each two-day period. In the six-day scenario, the needle and cannula are changed at the infusion site at day 3 (as per pump manufacturer recommendation) and the entire infusion set is discarded at the end of each six-day period. We calculated the total cost of discarded pump components for each two-day period for the “two-day scenario” and each six-day period for the “six-day scenario” based on AWP prices derived from the MediSpan database for December 2009.

    The daily insulin doses assumed to be taken by the pump user cohort were based on the distribution shown in Figure 1, which is derived from a large sample of U.S. diabetes patients (IMS LifeLink). All patients are assumed to be using insulin aspart [rDNA origin] 10-mg vials, as this would appear to be the most convenient method for transferring insulin into pump reservoirs.

    Distribution of insulin utilization

    Based on daily consumption (quantity dispensed/divided by days between refills) of pump users. (IMS LifeLink data.) Time period, 2000–2008. Includes prescriptions of NovoLog and insulin lispro [rDNA origin] (Humalog) in vials among 6,868 patients using pumps. (Total number of patients with diabetes in 2008 was 803,404).

    Daily dosage in units of insulin

    We calculated the amount of discarded insulin remaining in the reservoir at the end of the two-day and six-day period, assuming the pump reservoir is filled at the start of the two-day or six-day period and is filled whenever the reservoir is emptied during the period. We also included in our calculations any unused insulin remaining in the vial 28 days after opening. The cost of the discarded insulin in each two-day and six-day period was based on the wholesale acquisition cost (WAC) of insulin aspart [rDNA origin] 10-ml vials (Red Book).

    Finally, the difference in total cost of all discarded insulin and all pump components consumed over a one-year period for the six-day scenario was compared with the two-day scenario.

    The two population cohorts used in the model were based upon 1) a one-million member health plan and 2) total estimated pump users in the U.S. (360,000 U.S. pump users correspond to a prevalence of 0.118 percent or 1,182 pump users in a one-million member plan) (JMP Securities). These cohorts were selected as they represent common planning scenarios used by payers and epidemiologists.

    RESULTS

    Table 2 shows the breakout of cost savings on a per-patient basis, which are independent of total population. On average, a typical health plan of any size can expect total annual savings in drug and supply costs for each pump patient to average $2,873, assuming that patients follow the six-day scenario regimen.

    TABLE 2  Per-person average annual cost savings for a six-day versus a two-day scenario
    Source of annual per-person savings Estimated average annual per-patient savings
    Reduction in discarded insulin (WAC) $1,556
    Reduction in supplies (AWP) $1,317
    Total savings $2,873

    Table 3 shows the breakout of savings associated with each of the studied populations. For the one-million member health plan, the model estimates that there will be 1,182 insulin pump users with prescribed insulin amounting to 28 million units of insulin aspart [rDNA origin] at a WAC of $2.6 million each year. The reduction in discarded insulin in the “six-day scenario” compared to the “two-day scenario” is estimated at 19.8 million units, saving $1.84 million. The reduction in pump supply costs yields a further $1.55 million in savings. The overall annual savings associated with all 1,182 pump users is $3.39 million.

    TABLE 3  Population-based savings for a six-day versus a two-day scenario
    Health plan scenario (annual) Health plan scenario PMPM U.S. population scenario (annual)
    Population 1 million 307 million
    Estimated insulin pump users 1,182 362,746
    Insulin units prescribed (avg. 65 units per day) 28 million 8.6 billion
    WAC of prescribed insulin $2.6 million $798 million
    Reduction in discarded insulin (units) 19.8 million 6.1 billion
    Reduction in discarded insulin (WAC) $1.84 million $.15 $564 million
    Reduction in supplies (AWP) $1.55 million $.13 $478 million
    Total annual savings $3.39 million $.28 $1.04 billion

    Based on U.S. census data for July 2009, the population is estimated to be just over 307 million people. (U.S. Census Bureau) The model estimates 362,746 pump users with prescribed insulin, amounting to 8.6 billion units at a WAC of just under $800 million annually. The reduction in discarded insulin in the six-day scenario, compared with the two-day scenario, for the total U. S. cohort of pump users is estimated at 6.1 billion units, saving $564 million. The reduction in pump supply costs yields a further $478 million in savings. The overall annual savings associated with the entire U.S. cohort of pump users is just over $1 billion.

    DISCUSSION

    The potential clinical impact of uncontrolled diabetes to patients is well established as is the economic burden to both the patient and society. Patients utilizing insulin pumps have the additional costs and inconvenience of periodically having to replace both their insulin medication and infusion sets. Our results demonstrate that there is an opportunity to provide patients using an insulin pump with a six-day stability with a less complicated, cost-saving treatment regimen that is likely to increase patient and provider satisfaction with therapy.

    It is important to consider the major stakeholders in any decision to implement a broad-based program to migrate patients to a new regimen. These include the payer, provider, and patient. Insulin and pump supplies for patients covered under traditional multi-tier pharmacy benefit plans with typical medical benefit coverage for durable medical equipment cost substantially less for the six-day regimen compared to the two-day regimen. Each patient utilizing daily doses of insulin ranging from 10 to 150 units, with a mean of 65 units saved, on average, $2,873 ($1,556 insulin and $1,317 supplies) annually (IMS LifeLink). These savings are greater than the total cost at WAC ($2,199) of the prescribed insulin for a patient taking the average daily dose of 65 units. For a one-million member health plan, overall savings are estimated to be almost $3.4 million, equating to 28¢ per member per month (PMPM) savings.

    The implications of this level of savings to a health plan are dramatic, because there is a substantial difference in cost and profit compared with two-day regimen. Assuming that a health plan is operating on a 3 percent margin, to achieve $3.4 million in bottom-line profit, it would have to acquire $113 million in incremental revenue from new sources. In 2009, the average cost of health care premiums was $13,375 (Kaiser Family Foundation 2009); therefore, it takes new employer groups with 8,460 employees to yield an equivalent amount. The costs of health care premiums are likely to go up and therefore the implementation of this new regimen may help slow some of these increases.

    Another aspect that is important to health plans is for patients to maintain glycemic control through adherence to their treatment regimens. This is important to health plans, because members with diabetes utilize more health care services than members without the illness. One study found in a privately insured patient population that adults with type 2 diabetes and 24 months of continuous health plan enrollment had 2.4 times the adjusted health care costs of matched controlled non-diabetic patients (Durden 2009).

    It is important to recognize that managed care organizations make decisions by committee; therefore, a change in protocol is likely to require P&T or even medical technology committee approvals. As a result, like any other systematic change, an inter- nal champion must emerge to make the case and handle any objections that may arise. Based on the impact of the cost savings involved, it seems likely that either a pharmacy director or medical director with pharmacy budget responsibility will take the lead.

    Although these estimated cost savings from reduced wastage are impressive for private health plans, the cost implication also applies to the significant portion of the diabetic population covered by government sponsored plans such as Medicare, Medicaid, Tricare and the Veterans Affairs Department. The result is to further magnify the positive impact on both costs and patient outcomes at a societal level.

    Diabetes is a complex disease requiring patients to demonstrate excellent care management over their lifetimes in order to successfully keep their HbA1c levels within target range. It has been shown that medication adherence rates for patients with type 1 and type 2 diabetes who use a self- monitoring blood glucose regimen are 70 percent and 64 percent, respectively (Delamater 2006). Complex treatment regimens are a barrier to successful glucose control, resulting in increased morbidity and mortality as well as economic consequences. The Diabetes Control and Complications Trial proved that intense management of patients with respect to glycemic control resulted in dramatic reductions in the rate of development and progression of retinopathy, neuropathy, and neph- ropathy. In turn, tighter glycemic control yielded lower long-term medical costs from reduced hospitalization and fewer medical services (Zinman 1997).

    Lower adherence rates have been correlated with chronic conditions, asymptomatic, or varying symptomatology during disease progression, and complex treatment regimens, especially those requiring lifestyle changes (Delamater 2006). All of these are associated with diabetes and can represent a challenge to patients and health care professionals. From the payer perspective, tighter control represents a significant medical cost savings opportunity.

    Patients who make pharmacy copayments for drugs and have out-of- pocket coinsurance for some supplies under more traditional pharmacy and medical benefit plans have much to gain by converting to a six-day regimen. In 2007, Kaiser Family Foundation reported average copayments for generics, preferred brands, and non-preferred brands were $11, $25, and $43, respectively (Kaiser Family Foundation 2011). Under a six-day scenario, we assume that doctors will continue to prescribe the same number of insulin units per prescription; however, patients will refill them less frequently because of the changed label of insulin aspart, which allows for 6 days’ use in a pump, and the reduction in discarded insulin. Furthermore, patients save on the infusion sets because of the reduced number required throughout the year. Based on the six-day regimen, patients will refill 3 to 4 fewer prescriptions per year, resulting in $75 to $172 in annual savings, depending on whether the six-day insulin is reimbursed as a preferred or non-preferred brand.

    Relative to insulin costs and pump supplies, greater savings to the patient are more likely to occur through the reduction of the number of full infusion sets required during the year. Under the two-day regimen, patients require 15 infusion sets per month, costing an estimated $2,500 annually. Conversely, a six-day regimen requires only five complete infusion sets per month, costing $833 per year and resulting in $1,667 in infusion set savings for the year.

    There is, however, an additional cost of $350 to the six-day regimen associated with new needles and cannulas, which are required every three days. But even with this adjustment, the supply cost savings net at $1,317 per annum per patient. We would expect patients to realize additional savings from reduced medical costs, because adherence and glycemic control improves with the less complicated regimen.

    Further potential benefits to diabetic patients result from the reduction of these supply cost savings. Many health plans impose a durable medical equipment cap for the year, typically $2,500. By lowering the supply costs associated with pump supplies, patients are less likely to reach their cap, or they can have more coverage for other durable medical equipment purposes.

