Category Archives: Veterans

The State Paid Nearly $28 Million for a Flawed System That Fails to Meet the Needs of Its Veterans Homes

Source: California Department of Veteran Affairs, Report 2015-121, June 2016

Our audit concerning the development and implementation of the California Department of Veterans Affairs’ (CalVet) Enterprise-Wide Veterans Home Information System (system) revealed the following:

  • The system has not improved the efficiency of the homes’ process for documenting medical care nor has it reduced reliance on paper because of system flaws.
  • System instability and concerns about functionality resulted in CalVet implementing fewer system functions at some homes, thereby limiting CalVet’s ability to provide more efficient care for veterans. …
  • CalVet did not exercise adequate oversight of its system project. It did not complete or partially completed six of the 12 required management oversight plans to ensure effective project management. It hired one contractor to provide both independent project oversight and independent verification and validation services, and those services were inadequate.

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Fix For VA Health Snarls Veterans And Doctors In New Bureaucracy

Source: Quil Lawrence, Eric Whitney, and Michael Tomsic, Kaiser Health News, May 16, 2016

Veterans are still waiting to see a doctor. Two years ago, vets were waiting a long time for care at Veterans Affairs clinics. At one facility in Phoenix, for example, veterans waited on average 115 days for an appointment. … Congress and the VA came up with a fix: Veterans Choice, a $10 billion program. Veterans received a card that was supposed to allow them to see a non-VA doctor if they were either more than 40 miles away from a VA facility or they were going to have to wait longer than 30 days for a VA provider to see them. The problem was, Congress gave them only 90 days to set up the system. Facing that deadline, the VA turned to two private companies to administer the program — helping veterans get an appointment with a doctor and then working with the VA to pay that doctor. … Wait times have gotten worse. Compared to this time last year, there are 70,000 more appointments where it took vets at least a month to be seen, according to the VA’s own audit. …

… This is playing out in a big way in Montana. That state has more veterans per capita than any state besides Alaska. … Hospitals, clinics and doctors across the country have complained about not getting paid, or only paid very slowly. Some have just stopped taking Veterans Choice patients altogether, and Montana’s largest health care network, Billings Clinic, doesn’t accept any VA Choice patients. … The delays have become a frustration within the VA, too. Tymalyn James is a nurse care manager at the VA clinic in Wilmington, North Carolina. She said Choice has made the original problem worse. When she and her colleagues are swamped and refer someone outside the VA, it’s supposed to help the veteran get care more quickly. But James said the opposite is happening. …

Editorial: Fix formula for privatization

Source: Lansing State Journal, February 19, 2017

The State of Michigan has nearly 1,700 privatization contracts. Undoubtedly, many of them are beneficial for taxpayers and for government. But not all privatization makes sense, which is why there is a process by which the Civil Service Commission determines whether privatization will result in significant savings. What happens, however, if the state’s system of vetting privatization opportunities relies on faulty math? In the case of several Michigan contracts, the projected savings don’t even come close to the actual realized savings. A Lansing State Journal analysis of 23 privatization deals approved last year showed the state saved nearly $61 million less than projected. That’s because the current formula is flawed, allowing agencies to include savings on retirement debt. The catch, however, is that debt must be paid whether the jobs remain with the state or move to a contractor. … The cost of the state’s pension and health care liabilities is a problem independent of privatization of services. But the fact that current calculations tip the scales in favor of privatization is troubling. The state, and Civil Service Commission by proxy, must make decisions in the best interests of taxpayers on the issue of privatization. That review must begin with a formula that makes sense – one that acknowledges long-term retirement costs don’t go away when state jobs do.  Privatization is not bad. Neither are state-worker jobs. It’s incumbent on the state to use clear, defensible metrics to determine which option is best in each circumstance.  The current formula is broken. Michigan must fix it.


