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The Scout Report 368th Edition

The Scout Report 368th Edition

Military Families and Veterans News and Analysis

Monday, May 21, 2018

Friday was the day! We learned that Robert Wilkie, the acting VA Secretary and current Under Secretary of Defense for Personnel and Readiness, is the president’s next nominee to take the reigns at VA. What do we think about this development? Read on below!

With the VA Mission Act and the Cerner deal also making headlines last week, our analysis also looks at what it all means for veterans in this tumultuous time for the VA and its leadership. Keep an eye on our Twitter account this week for how the Wilkie nomination unfolds. –LJ

 

Congressional Hearings:

House:

Veterans’ Affairs: The Curious Case of the VISN Takeover: Assessing VA’s Governance Structure
When: 10:00 AM, Tuesday, May 22, 2018
Where: 334 Cannon

Veterans’ Affairs Subcommittee on Economic Opportunity: Legislative Hearing on H.R. 2409; H.R. 5452; H.R. 5538; H.R. 5644; and H.R. 5649
When: 10:00 AM, Wednesday, May 23, 2018
Where: 334 Cannon

Senate:

Armed Services Subcommittee on Personnel: Markup of the National Defense Authorization Act for Fiscal Year 2019
When: 2:30 PM, Tuesday, May 22, 2018
Where: 216 Hart

Armed Services: Closed: Full Committee Markup of the National Defense Authorization Act for Fiscal Year 2019
When: Beginning at 9:30 AM, Wednesday, May 23, 2018
Where: Russell 222

Community Opportunities:

Veterans Campaign and University of San Francisco: Master of Arts in Public Leadership
Who: Veterans and military families, but open to anyone interested in public service.
When: Applications open now!
Where: The hybrid curriculum combines online learning with five intensive weekend seminars in the D.C. area.

Tradeshows and Conferences 

USSOCOM and NDIA: Special Operations Forces Industry Conference (SOFIC) and Exhibition(Mon – Thur, May 21-24, 2018); Tampa Convention Center, Tampa, FL

 

Military and Veteran Issues:

President Trump announces he will nominate Robert Wilkie as next VA secretary
Donovan Slack (@DonovanSlack) and David Jackson (@djusatoday), USA TODAY
After 51 days with no Secretary of Veterans Affairs, President Trump on Friday announced that Robert Wilkie, the acting VA Secretary and also current Under Secretary of Defense for Personnel and Readiness, will be nominated for the permanent position. Wilkie was named acting secretary upon former VA Sec. David Shulkin’s termination in March, and has been commended for his leadership and unification skills during an otherwise very divisive time within the VA. Wilkie will have a lot of decisions to make upon his confirmation, including details regarding the impending overhaul of VA health care. –AB
Bottom line: Wilkie, as acting secretary, was on most shortlists of likely nominees for VA secretary. Yet, the announcement still managed to surprise just about everyone—including Wilkie—for its timing and lack of, well, Tweets. A lawyer by training, Wilkie has deep experience on Capitol Hill and in the Pentagon. He would be the second non-veteran to lead the agency (after Shulkin), but is the son of an Army veteran. Wilkie has already been Senate confirmed for his position at DOD, but will need approval of the Senate Veterans Affairs Committee before he takes the helm of the agency. One assumes that calculus came into play when the White House was making the decision on who would be next. Call it the Shulkin model. But while Shulkin came in with plenty of insight about how health care systems work, Wilkie comes with a lot of knowledge about how the military-industrial complex works. Navigating bureaucracy and the Hill are crucial skills for any VA Secretary, but it’s hard to get over the feeling that the White House took the easiest route to filling the position rather than doing what is best for veterans. The latest reports indicate the process, as it was, consisted of the president consulting Pete Hegseth and Ike Perlmutter on their thoughts about Wilkie, who is said to have lobbied them a bit for the position. All of this isn’t to say Wilkie isn’t a distinguished public servant, but that he doesn’t exactly fit the parameters advocates and veterans were hoping to see in the next secretary. –LJ