    In the United States, the number of individuals with high deductible health plans (HDHP) is increasing (AHIP 2009). According to a 2009 report from America’s Health Insurance Plans Center for Policy and Research, HDHP coverage rose to 8 million in January 2009. This is an increase of 1.9 million from 6.1 million in January 2008. For patients with high deductible health plans the six-day regimen has an even greater favorable financial impact than for patients with more traditional coverage. For the former, 100 percent of their medical and pharmaceutical expenses are paid out of pocket until their high deductible is reached. For a member with a $5,000 deductible, a reduction in out-of-pocket expenses of $2,500 or more is quite considerable.

    The change to the six-day regimen would be especially important for patients who are trying to stretch their health care out-of-pocket dollars. Perhaps these patients are not changing their insulin and infusion sets every two days as directed and therefore are at risk for less efficacious results because the insulin that they are using is outdated. Benefits of the six-day protocol include a reduction in frequency of changes.

    The six-day protocol also has meaningful advantages for health care professionals trying to simplify the complex and costly treatment regimens. With the ever-increasing costs of health care, the new regimen enables the provider to offer a more economical option to patients. It provides yet another opportunity to educate patients on the need to follow the health care professional’s guidance. It provides a much simpler method for patients to follow that could lead to better adherence, not only to the insulin pump dosing but to overall treatment.

    LIMITATIONS

    There are limitations to this analysis. The model assumes patients are currently adhering to the manufacturers’ recommendations for changing the insulin reservoir every two-days, as per the FDA’s indications or the pump instructions. In the real world, patients are not always compliant with their medication or with device instructions. If a patient continues to use the same insulin reservoir until it is empty, regardless of the two-day in-pump use limitation, this would diminish the savings projection. However, there may be clinical and economic consequences associated with adverse events caused by the use of expired insulin. In addition, in an effort to reduce costs, there may be patients who currently do not fill their reservoir to capacity as instructed.

    There will also be a certain level of noncompliance with proper insulin pump use, although this is likely to be less common with a pump-dependent group than with insulin-dependent diabetic patients in general, (Raccah 2011) because of the screen- ing that typically occurs before a patient is started on the pump and because of the hyperglycemic risks associated with running out of insulin too soon. A reasonable amount of resources applied by health plans toward educating health care professionals and patients on the clinical and economic benefits of the six-day protocol should result in new pump users initiating therapy with the new regimen.

    The model assumes typical distributions of patients and market shares of the three different insulin pumps. Individual health plans may, of course, have their own preferred insulin pump products and, therefore, have a different mix of pumps that will affect the outputs from the model.

    Another assumption in the model is that patients will continue to obtain prescriptions for insulin from their doctors as they are currently written. For example, if a patient is currently prescribed 2,000 insulin units for a 30-day supply, the patient will continue to refill that prescription—only the time between refills will be less frequent (more than 30 days). The result is less cost to the patient and payer; however, the plan will collect fewer copayments during the year.

    Overall, we believe that these limitations do not significantly change the impact of the savings that plans and patients are likely to experience.

    CONCLUSION

    Our model clearly demonstrates that significant costs savings can be achieved through the conversion of a two-day insulin regimen to a six-day regimen among insulin pump users. Pharmacy budgets can be expected to lower their insulin costs by $1,556 per patient and medical supply costs lowered by $1,317 per patient under the six-day regimen. Health plans with even small numbers of patients who use insulin pumps may find it useful to encourage the use of the six-day regimen. From a societal perspective, it appears that significant cost savings to the health care system might be achieved.

    REFERENCES

    1. Agency for Healthcare Research and Quality (AHRQ), Improving care for diabetes patients through intensive therapy and a team approach. Available at http://www.ahrq.gov/research/diabria/diabetes.htm. Accessed April 15, 2011.
    2. American Diabetes Association. Diabetes statistics. Available at: http://www.diabetes.org/diabetes-basics/diabetes-statistics/. Accessed April 15, 2011.
    3. American Diabetes Association. Living with diabetes. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/advantages-of-using-an.html. Accessed April 15, 2011.
    4. American Health Insurance Plans Center for Policy and Research. Available at: http://www.ahipresearch.org/. Accessed April 15, 2011.
    5. Centers for Disease Control and Prevention. Diabetes is common, disabling, deadly, and on the rise. Available at: http://www.cdc.gov/features/dsDiabetesTrends/. Accessed April 15, 2011.
    6. Delmater AM. Improving patient adherence. Clinical Diabetes. 2006; 24(2):71-77 (doi:10.2337/diabclin,24.2.71).
    7. Durden ED, Alemayehu B, Bouchard JR, Chu BC, Aagren M. Direct health care costs of patients with type 2 diabetes within a privately insured employed population, 2000 and 2005. J Occup Environ Med. 2009; 51(12):1460–1465.
    8. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–241 (doi:10.1001/jama.2009.2014).
    9. IMS LifeLink data. Time period 2000–2008.
    10. JMP Securities, March 2009.
    11. Joslin Diabetes Center. The advantages and disadvantages of an insulin pump, Available at http://www.joslin.org/info/the_advantages_and_disadvantages_of_an_insulin_pump.html. Accessed April 15, 2011.
    12. Kaiser Family Foundation. Average health insurance premiums and worker contributions for family coverage, 1999–2009. Available at: http://www.kff.org/. Accessed April 15, 2011.
    13. Medispan, December 2009.
    14. Prescribing information: NovoLog (insulin aspart [rDNA origin] injection. Available at: http://www.novolog.com/. Accessed April 15, 2011.
    15. Raccah D, Sulmont V, Reznick Y, et al. The RealTrend study: Effect on metabolic control in poorly controlled Type 1 diabetes using properly the Paradigm REAL-Time system vs. conventional blood glucose self-monitoring and continuous subcutaneous insulin infusion. Available at: http://professional.diabetes.org/Abstracts_Display.aspx?TYP=1&CID=74516. Accessed April 15, 2011.
    16. Red Book. December 2009 Update. Available at: http://www.redbook.com/redbook/index.html
    17. US Census Bureau Statistical Abstract. Available at: http://www.census.gov/compendia/statab/cats/population.html. Accessed April 15, 2011.
    18. Zinman B. Translating the diabetes control and complications trial (DCCT) into clinical practice: Overcoming the barriers. Diabetologia. 1997 40:S88–S90.

    Disclosures

    Funding for this study was provided to Managed Solutions by Novo Nordisk Inc., the manufacturer of Novolog. An honorarium was provided to Derek van Amerongen, MD, MS, for his contributions.

    Richard C. Weiss had primary responsibility for concept and design with assistance from van Amerongen and Gary Bazalo. The manuscript was drafted primarily by Weiss and van Amerongen with input from Bazalo.

    Corresponding Author:
    Richard Weiss
    PO Box 526
    Mt. Freedom, NJ 07970
    rich@managedsolutonsllc.com

    Appropriate patients for insulin therapy include patients with type 1 diabetes and individuals with type 2 diabetes who are unable to be controlled with other medications. Type 1 is an autoimmune disease in which the ability of the pancreas to make insulin has been destroyed. In type 2 diabetes, either the pancreas does not produce enough insulin or the body’s cells are resistant to the action of insulin. (AHRQ)

    Richard C. Weiss, BS, MS
    Principal, Managed Solutions
    Derek van Amerongen MD, MS
    Chief medical officer, Humana
    Gary Bazalo, BS, MS, MBA
    Managed Solutions
    Mark Aagren, MS
    Novo Nordisk
    Jonathan R. Bouchard, MS, RPh
    Novo Nordisk

              The VA, America’s largest integrated health system, turns 96 years old        
    The Department of Veterans Affairs is the country's largest integrated health system. Nearly nine million of America’s veterans get medical care from the VA. Ninety-six years ago today, the precursor to what we now know as the VA began with a stroke of President Warren G. Harding’s pen.
              Veteran commits suicide in VA parking lot        

    Peter Kaisen
    A 76-year-old Navy veteran shot himself in the parking lot of the Northport Veterans Affairs Medical Center on Long Island Sunday.
    Peter A. Kaisen, of Islip, New York, was pronounced dead at the scene. His family said he suffered from mental health problems and depression.
    Kaisen had previously been a patient at the hospital, but according to the hospital’s spokesman, Christopher Goodman, there is no indication Kaisen sought treatment at the hospital immediately before his death. However, sources who work at the hospital, speaking on the condition of anonymity, told The New York Times that isn’t true.
    “He went to the E.R. and was denied service, and then he went to his car and shot himself,” said one of the sources.
    Sources said Kaisen sought treatment and was unable to get it because the emergency room at the hospital was not staffed to handle mental health issues, with no psychologist at the ready. Nonetheless, the source said Kaisen should have been sent to the mental health building, which was always open and equipped to handle such issues.
    “Someone dropped the ball,” the source said. “They should not have turned him away.”
    Because the suicide occurred on federal property, the incident will be investigated by the FBI. Kaisen’s family has declined to comment on the incident, but a woman claiming to be his granddaughter has expressed anger via comments on news reports.
    Kaisen served in the United States Navy and was a retired police officer out of Long Beach. He was described as a “devoted husband, beloved father, grandfather, cherished friend and brother,” according to the funeral home’s website.
    [ New York Times ]
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              Despite Claims To Contrary, Trump Has Signed No Major Laws 5 Months In        
    Updated 12:30 p.m. ET President Trump kept one of his campaign promises, signing a bill Friday to make it easier for the secretary of veterans affairs to fire and discipline employees. It came in response to the 2014 VA scandal in which employees covered up long wait times while collecting bonuses. The bill, which passed earlier this month with strong bipartisan support, also gives the secretary authority to revoke bonuses and protects whistleblowers who report wrongdoing. "What happened was a national disgrace and yet some of the employees involved in these scandals remained on the payrolls," Trump said just before signing the bill. "Outdated laws kept the government from holding those who failed our veterans accountable. Today we are finally changing those laws." The Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 marks Trump's 40th law signed. Sounds like a lot. And in recent days, Trump has boasted about all the legislation he has signed. "We
              Bowling Green Veterans Nursing Home Still Many Years Away        
    Veterans advocates say the hard part has just begun as Bowling Green seeks to open the state’s fifth veterans nursing home. Officials from the Kentucky Department of Veterans Affairs offered a sobering update Tuesday to area lawmakers and veterans at the American Legion Post in Bowling Green. During this year’s General Assembly session, lawmakers authorized $10 million in state funding for a 90-bed skilled nursing facility, but the money hasn’t actually been appropriated.
              Minibus Leaves The Station        

    Ocean Leadership: Policy & Legislation ~

    On Thursday, the House passed an appropriations “minibus” (H.R. 3219) in a mostly-partisan 235-192 vote. The minibus combines the Department of Defense, Military Construction and Veterans Affairs, Energy and Water, and Legislative Branch appropriations bills; Appropriations Committee Chairman Rodney Frelinghuysen (NJ-11) said the package “ensure[s] the safety of the homeland and the American people.” An effort from several Democrats, led by Representative Chellie Pingree (ME-1), to reverse the National Ocean Policy implementation funding prohibition was rejected 192-235.