Michigan’s privatization savings overstated
Source: Justin A. Hinkley, Lansing State Journal, February 17, 2017

State guidelines on privatization allow agencies to count savings on retirement debt that has to be paid whether or not the jobs are outsourced. If that debt were not factored in, a State Journal analysis showed three contracts OK’d by the state Civil Service Commission last year — worth more than $92 million — would never have been approved because they didn’t actually save enough money to meet the commission’s threshold for privatization. Those contracts affected 265 state-worker jobs. The State Journal analysis was based on what Roland Zullo, a University of Michigan researcher working with state-employee unions on this issue, said is the more accurate calculation.

Using Zullo’s method, the State Journal analysis showed the 23 privatization deals approved last year saved nearly $61 million less than what state officials reported, though most contracts still would have saved enough taxpayer money to be approved. No state employees were laid off through privatization last year; many of the 23 deals approved last year were re-analyses of previously approved outsourcing. That’s because, when Civil Service compares the cost of state employees against the cost of a potential contract, it includes on the state employees’ tab what the government pays into its employee pension system, which was closed to new hires starting in 1997. However, as the Senate Fiscal Agency explicitly warned in a 2013 white paper, the debt to that system “must be funded regardless of whether employees remain directly hired by State or local government, or privatization occurs.” Currently, Civil Service guidelines claim privatization saves departments about 50 cents of retirement costs for every $1 in state employee wages. Zullo says the true savings is only 9 cents on the dollar, the amount the state chips in to employees’ 401(k) plans and retiree health care. Only one employee affected by the 23 deals approved in 2016 was on a pension plan. …

Opinion: Privatization does not Work
Source: Ron Bieber, Michigan AFL-CIO President, Detroit News, March 9, 2016

Six years ago, Republicans swept into Lansing after promising to “make government run like a business.” It was a catchy slogan. The trouble is, we as voters didn’t do such a great job asking hard questions about what running government like a business actually meant. For Gov. Rick Snyder and the Republican-controlled Legislature, it meant privatizing vital public services in our schools, prisons and a state-run home for veterans. The goal of privatization, we were told, was to save taxpayers’ money. The truth is the state’s two biggest experiments with privatization have been huge failures.

First came the prison food contract with Aramark. The trouble started when the Legislature rigged the bidding process by giving Aramark a do-over after its initial bid came in too high, allowing it to low-ball competitors. The state approved Aramark’s contract even though it had a terrible track record — including a prison riot in Kentucky and rampant contract violations in Florida. Then came a steady stream of horrible news. There were persistent food shortages, maggots repeatedly found in food, drug smuggling, sexual contact with inmates and even a murder-for-hire plot. …

What happened at the Grand Rapids Home for Veterans was even worse. In 2011, the governor and Legislature privatized 150 nursing assistant jobs and awarded the contract to J2S, a company founded by two brothers — Tim and Chris Frain — who had no background in health care. The complaints of chronic staff shortages started immediately. One former J2S employee told a local TV station “there definitely were times where a member would sit in their urine or feces for extended periods of time because we were shorthanded.” A scathing report from the auditor general last month found employees routinely failed to respond to alarm checks, and J2S failed to investigate complaints of abuse and neglect. …

Unfortunately, Lansing Republicans might not have learned their lesson yet. Right now lawmakers are considering legislation to privatize mental health services, making it harder for people to get access to needed treatments and medications. This would be a big handout to insurance companies, and it’s another privatization disaster waiting to happen.

Bush wants to privatize some veterans’ health benefits, but in Florida it didn’t go so well