House approves plan to increase private-sector care for veterans, fix VA funding crisis
Nikki Wentling (@nikkiwentling), Stars and Stripes
After more than a year of back and forth discussions, lawmakers in the House have approved a bill that will allow more veterans to receive private-sector care through VA. After bipartisan approval of The VA Mission Act in the House, it heads to the Senate for a vote, potentially as early as next week. The bill is said to be crucial for veterans receiving care outside of VA through Choice– a program that, without this bill, is expected to run out of funds as soon as May 31. As part of the Mission Act, more than $5 billion will be funneled into the Choice program to keep it afloat until an updated process is put in place next year. While many government officials and veterans organizations have expressed their concerns on VA privatization, the Mission Act would encourage all veterans to go through VA before being referred to a private provider. The Mission Act would also expand the caregiver program to veterans of all eras, something advocates have been working on for years. –DD
Bottom line: Yes, we all agree that access to healthcare and minimizing wait times are critical and that the Choice Program serves as a relatively effective fix to fulfilling both of these needs, but what many rightly fear is that the VA Mission Act takes one more step to privatization, due to the funding troubles that it creates for the VA over the next year and even longer-term. At face value, and not taking into account any other actions by the Trump Administration, the Mission Act seems reasonable, partially why it passed the House 347-70. But with there being no VA leadership in place and with 33,000 vacancies at the agency, we can’t seriously expect the VA to effectively administer this expansion. As the Daily Times highlights, “House Minority Leader Nancy Pelosi, attacked the bill as failing to do enough to keep veterans in the VA, instead opening ‘the doors to VA privatization.’” It’s pretty clear that Trump’s goal is VA privatization, when you take into account all the collective actions. The question remains, will VSOs and Congress continue to allow the chipping away of VA provided services, while replacing them with services in the private sector? It should also be noted, as Stars and Stripes points out that, “the American Federation for Government Employees, a union that represents hundreds of thousands of VA employees, remains opposed to the bill. AFGE claims it will “starve the VA for resources.” National Nurses United, the largest organization of registered nurses, wrote to lawmakers, also warning the bill would lead to privatization.” –CB

The Chasm Between Public Perception and Clinical Reality at the VA
Ryan Black (@Ryan_M_Black), Healthcare Analytics News
In an op-ed published in The Washington Post last week, Dr. Andrew Cohen, a nephrologist at the Providence VA Medical Center, defended the VA health care system and the quality of its care against its detractors. Dr. Cohen acknowledges the VA’s shortcomings, but writes that much of the media coverage presents an “unfair” depiction of the system and fails to highlight the VA’s successes. RAND, a leading policy research institution, has data that supports Cohen’s view. Rebecca Anhang Price, a researcher with RAND, authored a care quality study published in the Journal of General Internal Medicine that showed care provided by the VA health system “is higher in quality than what is offered elsewhere in communities across the nation.” Cohen calls on VA physicians to speak out in defense of the VA to change the public perception of the system. –NJ
Bottom line: To Cohen’s point, in most cases, yes, the politicians set the narrative, because they are the ones making the policy changes. So, we shouldn’t be too surprised that when we find ourselves with a Republican controlled Congress and White House, that there isn’t a positive narrative about our country’s biggest effectively running public health care system (the VA.) Republicans oppose a public healthcare option, that’s just a fact, so having one run successfully on their watch, isn’t politically advantageous. Cohen is very transparent in his analysis of the VA, ultimately concluding that where it’s working, it’s really working, and where it’s not, it’s not. In his op-ed, he points to a series of data points that highlight the areas that prove the VA is outperforming private healthcare, those include VA inpatient care being more or as effective, VA mortality rates declining more rapidly for some conditions, and VA outpatients receiving better follow-up care and better mental health, among other things. What we do know is that veterans have unique healthcare needs, and the VA is best suited to address those. Privatization of the VA only serves to make more money for private healthcare and pharmaceutical companies. –CB

VA joins military in fraught multibillion-dollar health IT contract
Arthur Allen (@ArthurAllen202), Politico
Despite concerns raised by many stakeholders, acting VA Secretary Robert Wilkie signed a contract on Thursday with Cerner to modernize and align the VA’s health care records with the military. Wilkie says this contract will allow the VA to provide veterans with continuous care as they transition to veteran status. Critics are saying that the contract lacks specific clinical and interoperability requirements and will not guarantee success for VA patients, doctors or taxpayers. Pilot implementations of the program have also raised red flags about the system’s clinical operability. –SM
Bottom line: It probably seems like such a small thing to the average person whether a certain electronic health record is being used over another but the fact that VA and the DoD have used different ones since they started any kind of EHR use has been a thorn in the side of every single transitioning service member and veteran. It has caused thousands of transfer errors, countless hours of unnecessary medical appointments and is one of the root causes so few transitioning service members immediately sign up for their VA benefits and healthcare. When I retired after 22-years as an aviator, my paper health records filled up three one inch thick folders. Starting new ones from scratch with VA is a complete mess so having one system is the answer. Of course, having one system that actually does what it’s supposed to do would be a basic requirement and if reports out of the military health facilities using the new Cerner records and system are an indicator this “good news” story has a long road ahead of it to actually being one. This isn’t truly an off the shelf purchase and the vastness of the two healthcare systems is incredible with some 13 million patients or more currently under the care of both DoD and VA. Having said that we are hopeful this is the first step in a long needed reform and hope it accomplishes its goals. –FPW