    The post Minibus Leaves The Station appeared on Ocean Leadership: Policy & Legislation.


              Carson Perrie Boyd        
    1930's Department Store Window

         A month or so ago, I was working a style set at my store.  A style set is visually merchandising the store.  One of my jobs was to dress the mannequins in the windows...something I had never done before.  Fortunately, I had help from someone who had.   The visual manager came around to see how we were doing and exclaimed how good the windows looked.  Laughing, I responded, well my cousin WAS a window dresser in New York City back in the 1930's.

         I was never certain that this was not an apocryphal story or one based in some fact.  Frankly, after researching, I still don't know for certain; however, I did find a story to blog about.

         My Dad had several "family stories" regarding his mother's cousin, Carson VanGilder.  Checking my genealogy records, there was no Carson VanGilder in the tree; however, my Grams, did have a cousin named Carson Boyd. Apparently Dad figured all of his Mom's cousin's had to have the surname of VanGilder since she did...LOL  Carson was a VanGilder.  His mother, Sallie Ellsworth VanGilder married William Milroy Boyd.  Sally and my paternal great grandfather, George Ethelbert VanGilder were siblings.

         Carson, my first cousin, two times removed, was born in the Morgantown, West Virginia area on February 7, 1897.  Oddly, I was not able to locate a birth record for him.  He joined five brothers and sisters.  Six more siblings were added to his large family.

         My paternal great grand aunt Sallie seemed to chose family names as the middle name for her children.  I have yet to find out what family line Carson's is from. Perhaps it is a Boyd woman's surname. To be fair, I have not researched them.  I should also add, I have no idea where Aunt Sallie's middle name, Ellsworth, came from and she is in a tree where I have done decades of research ;-)

         The 1900 West Virginia Federal Census places the Boyd family in Morgantown and William Boyd is providing for his family as an oil rig builder.  Of interest to me:  the census enumerator is my paternal great grand father, George Ethelbert VanGilder.  He would be Uncle George to Carson. (Year: 1900; Census Place: Morgan, Monongalia, West Virginia; Roll: 1767; Page: 14B; Enumeration District: 0083; FHL microfilm: 1241767)



         Carson's World War I Draft Registration does list his birth date and place. He was employed in 1918 with the Jeannette Coal Company in Point Marion, Pennsylvania, not far from Morgantown.  He is listed as medium height, with grey eyes and brown hair.  (World War I Draft Registration Cards, 1917-1918).  According to the US Department of Veteran Affairs, Carson served from September 4 1918 to March 25, 1919 World War I as a private in the United States Army. (Beneficiary Identification Records Locator Subsystem (BIRLS) Death File. Washington, D.C.: U.S. Department of Veterans Affairs.)



         Following his service with the United States Army during World War I, Carson married Betty C. Craft in a wedding ceremony in Cumberland, Maryland on November 2, 1919.

         There is a listing on the 1920 West Virginia Federal Census for the newly weds.  C. P. Boyd and wife, Elizabeth.  They are living in Morgantown and he is employed as a laborer with a brick company.  The birth information for C. P. Boyd's parents is not correct; however if Elizabeth was the person the enumerator was talking with, she may not have known.  (Year: 1920; Census Place: Morgantown Ward 4, Monongalia, West Virginia; Roll: T625_1964; Page: 9B; Enumeration District: 107; Image: 1002)

        Carson and Betty had one child, a son, Carson P. Boyd, Jr., born February 6, 1921 in Connellsville, Fayette County, Pennsylvania. (Original data: Pennsylvania (State). World War II Veterans Compensation Applications, circa 1950s. Records of the Department of Military and Veterans Affairs, Record Group 19, Series 19.92 (877 cartons). Pennsylvania Historical and Museum Commission, Harrisburg, Pennsylvania)

         On April 2, 1925 there is a brief article regarding the divorce of Carson and Betty Boyd on page 7 of The Morning Herald, Uniontown, Pennsylvania.

         By 1929, Carson is listed as living with his mother and several siblings at 271 Stewart Street in Morgantown and employed as a clerk.  (Polk's Morgantown City Directory 1929-1930.)



         The 1930's brings me to "the story of interest" for Cousin Carson.  According to the 1930 New York Federal Census, he is living in Manhattan at 128 East 29th Street as a lodger in an apartment. Interestingly, the building still exists.  Carson is listed as divorced and employed as a salesman with a New York department store.  He is sharing the apartment room with a married couple who are both in theater.  How cool is that!  Fifty-eight year old H. McRae Webster a director and his wife, a thirty- two year old actress, Genevieve Webster.  From the census information this is not H. Webster's first marriage, although it could be Genevieve's.  (Year: 1930; Census Place: Manhattan, New York, New York; Roll: 1558; Page: 2A; Enumeration District: 1191; Image: 859.0; FHL microfilm: 2341293.)

         Harry McRae Webster, a well known and regarded writer, producer and stage and film director. (all director, writer and stage information taken from various Internet websites)    
    Director (17 credits)
     1914 The Devil's Signature (Short)
     1914 Seeds of Chaos (Short)
     1913 The Brand of Evil (Short)
     1913/IV The Boomerang (Short)
     1913 In Convict Garb (Short)
     1913 The Spy's Defeat (Short)
     1913/I The Broken Heart (Short)
     1912 The Girl of the Mountains (Short) (as Henry McRae Webster)
     1912 The Fall of Montezuma (Short)
     1911 His Friend's Wife (Short)
     1910/II Love's Awakening (Short)
     1910 A Fortunate Misfortune (Short)

    Hide  Writer (4 credits)
     1913 In Convict Garb (Short) (scenario)
     1913 The Spy's Defeat (Short) (scenario)
     1912 The Fall of Montezuma (Short) (scenario)

    Hide  Producer (2 credits)

    Broadway
    Angels Don't Kiss
    [Play, Comedy, Original]
    • Staged by H. McRae Webster
    Apr 05, 1932 - Apr 09, 1932
    Air Minded
    [Play, Comedy, Original]
    • Directed by Harry McRae Webster
    Feb 10, 1932 - Feb 1932
    The Fatal Wedding
    [Play, Comedy, Revival]
    • Directed by Harry McRae Webster
    Jun 02, 1924 - Jun 1924
    Lilies of the Field
    [Play, Drama, Original]
    • Staged by Harry McRae Webster
    Oct 04, 1921 - Feb 1922
    Lieut. Dick, U.S.A.
    [Play, Melodrama, Original]
    • Written by Harry McRae Webster
    Nov 20, 1905 - Closing date unknown 
         How exciting for Cousin Carson to be living with this exciting theatrical couple while working in NYC.

         Carson's mother, Sallie Ellsworth VanGilder Boyd, died in 1933.  How long he lived in New York City is unknown; however, there is a Morgantown City Directory for 1935, which lists Carson living at the Boyd home, 271 Stewart Street with his sister, Edna and father, William.  Carson appears to have continued living at the 271 Stewart Street address into the 1940's, employed as a salesman. 


         I do not know when Carson married Mary M. Tamasy, perhaps in the late 1940's or 1950's.

         There is a listing for Carson P. Boyd in the public records index as living at 410 North Water Street, West Newton, Pennsylvania.  Unfortunately the date of the listing is not available.  (U.S. Public Records Index, Volume 2)  

         At some point in time, Carson and Mary moved to Venice, Florida.

    Captured from Find A Grave
    Photograph by Kathi Lynn King
         
         On Find A Grave there is a photograph of the tombstone for Carson P. Boyd, listed as Carson Perrie Boyd and his wife, Mary M. Boyd in West Newton Cemetery, West Newton, Pennsylvania.  He died at the age of eighty seven, on September 7, 1985.  I was able to locate an obituary for his wife, Mary M. Boyd, nee Tamasy.  Mary was born on August 10, 1908 in Reduction, to Barney and Mary Tamasy.  She died on Feb 27, 2000 at the age of ninety three in Green Tree, Pennsylvania. No children were mentioned in the obituary.


    I WOULD LOVE TO HEAR FROM YOU. All comments are welcome; however, if they are inappropriate, they will not be published.    PLEASE post your e-mail in the comment section if you would like to network about a particular surname or topic. I will capture it for my use only and not include it when I publish your comment.
    © 2016, copyright Linda Hughes Hiser
    

              Charlotte VA Health Center Project Team Wins 2017 John L. Martin Award        

    CHARLOTTE, N.C. – The project team for the Department of Veterans Affairs’ Charlotte Health Care […]

    The post Charlotte VA Health Center Project Team Wins 2017 John L. Martin Award appeared first on Cambridge.


              Cambridge Healthcare Solutions Completes VA Healthcare Center in Butler, Pennsylvania        

    Butler, Pennsylvania – Cambridge Healthcare Solutions has completed development of a Department of Veterans Affairs […]

    The post Cambridge Healthcare Solutions Completes VA Healthcare Center in Butler, Pennsylvania appeared first on Cambridge.


                      


    Trump and civil rights

    A prominent family member of the late Dr. Martin Luther King, Jr. is defending President Donald Trump from attacks by Congressman John Lewis (D-GA.)



    “We have come a distance. We made progress. But there are forces in America trying to slow us down or take us back,” Lewis said Friday on low-rated CNN. “I think the person we have in Washington today is uncaring,” Lewis said, adding that he believes Trump “knows very, very little about the history and the struggle of the Civil Rights Movement.”