Source: Chris Frates, CNN, May 1, 2015

Jeb Bush’s effort as governor to partially privatize veterans health care services in Florida went so poorly it was ended shortly after Bush left office. That hasn’t stopped the former Republican governor, now in the early stages of running for president, from arguing veterans should be given the choice to see a public or private doctor, with either visit being paid for by the government. …. But Bush’s experience outsourcing veterans’ nursing homes in Florida was a case study in privatization’s pitfalls. By the time it was over, Florida officials determined the state could provide higher-quality care at a better price for taxpayers. …. In 2001, the state opened a veterans’ nursing home in Pembroke Pines, Florida, that contracted out its nursing and food services to a private company. The contract went to PhyAmerica. The company’s chief executive, a major donor to Florida Republicans who gave to Bush’s campaign, lost control of the company in 2003 after it went into bankruptcy, according to news reports.
Two similarly operated facilities were open in Florida by 2004. By then, the Pembroke Pines facility was already having problems. It was placed on the state’s list of facilities providing substandard care and ranked in the bottom 20 percent of facilities in its county, the Fort Lauderdale Sun-Sentinel reported then. In one incident, the nursing home was cited after inspectors pulled the records of 10 patients and found nine were not being properly cared for, leaving them at risk for falls and accidents, according to the paper. One patient fell repeatedly before nurses found him on the floor with a half-inch deep gash over his eye. An Alzheimer’s patient escaped from a window before being spotted by staff, the paper reported……
Veterans’ Nursing Home Under Scrutiny
Source: Diane C. Lade, Sun-Sentinel, September 27, 2002

Flags flew brightly and old soldiers proudly snapped to attention on a breezy January morning as Gov. Jeb Bush dedicated the new Sandy Nininger State Veterans Nursing Home in Pembroke Pines — the long-awaited dream of local veterans who lobbied for years to bring long-term care closer to home. Twenty-one months later, Nininger is on the state’s latest Nursing Home Watch List of facilities providing substandard care. The state’s Agency for Health Care Administration online reports show that from March through July, Nininger had 29 deficiencies involving residents’ rights, privacy, care and management, as well as three safety code violations. The most serious came during a March 26 inspection, when Nininger was cited for failing to properly monitor nine out of 10 residents whose records state inspectors examined, putting them at risk of falls and accidents….

Florida takes over care at 3 nursing homes
Source: BY SCOTT ANDRON, Miami Herald (FL), Wed, Aug. 13, 2008

The state is taking over direct management of nurse’s aides and food workers at three veterans’ nursing homes, including one in Pembroke Pines. The 208 employees now work for a contractor, North Carolina-based PhyAmerica Government Services. But as of Aug. 29, PhyAmerica is laying them off, according to a notice filed Tuesday with the state labor department. ….. The PhyAmerica employees can apply for the new state jobs, said Courtney Heidelberg, a spokeswoman for the Florida Department of Veterans Affairs. …… ”It’s more cost effective, it’s better quality of care for our residents, and our employees get better benefits,” she said.

Inspectors general feud over VA official’s alleged contract steering

Source: Josh Hicks, Washington Post, Federal Eye blog, March 16, 2015

Two federal watchdogs are feuding over the legitimacy of a scathing report last year on questionable contracts at the Department of Veterans Affairs, causing a rare rift between government accountability offices. Treasury Department Inspector General Eric Thorson issued a letter to House Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.) last week contesting findings of misconduct by former VA procurement officer Iris Cooper, now a top contracting official with Treasury. A report last year from VA Inspector General Richard Griffin accused Cooper of steering $15 million in contracts to a friend’s company and ensuring that the deals would be non-competitive. It also alleged that she showed a “lack of candor” with investigators. Thorson said the conclusions are unsupported, adding that they appear to have been influenced by a VA contracting official who wanted to settle a score with Cooper for alleging that he created a hostile work environment. Five witnesses said the other VA official boasted of his ability to sic the inspector general on “anyone he wanted,” according to the letter….

For-profit colleges gouging veterans, U.S. Senate report finds

Source: Jerome R. Stockfisch, Tampa Tribune, August 18, 2014

On the heels of a student veterans group’s warning, a U.S. Senate report reveals the extent to which for-profit universities benefit from the federal G.I. Bill program. For-profit schools received $1.7 billion in veterans’ benefits during the 2012-13 academic year, 41 percent of all G.I. Bill dollars and almost as much as the cost of the entire program just four years earlier, according to the majority report of the Senate Health, Education, Labor and Pensions Committee released July 30. While overall enrollment at for-profits has declined nationally, enrollment of veterans in those schools has soared — from 61 percent to as much as 657 percent at the eight top for-profit G.I. Bill beneficiaries. Those eight schools received 23 percent of all G.I. Bill benefits last academic year. …
Is the New G.I. Bill Working?: For-Profit Colleges Increasing Veteran Enrollment and Federal Funds
Source: United States Senate, Senate Health, Education, Labor and Pensions Committee, Majority Committee Staff Report, July 30, 2014