Veterans Go Back to Court Over Burn Pits. Do They Have a Chance?
Seth Harp, The New York Times  
Veterans from Iraq and Afghanistan are seeking damages from the military contractor KBR Inc. in a case dating back to 2008. The plaintiffs cite that the use of burn pits to dispose of waste by KBR on American bases created toxic fumes that caused widespread respiratory, neurological and other health problems for returning veterans exposed to the fumes. Oral arguments were recently presented to the Fourth Circuit Court of Appeals in an attempt to overturn the previous case dismissal from July 2017. The trial court judge who dismissed the case held that the executive branch’s wartime decisions could not be questioned and that KBR shared the government’s immunity from being sued. For most service-related illnesses, veterans would look to the VA for recompense and treatment; however, the VA’s current stance is that there is not enough evidence to prove causation between exposure to burn pits and the various health issues reported. Law experts and others note that the “plaintiffs face an uphill battle,” but litigation may not be their only hope as advocates urge Congress to take action. Congress requested further investigation as part of the 2018 defense-spending bill and could intervene legislatively as it did for Vietnam veterans exposed to Agent Orange in 1991. –KG
Bottom line: This feels much like the path that led to recognition for those exposed to Agent Orange from Vietnam in many ways. The simple fact is that the military and contractors put everything in the burn pits. Everything without regard to its toxicity or whether exposure could cause harm to those exposed to the fumes which due to unique weather conditions often enveloped Forward Operating Bases in toxic clouds for long periods. The number of unexplainable illnesses and cancer clusters being reported by veterans of the wars in Iraq and Afghanistan continue to build. The lawsuits are probably a long shot but in the end this isn’t about getting big checks for victims or bankrupting KBR. It’s about getting recognition that this aspect of their service led to devastating illnesses and they need to be treated like a bad knee or hidden wounds. There also needs to be a hard look at how we dispose of the trash of war now and in the future so this doesn’t happen to future generations. We owe that to them. –FPW

Client Hits:

New degree program aimed at helping veterans run for public office
Leo Shane III (@LeoShane), Military Times
ScoutComms client Veterans Campaign recently announced a partnership with the University of San Francisco to launch a new hybrid online and in-person seminar degree program: the Master of Arts in Public Leadership. This program is for service members, veterans, family members and others interested in honing their leadership skills for continued public service. It is designed to provide students with the knowledge and know-how to succeed in running for public office, congressional affairs, campaign management, advocacy and civic leadership. The priority deadline is July 1, and those interested in applying can find more information at https://www.veteranscampaign.org/usfca-landing. –AB

Pentagon: loan forgiveness is a recruiting tool. Lawmakers: cut it anyway.
Natalie Gross (@ByNatalieGross), Military Times Reboot Camp
Student Veterans of America’s Policy Director, Lauren Augustine, provides insight on the fight over a controversial bill that would allow student loan forgiveness for public-sector employees, including service members. Augustine says that there are several concerns from both parties and that the bill will have less floor time since August recess is a short two and a half months away. –SM

Mental Health Players to perform
The Sparta Independent
May is Mental Health Month, and as such The Sussex County Mental Health Task Force and a number of partner organizations are coming together to feature a performance of the New Jersey Mental Health Players on Monday, May 21. They have taken the pledge to join client Give an Hour’s Campaign to Change Direction, and the performance will highlight the Five Signs of Emotional Suffering. –AB

Weakening SNAP will leave some veterans going hungry
Ginger Miller (@GingerBMiller), The Hill
In her latest op-ed, Ginger Miller – president and CEO of Women Veterans Interactive – discusses how significantly the Farm Bill would negatively affect veterans. This bill would impose harsh requirements, cuts and burdens on Supplemental Nutrition Assistance Program recipients – a service almost 1.5 million veterans use, one of which was Miller at a time in her life when she was enduring homelessness with her family. –AB

Quick Hits:

Military Times editor to receive ‘Leadership in Journalism’ award from war veterans group
Military Times Staff, The Military Times
Iraq and Afghanistan Veterans of America (IAVA) will give Leo Shane III, deputy editor for The Military Times, the Leadership in Journalism Award in a ceremony on June 6, 2018 in Washington, D.C. Paul Rieckhoff, Founder and CEO of IAVA, shared in a statement that Shane’s “reporting has changed the course of history for veterans,” by “holding leaders in Washington accountable” to improving conditions for the country’s former service members. IAVA also plans to honor Representative Brian Mast of Florida for his work to support veterans in Congress. –NJ

Trump donates first-quarter 2018 salary to VA
Eli Okun (@eliokun), POLITICO
President Trump pledged to donate his salary for this quarter to the VA’s caregiver programs that provide mental health services, peer support, research, education, training and financial aid. Trump also recently donated his salary to the Department of Transportation. Acting VA Secretary Robert Wilkie said of the donation: “The president’s gift underscores his promise to do all that he can for veterans, which includes supporting those who care for our veterans — not just those of us at VA, but the husbands, the wives, the families and the community caregivers who are out there, day in and day out, making life easier for those who have borne the battle.” –KG

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