    That drew a sharp response from Dr. Alveda King, pro-life civil activist and niece of Martin Luther King.

    King says Trump is “leading the charge for civil rights today for the little unborn persons in the womb who have a right to live.”

    “He has surrounded himself with African-American leaders,” King said. “At the African-American museum, for example, he was knowledgeable of much of the history of African-Americans.”

    Lewis also believes the 2016 election was rigged with secret computers, and that Trump is not really the President.

    “I truly believe to this day that this election was rigged in his favor,” Lewis told low-rated CNN.

    SOURCE

    ****************************

    Disgraceful V.A. hospital in Manchester, N.H.

    The Trump team has made a start on sorting out the V.A. but they have decades of rot to correct

    This is what the US Department of Veterans Affairs says a four-star hospital looks like:

    One operating room has been abandoned since last October because exterminators couldn’t get rid of the flies. Doctors had to cancel surgeries in another OR last month after they discovered what appeared to be rust or blood on two sets of surgical instruments that were supposedly sterile.

    Thousands of patients, including some with life-threatening conditions, struggle to get any care at all because the program for setting up appointments with outside specialists has broken down. One man still hadn’t gotten an appointment to see an oncologist this spring, more than four weeks after a diagnosis of lung cancer, according to a hospital document obtained by the Globe.

    And when patients from the Manchester Veterans Affairs Medical Center are referred to outside specialists, those physicians are sometimes dismayed by their condition and medical history. A Boston neurosurgeon lamented that several Manchester patients sent to him had suffered needless spinal damage, including paralysis, because the hospital had not provided proper care for a treatable spine condition called cervical myelopathy.

    “Only in 3rd World countries is it common to see patients end up as disabled from myelopathy as the ones who have been showing up after referral from you,” wrote Dr. Chima Ohaegbulam , of New England Baptist Hospital, to a doctor at the Manchester VA in 2014.

    But this hospital, the only one for military veterans in New Hampshire, is just 50 miles from Boston. And it’s supposedly one of the better VA hospitals in the country. Late last year, in fact, the veterans affairs department raised Manchester’s quality rating from three stars to four, putting it in the top third of the entire VA system.

    Ratings can deceive. Inside the unassuming red-brick walls of the Manchester medical center is ground zero for an extraordinary rebellion led by doctors who say they have almost no say in how the hospital is run, lack tools to do their jobs, and witness chronic shortcomings in patient care. They say the four top administrators, only one of them a doctor, seem more concerned with performance ratings than in properly treating the roughly 25,000 veterans who go to Manchester for outpatient care and day surgery each year.

    So far, 11 physicians and medical employees — including the hospital’s retiring chief of medicine, former chief of surgery, and former chief of radiology — have contacted a federal whistle-blower agency and the Globe Spotlight Team to say the Manchester VA is endangering patients. The US Office of the Special Counsel, the whistle-blower agency, has already found a “substantial likelihood” of legal violations, gross mismanagement, abuse of authority, and a danger to public health, according to a January letter to one of the doctors who alleged wrongdoing.

    “I have never seen a hospital run this poorly — every day it gets worse and worse,” said Dr. Stewart Levenson, chief of medicine, an 18-year veteran of the hospital who is among the whistle-blowers. “I never thought I would be exposing the system like this. But I went through the system and got nowhere.”

    On Thursday night, a spokesman for Veterans Affairs Secretary David J. Shulkin expressed concerns about the problems relayed by the Spotlight Team.

    “These are serious allegations, and while we cannot comment on the specifics due to patient privacy issues, rest assured that we will look into them right away,” said the VA press secretary in Washington, D.C., Curt Cashour.

    Remarkably, leaders of the Manchester VA have confirmed many of the problems, from the fly-infested operating room — “an episodic issue,” said one administrator — to thousands of patients waiting indefinitely for specialist care, which the leaders blamed on the private company hired by the federal government to set up veterans’ appointments outside the hospital.

    In a recent hourlong interview with the Globe, hospital director Danielle Ocker and her chief of staff, Dr. James Schlosser, also acknowledged significant cuts in services, such as the elimination of cataract surgery, as well as administrative glitches that further limited care.

    For example: The hospital ordered a $1 million nuclear medicine camera in 2015 to replace a balky one, but never installed it because it was too big for the examination room. Without a reliable camera, the hospital in February stopped offering nuclear stress tests for heart disease risk, and bone scans that can detect tumors. The building is expected to be remodeled for a new camera in 2018.

    But Ocker and Schlosser expressed surprise that so many members of the medical staff have reported the hospital’s problems to federal investigators. They said the hospital is addressing shortcomings and that patient safety has not been compromised. Ocker, a nurse, contended that Manchester boasts “a zero infection rate” in the operating rooms — a hospital spokeswoman said the unblemished record dates back to 2011 — and shared a veteran’s recent letter praising Manchester VA care.

    Ocker also said she wanted medical staff to know that she and other leaders take their concerns seriously.

    “My feeling is that if there are issues that we need to address, or if there are concerns, that we need to hear about them,” she said.

    In many ways, the Manchester VA is under investigation because doctors became convinced that Ocker and other leaders were not listening. A number of problems date back years before Ocker arrived in 2015, and often reflected lapses in care that occurred when Manchester referred veterans to other VA hospitals or when multiple hospitals failed to coordinate follow-up treatment. But they are coming to the forefront now, in large measure, because one outspoken doctor went public about many patients that he believed had gotten subpar care. Patients like Robert McWhinnie.

    McWhinnie, a Korean War veteran who lives in the small New Hampshire town of Gilmanton, relied mainly on a wheelchair to get around when he first visited Dr. William “Ed” Kois, head of Manchester VA’s spinal cord clinic, in July 2016. McWhinnie, who was 84 at the time, had long been a vigorous man who built much of the furniture in his house from maple trees on his land. But then his legs and arms grew weak, he had difficulty talking, and he became incontinent.

    Kois immediately got alarmed when reading McWhinnie’s medical records.

    They showed that the retired telephone cable splicer had undergone two surgeries at the VA hospital in Jamaica Plain to remove a tumor from his spine in 1995 but that the surgeon could not remove all of it, according to a copy of the records that his family shared with the Globe.

    Over the next 21 years, McWhinnie went to the Manchester VA dozens of times for treatment of a variety of ailments. But no one had done imaging to find out if the tumor was growing again, even though regular monitoring was the standard of care after surgery on this type of tumor, according to his lawyer, Mark Abramson.

    At least as far back as 2007, McWhinnie was gradually losing the ability to walk, the records indicate, something that could have been caused by a tumor pressing on his spine.

    Kois “took one look at Bob, and he said, ‘Oh, my God, this is a disgrace. This man should have been taken care of,’ ” recalled McWhinnie’s wife of 63 years, Janice McWhinnie.

    So Kois ordered an MRI and an X-ray and, sure enough, the tumor was choking McWhinnie’s upper, or cervical, spine. It had also grown too big to remove.

    “They ignored him basically for 20 years and allowed this thing to grow and grow and grow,” said Abramson, who recently wrote the VA in Manchester and in Boston that his client intends to sue for negligence.

    Hospital officials declined to comment, citing potential litigation.

    For Kois, McWhinnie’s condition was sickeningly familiar. In his five years at the VA, Kois has compiled a list of at least 80 Manchester patients who were suffering from advanced and potentially crippling nerve compression in the neck, or myelopathy. Some, like McWhinnie, had undergone surgery at other VA hospitals and then relied on Manchester for subsequent care.

    Kois said he complained about the situation to administrators and other doctors. He even organized a September 2015 conference at Manchester, where he told a roomful of doctors and other VA staff that patients were getting substandard spinal care.

    Ocker herself gave introductory remarks at the conference. Yet, in the interview with the Globe, she said she only became aware of Kois’s concerns more than a year later when she heard that they were part of the federal investigation. She said she left Kois’s conference after welcoming guests and was never briefed on the content of his presentation.

    “I did not hear that,” she said of Kois’s allegations.

    Kois found a far more receptive audience the following year at the federal Office of the Special Counsel, which made his contentions about poor care a central part of its inquiry. After finding a “substantial likelihood” of wrongdoing, the office recommended a full-fledged investigation by the Veterans Affairs Office of Medical Inspector, which began in January.

    The VA medical care system, which is used by about 6 million military veterans each year, has been stumbling since 2014. News stories reported that the Phoenix VA Health Care System had engaged in an elaborate scheme to hide the fact that sick veterans were waiting months to see a doctor, and that some had died before they could be seen.

    As similar allegations surfaced at other VA hospitals and tens of thousands of veterans around the country were found to be waiting months for care, Veterans Affairs Secretary Eric K. Shinseki resigned.

    “I can’t explain the lack of integrity among some of the leaders of our health care facilities,” he said, shortly before stepping down.

    But Shinseki’s departure did not stop the drumbeat of scandal. Last year, nearly three dozen whistle-blowers charged that the VA hospital in Cincinnati had made budget cuts that forced out experienced surgeons, reduced access to care, and endangered patients’ safety. The head of the VA’s Ohio-based regional network then retired, and the Cincinnati hospital’s chief of staff was suspended and later indicted on criminal charges.

    Now President Trump’s appointee as VA secretary, Shulkin, is vowing to stabilize the health care system. “We are still in critical condition and require intensive care,” Shulkin said at a May press briefing. Last month, Trump signed a bill into law to make it easier for whistle-blowers to come forward and for employees to be fired for misconduct.