From the press release:
Two years after a landmark investigation into the for-profit college industry revealed a host of serious problems, including poor student outcomes and high debt burdens, a new report by the majority staff of Chairman Tom Harkin’s (D-IA) Senate HELP Committee shows that for-profit colleges are collecting billions of taxpayer dollars from veterans using their Post-9/11 G.I. Bill benefits. Although overall student enrollment has decreased at each of the eight top for-profit Post-9/11 G.I. Bill beneficiaries, their enrollment of veterans has dramatically increased—anywhere from 61 to 657 percent—during the same period.

The Post-9/11 G.I. Bill, which went into effect in 2009, provides veterans with up to $19,200 a year in education benefits for four years. The HELP Committee’s new report raises concerns, given that the previous Committee investigation revealed that many for-profit schools utilize aggressive and often questionable marketing and recruiting tactics, provide programs of questionable value, and often cost far more than comparable programs offered at public schools. These findings have provided the underpinnings of a nationwide series of investigations and lawsuits by dozens of state Attorneys General and federal enforcement agencies….

Amid backlogs, vets can seek private primary care docs

Source: Patricia Kime, Military Times, August 14, 2014

Veterans waiting for a primary care appointment at a VA medical facility may now be able to get one at a private physician under a program that allows veterans to seek medical treatment outside the Veterans Affairs Department. VA officials announced Wednesday that primary care has been added to its Patient-Centered Community Care, or PC3, program. The initiative originally was designed to provide specialty care, in-patient and mental health treatment to veterans who could not access a VA hospital or clinic because of distance or prolonged wait times at their regular facility. But it was expanded to include primary care in an effort to expedite treatment to patients sitting on wait lists, according to a VA release.
Adding a Private Option to VA Health Care Is Going to Cost a Bundle. We Should Study Whether It Works.
Source: Kevin Drum, Mother Jones, June 13, 2014

As part of the deal to fund new VA facilities in underserved areas, Democrats agreed to a Republican proposal that would allow veterans to seek private health care if they live more than 40 miles from a VA facility or if they have been waiting more than 30 days for an appointment. Here’s what the CBO has to say about that: “All told, CBO expects that veretans would ultimately seek additional care that would cost the federal government about $50 billiob a year, on net.”….

Should We Be Concerned About Privatization of the V.A.?
Source: Paul Waldman, American Prospect, June 11, 2014

Congress is about to pass a bill allowing vets to receive care at private providers. If it’s the first step toward privatization, that could be a big problem….But there is a down side to this private option. As Philip Longman argues, outsourcing V.A. medical care compromises the very thing that makes it so good: coordination. The V.A. was a pioneer in the development of electronic medical records, and its record of quality care comes in large part from the fact that it’s a unified system. ….

Bernie Sanders, John McCain strike VA deal
Source: Jeremy Herb, Politico, June 5, 2014

Sens. Bernie Sanders and John McCain have struck a deal on legislation to reform the Department of Veterans Affairs to expand veterans’ access to health care and make it easier to fire VA officials for misconduct. The compromise measure, announced Thursday on the Senate floor, includes pieces of three VA bills that have been introduced in the Senate. The legislation would allow veterans to see private doctors outside the VA system if they experience long wait times or live more than 40 miles from a VA facility. And it incorporates provisions from legislation introduced in the Senate by Sen. Marco Rubio (R-Fla.) making it easier to fire VA officials.