    SOURCE

    *******************************

    For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated),  a Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

    Email me  here (Hotmail address). My Home Pages are here (Academic) or  here (Pictorial) or  here  (Personal)

    ***************************



              Motor Vehicle Operator - Veterans Affairs, Veterans Health Administration - Montrose, CO        
    Employee is required to hold a valid state driver's license and meet all requirements necessary to obtain a government operator's license.... $18.08 - $21.10 an hour
    From Department of Veterans Affairs - Thu, 03 Aug 2017 03:06:41 GMT - View all Montrose, CO jobs
              Re: Looking for info on grandfathers fily        
    Vermont, Vital Records, 1720-1908 Birth, Baptism & Christening View Image
    Name: Clyde Nelson Beede
    Father: Walton Beede
    Birth: 16 Feb 1907 - Barre, Vermont, USA
    **
    Clyde Nelson Beede

    Vermont, Vital Records, 1760-2003

    birth:
    16 February 1907
    death:
    30 October 1972
    Hartford, Windsor, Vermont, United States
    (according to the death record, he was buried in Washington,Vt. Maple Hill Cemetery

    father:
    Walter Beede
    mother:
    Nellie Batchelder
    **

    U.S., Department of Veterans Affairs BIRLS Death File, 1850-2010
    - Clyde Beede
    Branch 1: ARMY
    Enlistment Date 1: 1 Feb 1944
    Release Date 1: 17 Oct 1944
    ~~~~~~~~~~~~
    Name: Clyde N Beede
    [Clyde Nelson Beede]
    Gender: Male
    Age: 21
    Birth Date: abt 1907
    Father: Walter
    Mother: Nellie
    Marriage Date: 14 Jul 1928
    Marriage Place: Washington, Orange, Vermont, USA
    Spouse: Sarah M Hayward
    Spouse Gender: Female
    Vital Event Type: Certificate of Marriage
    Cancel
    ~~~~~~~~

    Children listed for Clyde N & Sarah Beede:

    Name: Lillian Mary Beede,

    Richard Nelson, b. 1934

    Raymond,

    Mildred Louise, b. 1929, married Paul Benzie Carpenter, 27 July 1946
    Brattleboro, Vermont, United States

    Theodore Franklin , b. 1938

    Charlie , b/d. 1940

    James Frederick , b/d. as infant 1932

    Leo John, b. 1943

    female infant, b/d 15 Dec 1933
    ~~~~~~~~~~~~~~~~~~~~~~~



    Father of Clyde:

    Walter L Beede


    Vermont, Vital Records, 1760-1954

    birth:
    28 June 1872
    Orange, Orange, Vermont, United States

    father:
    Bliss D Beede
    mother:
    Roanna

    * the marriage record has his name as Walton Beede


    children of Walter & Nellie that I can find:

    Arthur, Archie, Clarence, Delmer, Earl John, Elmer, Ralph, Jesse Ray, Ivis Lydia,
    ********************

    Walton Luther Beede

    Vermont, Vital Records, 1760-1954

    birth:
    1872
    death:
    13 November 1933
    Washington, Vermont, United States

    father:
    Bliss Beede
    spouse:
    Nellie Batchelder
    **************

    Bliss D Beede

    Vermont, Vital Records, 1760-1954

    birth:
    1838
    death:
    15 July 1910
    Topsham, Vermont, United States

    father:
    Alnah Beede

    *
    Bliss D Beede

    Vermont, Vital Records, 1760-1954

    marriage:
    10 April 1867
    Orange, Vermont, United States

    father:
    Alvah Beede
    mother:
    Ruth
    spouse:
    Rosan E Philbrick

    mother:
    Ruth Carr
    Spouse's Father's Name: Samuel Smith
    Spouse's Mother's Name: Jennette
    ----
    hope this helps!!

              Mark Kirk And The Failure Of GOP Moderates        
    In this June 9, 2014, file photo, U.S. Sen. Mark Kirk R-Ill., speaks in his office in Chicago. In his fight to keep his Senate seat, Kirk has repeatedly criticized opponent Democratic U.S. Rep. Tammy Duckworth's service as director of the Illinois Department of Veterans Affairs. His latest attacks come [...]
              Why I am a Euro-optimist [Audio]        
    Speaker(s): Alain Juppé | At this time of mistrust towards the European Union, Alain Juppé reiterates his strong beliefs and his faith in Europe's future. A plea by a French statesman who has always been committed to the European enterprise. Alain Juppé was President of the political party Union for a Popular Movement from 2002 to 2004. He served as the Minister of Foreign Affairs from 2011 to 2012. He also served as Prime Minister of France from 1995 to 1997 under President Jacques Chirac and the Minister of Defence and Veterans Affairs from 2010 to 2011. He had previously served as Minister of Foreign Affairs from 1993 to 1995, and as Minister of the Budget and Spokesman for the Government from 1986 to 1988.
              Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 (S 1094) - Passage Passed - House        
    none
              Department of Veterans Affairs Accountability and Whistleblower Protection Act of 2017 (S 1094) - Passage Passed - Senate        
    none
              â€œPOOR AS WE ARE . . .”        
    The ruins of Manila in 1945, five years before the Philippines chose to defend South Korea in the Korean War.


    THE PHILIPPINES joined the Korean War despite having to contend with a communist-led rebellion and an economy crippled by the immense destruction wrought by the Second World War.

    The Philippine Army had nine out of its 10 Battalion Combat Teams (BCTs) and its lone artillery battalion fighting the communist-led Hukbalahap or Huks when the 10th BCT was selected as the first Korea bound combat unit on 23 August 1950. Together with other military units such as the Philippine Constabulary (the national police force), the government was holding the line against the Huks with some 25,000 men.

    The BCTs were highly mobile, compact and self-supporting battalion-size fighting units designed to operate independently of each other in their territories. They were organized specifically as anti-guerilla units and were successful in this role.
    Pres. Elpidio Quirino

    After World War 2, the Huks launched a rebellion aimed at overthrowing the democratically elected Philippine government and replacing it with a Marxist-Leninist state. The Huks had an armed strength of some 11,000 men in 1949, and many of their men were veterans of the guerilla war against the Japanese. The Hukbalahap, an acronym for the “Hukbo ng Bayan Laban sa Hapon” (the Anti-Japanese People’s Army), was probably the most potent of all Filipino guerilla units in the war.

    The strict discipline of its guerillas; the mobility and hitting power of its “squadrons” (units of 100 or more men) and the widespread support of civilians in Central Luzon allowed the Huks to inflict significant losses on the Japanese.

    During the American campaign against the Japanese in 1945, the Huks assisted the US Army in freeing towns and provinces in Central Luzon from the Japanese. In Tarlac, they raised both the Philippine and American flags after liberating the provincial capital. The Huk leadership took a Marxist-Leninist bent following widespread (and probably misguided) government suppression of the movement after the war.

    The Huks had superior knowledge of the terrain in North and Central Luzon, the main theaters of the guerilla war. They could also count on the support of a mass base of peasants and farmers alienated from the government by chronic landlord abuses, grinding poverty, bureaucratic neglect and military atrocities, particularly those committed by the Military Police and Civilian Guards. By 1952, the high watermark of their rebellion, the Huks had an active and armed strength of more than 170,000 men and women and a mass base of over two million people. The Huks were finally defeated by a combination of battlefield losses and a dwindling mass base in 1955.

    Elpidio Quirino, Philippine President in 1950, said the Philippines was sending its men to fight in Korea in fulfillment of the country’s obligation as a co-signer of the United Nations Charter. There was another, deeper reason for committing the Philippines’ limited military power to a foreign war. Korea was 1,600 miles away and a communist victory would probably have been a severe blow to the Philippines’ campaign against the ascendant Huks.

    “Poor as we are, this country is making a great sacrifice in sending you there (Korea), but every peso invested in you is a sound investment for the perpetuation of our liberty and freedom,” said Quirino to Filipinos who attended the farewell rally for the 10th BCT on 2 September 1950 at the Rizal Memorial Coliseum in Manila.

    1Lt Tommy Quirino, Pres. Quirino's son,
    fought in the Korean War.
    And the Philippines was poor. The national government was almost bankrupt in 1950, relying heavily on aid from the United States and reparations from Japan to stay afloat and to rebuild an economy shattered by the Second World War. Damage to industries was estimated at some P600 million while a further P800 million in assets were destroyed.

    The government was also plagued by massive bureaucratic corruption that, in 1950, siphoned off more than P1 billion in badly needed foreign aid. Despite these daunting realities, the Philippines committed its meager armed strength to aid Korea, and also offered to send combat troops to Nationalist China to deter a feared Communist Chinese invasion.

    Beginning a tradition of service to humanity
    PEFTOK began the Philippines’ noble tradition of providing military or humanitarian aid to nations in need.

    Since the Korean War, the Philippines has sent its soldiers, police and medical personnel to aid United Nations missions around the world. Filipinos were in the Vietnam War as the Philippine Civic Action Group (PHILCAG) that served in Tay Ninh province in South Vietnam and in Cambodia, among others.

    As of April 2010, the Philippines was the world’s 24th largest contributing country to UN peacekeeping operations. Over 1,000 Filipino soldiers and policemen serve in eight countries as members of the United Nations Department of Peacekeeping Operations (DPKO). Of the total number of Filipino peacekeepers, some 650 are from the Armed Forces of the Philippines (AFP) and 410 from the Philippine National Police (PNP).

    Among the countries and regions where Filipinos have kept the peace are Afghanistan, Burundi, Cambodia, The Congo, Cote d’ Ivoire, Darfur, Georgia, the Golan Heights, Haiti, Iraq, Liberia, Kashmir,  Kosovo, Nepal, Sudan and Timor-Leste.

    The Philippines will also expand its role in UN peacekeeping operations in coming years with the acquisition of more equipment for its security forces and by deploying more Filipinos abroad to support UN peacekeeping operations.

    Remembering our heroes of the Korean War
    Memory fails over time. Monuments exist so the memories of past greatness live on despite our frail human memories. Since the end of the Korean War in 1953, the Philippines has undertaken three other great efforts to enshrine the memories of its men who fought so valiantly in that war:

    * ON 4 AUGUST 2000, Pres. Joseph Estrada issued Presidential Proclamation No. 353 declaring September 7 and every year thereafter “Korean War Veterans of the Philippines Memorial Day.”

    * ON 25 JUNE 2005, the “Marikorea Monument” was unveiled at Marikina Heights, Marikina City. A project of the PEFTOK Veterans Association, Inc. (PVAI) and its President, the late BGen Bienvenido R. Castro, the Marikorea Monument and the “Korean War Memorial Pylon” at the "Libingan ng mga Bayani" honor our soldiers who served in Korea from 1950 to 1955.
    The Marikorea Monument.


    The word “Marikorea” was coined from the words Marikina and Korea. Before deploying to Korea, all five PEFTOK BCTs trained extensively for mountain combat in Marikina, whose rolling hills and rugged terrain resembled that of Korea. Castro said the Marikorea Monument filled a decades-old yearning by Korean War veterans for a monument to call their own.

    Standing some 20-feet tall, the monument is crowned by an eternal flame atop a granite pylon. Inscribed on metal plaques in the monument’s base is the history of the Philippines’ participation in the Korean War and unit histories of the five BCTs that served in Korea, all of which I wrote.

    * ON 29 MARCH 2012, President Benigno Simeon Aquino III inaugurated the "PEFTOK Korean War Memorial Hall" (PKWMH). Located insided the "Philippine-Korea Friendship Center" along Bayani Road inside Fort Bonifacio, PKWMH houses the Philippines' first Museum dedicated to the Philippines' role in the Korean War.

    It also consists of a library; auditorium; a roof deck and offices for the Museum staff and PVAI.

    I am proud to have written, laid out and provided the pictures for the history of the Philippines' role in the Korean War printed on all the large floor panels and part of the wall panels at the Museum.

    PKWMH stands on a 5,000 square meter prime lot donated by the Philippines. South Korea provided funds to build the entire complex inside the Friendship Center. An HRD Center operated by the Philippine government located inside the Friendship Center trains Filipinos for employment in South Korea.

    The PEFTOK Korean War Memorial Hall

    The Department of National Defense and the Philippine Veterans Affairs Office took charge of the Philippines’ role in building the Friendship Center. The Korea International Cooperation Agency (KOICA) was responsible for the South Korean contribution. South Korean firms began work on building the Friendship Center in 2010.

    The Memorandum of Agreement that gave rise to the Friendship Center was signed in May 2009 by former Ambassador Choi Joong-Kyung, former Secretary of National Defense Gilberto Teodoro, Jr. and the late BGen Victorino Azada, former PVAI President.

    Filipino veterans of the Korean War and World War II and visitors tour the PEFTOK Korean War Museum.

    * PVAI ALSO PUBLISHED TWO souvenir programs that were, in effect, mini-histories of PEFTOK and the Philippines’ involvement in the Korean War. I was honored to have been chosen to develop, edit and layout both magazines: the first published in September 2006 and the next in September 2008 to mark Korean War Veterans of the Philippines Memorial Day.

    The names of all Filipino soldiers who served in Korea from 1950 to 1955 are printed on panels at the Museum.

    The first was named “Honoring Democracy’s Forgotten Heroes” while the second carried the title, “Significant Filipino Battles of the Korean War.”





    PEFTOK Veterans Association, Inc. 
    The PEFTOK Veterans Association, Inc. (PVAI) is the only organization of our Korean War veterans.

    The main objective of PVAI since its founding on July 23, 1959 remains true to this day: to uplift, through self-reliance, the economic well-being of all PEFTOK veterans, their widows, orphans and dependents.

    PVAI’s other objectives are the preservation and maintenance of the PEFTOK Scholarship 
    Program for the descendants of PEFTOK veterans, and further enhancing the close relationship between Filipino and Korean war veterans and the local Korean community.

    The Republic of Korea funds the “Revisit Korea Program” (begun in 1975) that allows veterans and their families and descendants to return to visit the Republic of Korea.

    PVAI's office is located inside Camp Gen. Emilio Aguinaldo in Quezon City. Its phone number is 911-2579. Its email is peftokwarriors@gmail.com.


              Teaching Veterans Day (November 11)         
    On Veterans Day, we honor and thank those who have served in the U.S. Armed Forces. The Department of Veterans Affairs website includes useful materials for teaching about Veterans Day. Also, the following Annenberg Learner materials are available online for use in your classroom: Professor Donald Miller gives a personal view as he describes what life […]
              Trump cuts Homeless Vets Funding!!! Where are the "real" Americans?         
    Well, this is a not-so-new wrinkle for Republicans; the abandonment of veteran support for the sacrifice they made to their country, in particular, vet homelessness. 

    The car magnet myth pushed by Republicans for military families votes has now been exposed as a complete and cruel lie...but will they notice? Probably not:


    WISN: A letter from the Wisconsin Department of Veterans Affairs released Friday announced that federal funding for Cottage 16, which houses 28 homeless veterans in Union Grove, has been eliminated and that it will close in 2018.

    "As part of an ongoing evolution of federal housing programs, federal funding has been eliminated for our Veteran Housing and Recovery Programs (VHRPs) at King and Union Grove," the letter reads. "

    Veteran Kelly Manderfield completed three tours Iraq with the Wisconsin Army National Guard. He's coping with post-traumatic stress disorder and has been living at Cottage 16 for the past three months. He said he's working to get back on his feet and Cottage 16 is helping him do just that. 
    "It’s kind of devastating because there is talk about ending homelessness for vets and now they are closing down these programs. I don't know beyond Wisconsin how far the cuts are going but it's not good."
    President Obama desperately tried to support new housing and health alternatives for homeless veterans, but now it looks like Trump cut that too:
    Prevent and End Chronic Homelessness in 2017: President Obama’s 2016 Budget demonstrates his deep commitment to ending homelessness. The Budget makes investments needed to end chronic homelessness in 2017, make significant progress toward ending homelessness among families, children and youth in 2020,
    The Budget calls for the investments needed to end chronic homelessness in 2017. As part of an overall investment of $2.5 billion in HUD’s Continuum of Care (CoC) and Emergency Solutions Grant (ESG) Programs, the Budget calls for the resources to create 25,500 new units of permanent supportive housing—the proven, cost-effective solution to chronic homelessness. Shortfalls in the most recent budget passed by Congress have forced us to move the national goal to end chronic homelessness from 2015 to 2017.

              Where Do SGLT-2s Fit in the Treatment of Diabetes?         
    Host: Steven Edelman, MD
    Guest: Robert Henry, MD
    The potential benefits of a new class of medications, sodium-dependent glucose cotransporter-2 therapy (or SGLT-2s), for type 2 diabetes is promising, but where will they fit in the treatment of diabetes and what are the risks? Join host Dr. Steven Edelman and his guest, professor of medicine at the Veterans Affairs Medical Center in San Diego, California, Dr. Robert Henry, as they discuss the mechanism, benefits and potential cardiovascular risks of this new class of medication.
              Original Blog Entry: VA: 3 patients HIV-positive after clinic mistakes        

    VA: 3 patients HIV-positive after clinic mistakes

    By BILL POOVEY, Associated Press Writer6 mins ago

    CHATTANOOGA, Tenn. – Three patients exposed to contaminated medical equipment at Veterans Affairs hospitals have tested positive for  HIV, the agency said Friday. Initial tests show one patient each from VA medical facilities in Murfreesboro, Tenn.;  Augusta, Ga.; and  Miami  has the virus that causes AIDS, according to a VA statement.

    The three cases included one positive HIV test reported earlier this month, but the VA didn't identify the facility involved at the time.

    The patients are among more than 10,000 getting tested because they were treated with endoscopic equipment that wasn't properly sterilized and exposed them to other people's  body fluids.

    Vietnam veteran  Samuel Mendes, 60, said he was surprised to learn of an HIV case linked to the Miami facility, where he had a  colonoscopy. He was told he wasn't among those at risk.

    "I was hoping and expecting to not get anyone contaminated like that," he said. "It's probably a little worse than we thought."

    The VA also said there have been six positive tests for the  hepatitis B virus  and 19 positive tests for  hepatitis C  at the three locations.

    ....

    [ More ]


              New Health Clinic Combines Services For Veterans and Active Duty        
    A new health clinic opening on the former Fort Ord will serve both active duty military and veterans. It’s an early effort by the Department of Defense and Veterans Affairs to work together on health care.
              Service Dogs Working for Veterans Suffering from PTSD        

    Post-Traumatic Stress Disorder (PTSD) symptoms can be terrifying and utterly disruptive to the lives of the many people who suffer from it. People who have survived car accidents, victims of sexual abuse, and military veterans are all extremely susceptible to this socially crippling problem, which can cause extreme anxiety, nightmares, difficulty breathing, and even total isolation from society. A variety of therapies and medication can be used to treat the condition, each with varying degrees of success. A relatively new option that is having positive results in many instances is the use of working dogs to provide help and companionship for people suffering from PTSD symptoms.

    When more traditional forms of medicine fails, the use of PTSD service dogs, as they are sometimes called, can be a very effective form of treatment. This has been particularly successful in treating discharged members of the military. A non-profit program called K9s for Warriors specializes in matching people in need with a helping paw from man's best friend.

    These helpful and devoted creatures are specially trained to pick up on their owner's cues when they appear under distress and need support and comfort.

    “In the military, these warriors are never alone, but when they come back to civilian life, they feel like they can’t let their guard down. But a dog is always on alert and on guard. Having that buddy next to them allows them to relax." (Sandi Capra, director of development for K9s for Warriors)

    These dogs are also trained to provide a barrier between their owners and strangers when needed. For most sufferers of PTSD, this is a very comforting and reassuring feeling. Capra also adds that so far, 92 percent of her program's graduates are able to reduce their medications through the companionship of their working dog.

    Utilizing working dogs is still considered more of a supplemental treatment than a stand-alone option, and it is a fairly recent development in the field of PTSD treatment. However, studies are underway to test the positive effects of service dogs in this area. The results from these studies could go a long way in understanding the potential benefits of this concept and maybe even convince the U.S. Department of Veterans Affairs to start providing working dogs for veterans who need them.

    Wiredog is a proud manufacturer and distributor of dog supplies located in northeast Ohio. Wiredog specializes in service dog equipment. Visit our website today for more information on any of our top quality products. We would love to be able to assist you and your K9 companion.


              Re: Claire D Osborn 1916-1977. Looking for my family        
    Hi,
    Idaho restricts access to it's vital records but I did find information about Claire, his parents and siblings.