Senator unveils proposal to revamp VA health care
Source: Susan Davis, USA TODAY, June 1, 2014

Senate Veterans Affairs Committee Chairman Bernie Sanders unveiled a broad proposal Sunday to revamp health care for 6.5 million veterans as the department faces an expanding investigation into the way care is provided at VA medical facilities. …. Sanders’ bill would make it easier for veterans to receive treatment outside the VA system if timely care is not available. A preliminary investigation revealed last week that VA facilities have altered medical records to hide delays of nearly four months for patients to see a doctor. The proposal would allow veterans to seek treatment at community health centers, military hospitals or from private doctors.

Pelosi open to privatizing more vets’ care
Source: Mike Lillis, The Hill, May 29, 2014

House Minority Leader Nancy Pelosi (D-Calif.) said Thursday that she’d support a shift to privatizing more healthcare services for the nation’s veterans. “I don’t have any problem with that,” she told reporters in the Capitol. Amid the simmering scandal over protracted wait times at facilities run by the Department of Veterans Affairs, House Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.) is vowing to introduce legislation granting veterans more flexibility to seek care in the private sector. Some liberals fear the move is part of a broader GOP plan to privatize veterans care altogether. But Pelosi said the sheer number of veterans entering the VA system, combined with geographic and logistical hurdles facing many of those patients, makes Miller’s idea an attractive one — as long as government-run facilities also remain available to cater to vet-specific needs.

Harris seeks privatization of some veterans’ health care
Source: Nicole Gaudiano, DelMarVaNow, May 29, 2014

Veterans would be able to opt out of the Veterans Health Administration system and get care through a private insurer, under a plan being pushed by Rep. Andy Harris. The Maryland Republican says veterans should have the option to get a health care plan as good as the plans for those providing their care. The “Veterans’ Choice Plan” would be comparable to what federal employees are provided through the Federal Employees Health Benefits Program, he says….

Andy Harris pushes VA privatization plan
Source: Kendall Breitman, Politico, May 27, 2014

Rep. Andy Harris (R-Md.) is hoping to resolve the “bureaucratic mess” that is the Veterans Affairs office by pushing a plan that would allow privatization of some vets’ health care. …

Veterans Fire Back at Letter by Senator
Source: Jonathan Weisman, New York Times, May 26, 2014

An “open letter” from a senior Republican senator to the nation’s veterans in which he castigates the leadership of veterans’ organizations prompted a brutal war of words over the Memorial Day weekend, including a promise from the Veterans of Foreign Wars that its “hat in hand” approach to Congress will turn more combative. …. The issue carries risk for Republicans because they could be left with a politically difficult effort to privatize at least some veterans’ health care or to pump more money into a system covering about 2.8 million veterans of the wars in Iraq and Afghanistan, an option veterans groups have demanded but Republican leaders have resisted. …. Over the weekend, the Obama administration said it would allow more veterans to get access to care through private health facilities to ease the backlog at the department’s 152 medical centers and 900 community care facilities.

The Republican Party Has a VA Problem, Too: Privatization Isn’t Popular
Source: Brian Beutler, New Republic, May 22, 2014

In light of the GOP’s decision to fold the Veterans Affairs scandal into a broader ideological crusade, I noted on Wednesday that in seeking redress, liberals shouldn’t lose sight of the fact that the GOP’s answer to every administrative blunder is to dissolve whatever program or agency screwed up. The unspoken corollary is that, by using the VA scandal as a narrative building tool, they’ll face pressure to put up a “small government” alternative to the VA that would be a better deal for actual veterans. And that carries risk, because the Republican alternative is unpopular….

Maryland VA looks to private docs to speed up care

Source: John Fritze and Matthew Hay Brown, The Baltimore Sun, July 28, 2014

The medical system charged with caring for Maryland’s veterans is seeking help from private physicians in the Baltimore region to address a primary-care backlog that has become one of the worst in the nation, federal officials said Monday. With Central Maryland’s veterans waiting months to schedule an initial visit with a primary-care doctor, the Veterans Affairs Maryland Health Care System is hoping to tap into whatever reserve capacity is available in the area’s extensive network of private clinics, according to a formal solicitation. While the agency’s move is unusual, it comes as lawmakers in Congress unveiled a bipartisan agreement Monday to spend $10 billion to expand access to medical care outside the traditional VA system for veterans who live more than 40 miles from a medical center or face long wait times….