    In 1930 they lived in Jerome, Jerome, Idaho.
    Jess Osborn, b. IA, 47, general farmer.
    Frances S., wife, b. IA, 44.
    Virgin J., b. ID, 16.
    Edith E., b. ID, 15.
    D. Claire, son, b. ID, 13.
    Cleon P., dau, b. ID, 11/12.

    Claire D. Osborn
    Born: 1917, Idaho
    Residence: Twin Falls Co., ID
    Enlisted: 24 Jan 1944, Boise, ID
    Education: 4 yrs high school
    Civil Occupation: farm couples
    Marital Status: single without dependents
    Source: U. S. World War II Army Enlistment Records 1938-1946.

    His father Jess died Dec. 1948 in Twin Falls Co., ID. His obituary might say where Claire was living at that time or mention his wife. There are two obituary volunteers in Twin Falls Co. at freepages.genealogy.rootsweb.ancestry.com/~obitl/volid.html
    Scroll down to Twin Falls.
    Choose ONE volunteer at a time.

    His mother Frances died May 1976, Shoshone Co., ID. Contact Wallace Public Library, http://wallace.lili.org/node/69 for a copy of her obituary.

    His brother Virgil died Jan 1980 in Twin Falls Co.

    His sister Edith married Leonard V. Kennison on 9 Sept. 1945 in Cassia Co., ID
    Edith Residence: Burley, Cassia, ID
    Leonard Residence: Jerome Co., ID
    Source: Volume 6, p. 188, Western States Marriage Record Index.

    Edith E. Kennison
    Born: 3 Sept. 1914
    Died: 24 July 2002 possibly Jerome, Jerome, ID
    Source: Social Security Death Index

    There are two obituary volunteers in Jerome Co. at freepages.genealogy.rootsweb.ancestry.com/~obitl/volid.html
    Scroll down to Jerome Co. & choose ONE volunteer at a time.

    The obituary should list Kennison survivors and where they were living in 2002. Then I use spokeo.com or zabasearch.com to find current contact info.

    Claire Osborn
    Born: 21 Aug 1917
    Enlistment Date: 14 Feb 1944
    Release Date: 10 Feb 1946
    Died: 2 June 1977
    Source: U. S. Dept. of Veterans Affairs BIRLS Death File 1850-2010.

    Claire Osborn
    Born: 21 Aug 1917
    Died: June 1977 possibly in Rupert, Minidoka, ID
    Source: Social Security Death Index.

    There is an obituary volunteer at freepages for Minidoka Co. too.

    He might also have died in Emmett, Gem Co., ID. Idaho won't release death info until 50 years after the death so that's why I can't be sure where he died.

    Gem Co. also has an obituary volunteer at freepages. Successful Searching!
              What You Should Know About Preventable Harm        

    This post is a reprint of a piece from MHA@GW, the online master of health administration from the Milken Institute School of Public Health at the George Washington University.

     

    The Latin phrase “Primum non nocere” is familiar to all physicians: First, do no harm. Care providers do their best to avoid hurting people in the process of treating disease, but despite their best efforts, patients are sometimes harmed while undergoing medical care. Some harm is considered unavoidable, such as post-operative bleeding despite perfect surgical technique. Preventing other harm — harm due to mistakes — is a cornerstone in the movement to improve patient care and safety. This issue is serious. Up to1,000 patient deaths per day can be attributed to preventable medical errors. This means preventable harm is the third leading cause of death among Americans, behind only heart disease and cancer.


    What Is Preventable Harm?


    Lack of a clear, agreed-upon definition obfu¬scates a full understanding of the nature of preventable harm. Most working definitions include the idea that the harm is “identifiable” in that it can be attributed to medical care and “modifiable” in that it is possible to avoid. For the purpose of this article, we will be using TheInstitute for Healthcare Improvement definition of preventable medical harm as “Unintended physical injury resulting from or contributed to by medical care (including the absence of indicated medical treatment), that requires additional monitoring, treatment or hospitalization, or that results in death.” Defining preventable harm is important because some studies suggest that up to half of the harm patients experience in hospitals is not preventable or not the result of an identifiable error. In addition, there is conflicting evidence regarding the prevalence of preventable harm.


    Eliminating preventable harm is certainly a desirable goal, but, in practice, it may not actually be possible. The sad fact is, while harm may be “preventable,” a certain level of harm is considered inevitable because health professionals, like everyone, make mistakes. Hospital-acquired infections, misdiagnosis, wrong surgeries, medication errors, in-hospital falls and burns, some cases of deep vein thrombosis, surgical site infections and bedsores are common examples.


    Most Common Types of Preventable Harm

     

    Type of Harm Explanation Prevalence/Incidence
    Hospital-Acquired Infections Hospital-acquired infections are caused by bacteria, viruses or fungal agents. Common types include blood stream infections, pneumonia, surgical infections, urinary infections and methicillin-resistant Staphylococcus aureus (MRSA). A Centers for Disease Control and Prevention survey found that, on any given day, an estimated 1 in 25 hospital patients are affected by a hospital-acquired infection.
    Surgical Error - Wrong Site Surgery Wrong site surgeries include performing surgery on the wrong side or site of the body, performing the wrong surgical procedure and performing surgery on the wrong patient. An Agency for Healthcare Research and Quality study that analyzed information from nearly 3 million operations between 1985 and 2004 discovered a rate of 1 in 112,994 cases of wrong-site surgery.
    Medication Errors Medication errors include prescribing errors, dispensing errors, medication administration errors and patient compliance errors. Somewhere between 3 and 6 percent of patients experience medication errors every year.
    In-Hospital Injury Most in-hospital injuries are the result of falls. Rates of falls in U.S. hospitals range from 3.3 to 11.5 falls per 1,000 patient days. 
    Misdiagnosis  

    There are three types of medical misdiagnosis:

      • False positive: misdiagnosis of a disease that is not actually present.
      • False negative: failure to diagnose a disease that is present.
      • Equivocal results: inconclusive interpretation without a definite diagnosis.
    No reliable data is available on misdiagnosis. Available studies vary widely in their conclusions. 
    Deep Vein Thrombosis DVT is a blood clot that forms deep in the body, often in the lower leg or thigh. When a blood clot breaks off, it can travel through the blood stream and block blood flow in the lungs, heart or brain, resulting in an embolism. Risk for DVT is greater when in the hospital because major surgery and immobility can both cause DVT.  A Centers for Disease Control and Prevention study found the estimated annual hospitalization rate for DVT at 547,596 from 2007 to 2009. It is unknown how many of those cases were preventable. 

     

    What Are the Costs?


    The human toll of preventable harm is staggering. The most cited statistics come from a famous 1999 report by the Institute of Medicine (IOM) â€œTo Err is Human.” This report, one of the first of its kind to bring hard science to the study of preventable harm, shocked readers by reporting 98,000 people die every year due to preventable adverse events. While many still quote this figure today, newer, similarly rigorous studies estimate the actual prevalence of preventable harm to be much higher — between 210,000 and 440,000 instances per year.


    Besides the toll preventable harm takes on human life, ample evidence suggests medical errors cost health consumers billions of dollars each year. A 2012 study broke down these costs into additional medical bills ($17 billion), increased mortality rates ($1.4 billion) and lost productivity ($1.1 billion). If we include the indirect costs of preventable harm, the economic impact could easily reach $1 trillion annually. It should be noted that these cost analyses are based on the incident numbers provided by the IOM’s “To Err Is Human” study — if these calculations were redone using the higher numbers reported by more recent studies, the resulting costs would be up to 10 times higher.


    Preventable harm also levies an emotional toll on everyone involved. Treating instances of preventable harm means doctors have patients under their care for a longer period of time, nurses have more patients, and resources get stretched — creating an environment that could produce more instances of harm and a loss of morale. Family, friends and caretakers are affected as they put extra time and effort into helping loved ones recover. Finally, patients take more time off from work, school and other activities they enjoy in order to fully regain health.


    What Can Be Done to Prevent This from Happening?


    In order to prevent harm, administrations, governing bodies and professional organizations do their best to develop evidence-based guidelines and best practices to raise the standard of care. When things go wrong, it is typically multifactorial and involves a systematic or human error (and sometimes both). Systematic safeguards are typically in place to prevent human error. So systematic failures, such as dysfunctional teams, lack of resources, bad communication, poor health administration, disregard for safeguards and checklists, or malfunctioning technology often predicate and facilitate human errors such as lack of knowledge or skill, caretaker fatigue and technical mistakes. Continuous monitoring of adverse events, along with working to update policies and safeguards, is the best defense against repeated adverse medical events.


    As we develop new treatments and safeguards, what seems inevitable today can be preventable tomorrow. How do standards of care get developed and put into practice? Lets look at a common example: An elderly patient falls getting out of her hospital bed to go to the bathroom. The patient requires further care to set her arm and prevent infection, and she does not leave the hospital until several days past her original discharge date. After getting back home, friends and family must monitor her and assist her with every day tasks.


    Back at the hospital, a team of health care providers and administrators investigate if an intervention on their part would have prevented the patient’s fall. Was the nursing staff spread too thin to respond to her call promptly? Should she have been fitted with a catheter or bedpan? Was the floor wet? Was she given non-slip socks? There are three possible outcomes to such an investigation: (1) they could find that the current standards of care would not have prevented the fall and modify them as a result; (2) they could find there were reasonable safeguards in place but they were not followed; (3) they could find there was no way to prevent the incident in the first place.


    The hospital’s analysis finds that while all current safeguards were adhered to, no one discussed the high risk of falls with the patient, and the patient did not consider herself at a high risk for a fall. To prevent this from happening in the future, an additional safeguard was put in place where the nurse on duty communicates with the patient about the danger of hospital falls and encourages her not to leave her bed without assistance.


    There are many resources available to those looking to reduce the number of adverse medical events. Many nonprofits, health organizations and governmental organizations work to provide both the public and the medical community with the latest and greatest in health care innovations. In addition, it is important that we educate the next generation of doctors, nurses and health administrators to understand the gravity of preventable adverse medical events and encourage innovation in finding solutions.


    Additional Resources


    National Patient Safety Foundation 

    A 501(c)(3) nonprofit, the National Patient Safety Foundation (NPSF) has been a central voice for patient safety since 1997. NPSF organizes Patient Safety Awareness Week and offers resources for patients, families and health care professionals.

    Synensis 

    Synesis is a Georgia-based consulting company that works with hospitals to help them pursue “zero preventable harm.” Their clients include the Mayo Clinic, Inova Health System and the United States Department of Veterans Affairs.

    Patient Safety Movement 

    Founded by Joe Kiani, the Patient Safety Movement calls on hospitals, physicians and medical device companies to make pledges to reduce preventable harm. Massachusetts General Hospital, Baylor Scott and White Health Care System, and GE Healthcare are among the health care organizations that aspire to reach zero preventable harm deaths by 2020.

    National Quality Forum 

    The National Quality Forum (NQF) is a “not-for-profit, nonpartisan, membership-based organization that works to catalyze improvements in health care.” In 2012, NQF endorsed the implementation of 26 patient safety measures related to medical errors.

    Patient Safety America 

    Dr. John T. James, the former chief toxicologist for the National Aeronautics & Space Administration (NASA), created Patient Safety America. He started the organization after his son died in 2002 as a result of what he describes “as uninformed, careless and unethical care by cardiologists at a hospital in central Texas.” A National Hospitalized Patient Bill of Rights is among the organization’s policy goals.

    Beth Israel Deaconess Medical Center 

    Beth Israel Deaconess Medical Center is a model of hospital transparency. Its website provides up-to-date preventable harm statistics by injury type and detailed accounts of how it is working to address those issues.

    Hospital Safety Score 

    Founded by the Leapfrog Group, Hospital Safety Score assigns safety scores to nearly 2,500 hospitals around the country. The scores allow patients and families to understand how reliably a particular hospital delivers safe care from the correct use of antibiotics to the frequency of employee hand washing.

    Partnerships for Patients 

    Spearheaded by the Center for Medicare and Medicaid Services, the Partnerships for Patients is a collaborative effort between health providers and federal and state governments to make hospitals safer.

    Gordon and Betty Moore Foundation 

    Through its Patient Care Program, the Gordon and Betty Moore Foundation spent $49 million in 2013 on projects that “eliminate preventable harms and unnecessary heath care costs.” Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, and the University of California, San Francisco, were among its grant recipients.

    IHI Global Trigger Tool 

    The Global Trigger Tool allows researchers to comb for triggers or clues to “measure the overall level of harm within a health care organization.”

     



              If I Knew Then What I Know Now: Research As Reflection        

    Christina Vair, PhD, is the 2013 CFHA Fellowship Award recipient. Below is her reflection on her research project.

    As the old saying goes, “hindsight is 20/20.”

    With the 2014 CFHA conference nearly upon us, I cannot help but think back on last year’s conference, in particular, my receipt of the 2013 CFHA Fellowship Award. In doing so, I have found that oft used phrase referenced above coming to mind regularly. Looking back over the course of this past year, I appreciate how this particular project was inspired by and, in many ways encapsulates, my own professional journey. Though I am certainly excited to present the findings of my study on advanced psychology trainees’ perspectives on preparation for practice in integrated care settings, this forum grants me the unique opportunity to reflect on the process of conducting this research, rather than just the outcome. Through undertaking this project, I have been provided with an opportunity to reflect on my own learning over the last several years and contemplate where I’m headed in the future.

     

     

    My interest in developing an academic understanding of the primary care psychology trainee perspective is rooted in my own personal training experiences. I first stumbled into the world of integrated care during my last year of graduate school.  Though I was quite naïve to the concept of integrated care at that time, I was none-the-less tasked with providing brief assessment and treatment to older adults attending a day heath care program. What might have simply been a one-time, “been there done that” training experience touched off a desire to develop a career as a psychologist in integrated care. This was the first time in my training as a psychologist that I felt as if things really “clicked” for me. The whole person, patient-centered approach to care, the consideration of the interrelationship between mental and physical health, and the dynamic, team-based approach resonated with me on many levels.   

    From that first experience, I was hooked. I had found my professional “home.” Next came an internship with emphasis in behavioral medicine, then a postdoctoral fellowship focused on primary care-mental health integration with the Department of Veterans Affairs Center for Integrated Healthcare. These increasingly focused opportunities further opened doors that solidified my dedication to integrated care, and in turn, my desire to learn more about what other trainees like me were experiencing in their journeys into primary care psychology.  As the intensity of my training increased, I found myself regularly wondering how other trainees found the path to primary care psychology, whether they too intended a career in this field, and what they needed to succeed in this pursuit. These questions set the stage for my research proposal to investigate the trainee perspective, particularly as a review of the literature on training models for behavioral health providers in integrated care appeared to lack this consideration.

    I found myself thinking, "what if I knew then what I know now?" 

    Flash forward to a year later. A survey was designed, distributed nationally, piloted along with the Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ)1, a recently developed measure of fidelity to model adherent behaviors in providing mental and behavioral health care in integrated care settings. Responses from across the country trickled in, and a data set was born. Analyses were undertaken, and various themes emerged. All the while, with each iterative step, I found myself learning new and different things.  I found myself thinking often about my own professional path, and wondering, “what if I knew then what I know now?” 

     

    One particularly salient response that I found myself pondering in relation to that question was a desire to learn to embrace the inherent challenge of having dual identities. One particular duality that sprang to mind was how to balance being both a clinician and researcher. Though I had been training as a “scientist-practitioner” since graduate school, conducting this study was truly the first time that I authentically felt like a “scientist” thus far in my career. Within scientist-practitioner programs, students are theoretically taught to equally value clinical practice and research, and to appreciate the reciprocal and potentially mutually beneficial relationship between the two. Though internship had helped me feel as if I had developed solid clinical “muscle,” my sense of identity as a scientist was comparatively puny. I found that I had learned to “walk the walk” as a clinician, but was not yet comfortable in my ability to “talk the talk” of a clinical scientist. 

    Having had several rich opportunities to explore assorted supportive roles on research teams prior, this project represented my first foray into the role of a principal investigator. Up until this point, I had learned the basics of integrated care in a mostly experiential manner, and found my knowledge wanting in regard to the theory behind the practice. Delving headlong into the scholarly literature on training models, core educational components, and the development of competencies for practice in primary care psychology provided a solid foundation for learning the language of integrated care. Understanding and adopting this lexicon has facilitated my ability to not only articulate more thoughtfully and concisely what it is I “do” as a psychologist in primary care, but has also helped me define where I see myself going in the future. Further, exploring and engaging with this literature has also helped me develop an awareness of the gaps in my own training thus far, and presented the opportunity to develop goals to address the areas in which my own competence lags.

    This lexicon helped me define where I see myself in the future 

     

    So where do I go from here? How do I use what I have learned from this experience to move forward, to continue to develop as an integrated scientist and clinician, and help shape the field of primary care psychology? Research is of little use if it’s not disseminated. Then of course every good study has a “Future Directions” section. 

    As another old saying goes, “the journey of a thousand miles begins with a single step.”      

     

    References 

    1. Beehler, G. P., Funderburk, J. S., Possemato, K., & Vair, C. L. (2013). Developing a measure of provider adherence to improve the implementation of behavioral health services in primary care: A Delphi study. Implementation Science, 8(19). doi:10.1186/1748-5908-8-19

     

    Christina L. Vair, PhD is a licensed clinical psychologist with the Center for Integrated Healthcare (CIH) at the VA Western New York Healthcare System (VAWNYHCS) in Buffalo, NY.  Prior to her current role as a clinical researcher, she completed a two-year postdoctoral fellowship with the VA Advanced Fellowship Program in Mental Illness Research and Treatment (MIRECC) with the CIH that focused on improving the health of veterans through enhancing primary care-mental health integration. During her post-doc and internship with the VAWNYHCS, Dr. Vair provided mental and behavioral health services in primary care, chronic pain management, behavioral medicine, and long-term care. Dr. Vair earned both her MA and PhD in clinical psychology with emphasis in Aging and Geropsychology from the University of Colorado, Colorado Springs. Her research interests including exploring mental health concerns of the aging population within the primary care (PC) medical setting, dementia screening and treatment in PC, and improving the implementation of primary care-mental health integration through provider training, fidelity assessment, and the utilization of measurement in guiding care.  


              Robert Blanche, MD        
    Robert Blanche is an internal medicine physician who practices at La Clinica’s West Medford Health Center. He joined the organization in 2015. He is a former physician for the U.S. Department of Veterans Affairs, Southern Oregon Internal Medicine, and the Southern Oregon Health Trust. Dr. Blanche earned his doctorate from Wake Forest University in Winston-Salem, […]
              Food Service Worker - Veterans Affairs, Veterans Health Administration - Prescott, AZ        
    Following label directions in using cleaning or disinfecting/sanitizing agents. Technical practices (theoretical, precise, artistic).... $10.80 - $12.61 an hour
    From Department of Veterans Affairs - Thu, 27 Apr 2017 10:28:39 GMT - View all Prescott, AZ jobs
              Farris, Riley & Pitt, LLP to Help Local Veterans for National Day of Action        

    To help do its part, Farris, Riley & Pitt, LLP has teamed up with the U.S. Department of Veterans Affairs and Guiltless Giving to show support to homeless veterans in the local community by volunteering time to the Birmingham VA facility as part of a nationwide community outreach event — known as the Injury Board Day of Action (#IBDayofAction).

    (PRWeb October 28, 2014)

    Read the full story at http://www.prweb.com/releases/2014/10/prweb12281610.htm


              Understanding our heroes: HCC hosts conference to serve needs of veteran community        
    The HCC Office of Veterans Affairs/Counseling & Disability Support Services and the Center for Deployment Psychology (CDP) recently presented the UC4 (University Counseling Center Core Competency) Conference at the HCC administration building.
              Grand opening of Veterans Affairs Resource Center Set for August 14th at HCC Central        
    HOUSTON, TX [July 28, 2014] – Members of the nation’s armed forces in Houston will soon have a new place through which they can streamline their access to higher education and alleviate many of the issues they may encounter as they resume civilian lives.