Video: Profiting from the GI Bill

Source: Aaron Glantz, Adithya Sambamurthy, Center for Investigative Reporting, July 7, 2014

The post-World War II GI Bill helped veterans live the American Dream. But a new GI Bill designed to help those returning from Iraq and Afghanistan is coming under fire. The Center for Investigative Reporting found more than $600 million dollars in GI bill money had gone to hundreds of for-profit schools in California with low graduation rates and high rates of student loan default.

For-Profit Schools Under Fire For Targeting Veterans

Source: Larry Abramson, NPR, Morning Edition, April 5, 2012

Hundreds of thousands of veterans have returned from Iraq and Afghanistan in recent years, eager to get an education under the new post-Sept. 11 GI Bill.

Many vets looking for a school find they are inundated by sales pitches from institutions hungry for their government benefits. Now, lawmakers are looking for ways to protect vets without narrowing their education choices….Some members of Congress are worried that for-profit schools are ripping off the government by luring students into programs that seldom lead to good jobs..

…..Concern about the lead generators’ sales tactics has prompted Congress to explore tighter limits on the public funds that can go to for-profit colleges. But Sweizer says limiting government funding would just hurt the schools that are trying to deal honestly with vets. Instead, he says, schools that don’t deliver what they promise should be punished.

VA Health Care: Further Action Needed to Address Weaknesses in Management and Oversight of Non-VA Medical Care

Source: U.S. Government Accountability Office, GAO-14-696T, June 18, 2014

From the summary:
GAO’s May 2013 report on the oversight and management of the Non-VA Medical Care Program found that the Department of Veterans Affairs (VA) does not collect data on wait times veterans face in obtaining care from non-VA providers. The lack of data on wait times limits VA’s efforts to effectively oversee the Non-VA Medical Care Program because it is not possible for VA to determine if veterans who receive care from non-VA providers are receiving that care sooner than they would in VA facilities. In addition, GAO found that VA cannot assess the cost-effectiveness of non-VA medical care because it cannot analyze data on all services and charges for an episode of care, which is a combined total of all care provided to a veteran during a single office visit or inpatient stay. As a result, VA cannot determine whether delivering care through non-VA providers is more cost-effective than augmenting its own capacity in areas with high utilization of non-VA medical care.

GAO’s March 2014 report found patterns of noncompliance with applicable requirements for processing emergency care claims covered under the Veterans Millennium Health Care and Benefits Act (Millennium Act) at each of the four VA facilities visited. This led to the inappropriate denial of some claims and the failure to notify veterans that their claims had been denied at these facilities. The Millennium Act authorizes VA to cover emergency care for conditions not related to veterans’ service-connected disabilities when veterans who have no other health plan coverage receive care at non-VA providers and meet other specified criteria. Specifically, GAO determined that about 20 percent of the 128 claims it reviewed had been denied inappropriately, and almost 65 percent of the reviewed claims lacked documentation showing that the veterans were informed their claims were denied and explained their appeal rights. As a result of GAO’s review, the VA facilities reconsidered and paid 25 claims that they initially had inappropriately denied. GAO also found that there is significant risk that these patterns of noncompliance will continue because VA’s existing oversight mechanisms do not focus on whether VA facilities appropriately approve or deny non-VA medical care claims or fail to notify veterans that their claims have been denied.

GAO also reported in March 2014 that gaps exist in veterans’ knowledge about eligibility criteria for Millennium Act emergency care, and communication weaknesses exist between VA and non-VA providers. Specifically, GAO found that veterans’ lack of understanding about their emergency care benefits under the Millennium Act presents risks for potentially negative effects on veterans’ health because they may forgo treatment at non-VA providers, and on veterans’ finances because they may assume VA will pay for care in situations that do not meet VA criteria. Despite VA’s efforts to improve communications, some non-VA providers reported instances in which VA facilities’ claims processing staff were unresponsive to their questions about submitted claims.