Sunday, February 26, 2017

VA Secretary Shulkin to eliminate 40-mile, 30-day rule for non-VA care

WASHINGTON – Veterans Affairs Secretary David Shulkin on Sunday proposed eliminating a controversial policy that limits veterans from receiving private-sector health care.
Speaking to hundreds of people at the Disabled American Veterans annual conference in Arlington, Va., Shulkin laid out his top 10 priorities for the Department of Veterans Affairs. It was his first public address since becoming VA secretary.
High on Shulkin’s list was redesigning the Veterans Choice Program into what he called “Choice 2.0.”
His plan would include removing the rule that allows veterans to go outside the VA for health care if they had to wait more than 30 days for an appointment or live more than 40 miles driving distance from a VA facility. Some veterans and lawmakers have criticized the 40-mile, 30-day rule for limiting veterans’ health care choices, and Shulkin called the program “extremely complex and bureaucratic.”
President Donald Trump issued a plan for VA reform during his campaign that he said would ensure every veteran could choose between the VA or private-sector care. Shulkin said Sunday that he wanted a system with less “red tape.”
“We want to be thoughtful about how we propose what the new choice program will look like, and do that in conjunction with Congress, and to make sure we are fulfilling the president’s promise and commitment that he has made to the country’s veterans,” Shulkin told Stars and Stripes.
Choice set to expire
Before he can propose Choice 2.0, Congress first must eliminate the expiration date for the original Veterans Choice Program, Shulkin said.

“We want to make sure we continue the current program so veterans don’t experience any gap in care,” he said.
The program was created as a temporary measure in 2014 after it was discovered veterans were suffering long waits for health care at some VA facilities. It was funded with $10 billion and given an expiration date of Aug. 7, 2017.
Sen. John McCain, R-Ariz., and Rep. Phil Roe, R-Tenn., introduced legislation last month to do away with the expiration date. The lawmakers estimated by August, the choice program would still have approximately $1 billion in funding.
Congress has yet to taken action on either the House or Senate bill.
“If Congress doesn’t act, we will see a significant amount of resources be removed,” Shulkin said.
Shulkin has previously attempted to ease concerns that the VA would move completely to the private sector. He did so again Sunday, saying the private sector does not have the "military cultural competency" that the VA provides.
Other priorities
Shulkin on Sunday also listed employee accountability as a top priority. He said he would work to push legislation in Congress that would allow the VA to “make sure bad employees are leaving the system.”
Some lawmakers have pushed to make it easier to fire VA employees as a way to root out a perceived culture of corruption in the department.
The VA will also announce some “bold proposals” regarding suicide prevention in coming weeks, Shulkin said.
Trump commented during his campaign on the number of veteran suicides – calling it a “national tragedy” – and said he would improve mental health care at the VA. According to the latest VA statistics, an average of 20 veterans died from suicide each day in 2014.
Other priorities Shulkin listed Sunday included improving VA infrastructure, better coordinating with the Department of Defense, enhancing information technology and making quicker decisions on claims for disability and pension compensation.
“Now I’m focused on the future,” Shulkin told Stars and Stripes. “I’m focused on how we can make significant advancements from where we were to make this a better system.”
Disabled American Veterans and other veterans organizations will have opportunities soon to highlight their own priorities for VA reform to the Senate and House veterans' affairs committees.  
Disabled American Veterans will present their priorities to lawmakers on Tuesday, followed by The American Legion and Veterans of Foreign Wars on Wednesday.

Wednesday, January 11, 2017

David Shulkin to lead the Department of Veterans Affairs.

WASHINGTON — President-elect Donald Trump on Wednesday announced his choice of David Shulkin to lead the Department of Veterans Affairs.
Shulkin is the current undersecretary for health at the VA and has been in that post since July 2015.
During his tenure, Shulkin told USA TODAY recently that he had cut the number of veterans waiting for urgent care from 57,000 to 600. At the same time, he spearheaded an effort to provide same-day care at all 167 VA medical centers across the country by the end of last year. It’s unclear whether he reached that goal.
Shulkin is a physician who previously ran hospitals in New Jersey and New York and was named among the 100 most influential people in American health care by Modem Healthcare.
Trump promised during the presidential campaign to overhaul the VA so that veterans wouldn’t have to wait for care and could choose to get care outside the VA if they wanted. Currently, they can do that if they can’t get a VA appointment within 30 days or within 40 miles of their homes.
Shulkin has said in interviews that he favors a hybrid model, where the VA provides care that it specializes in, such as treatment for post-traumatic stress disorder, traumatic brain injuries and loss of limbs, for example. And he said the VA should consider discontinuing other services that the private sector may better provide, such as obstetrics and gynecology.
Shulkin is blunt about the challenges facing the VA. He has said the agency has had trouble attracting talent from outside the agency, at one point, saying simply, "I need help."
Trump made the announcement about Shulkin during Wednesday's long-awaited news conference.

Monday, January 9, 2017

Delta Residents Evacuating As Floods Threaten

WALNUT GROVE, Calif. - Residents of Walnut Grove's New Hope RV Park are evacuating ahead of the big storm.
Park manager Jim Timberlake said he has everything under control. He said officials told him that they anticipate they expect water levels to fall tomorrow and next week. The park has 60 RV's, and Timberlake said everyone will be taken care of.
“Got everything under control. Everything is looking good," Timberlake said. "The rest of the rigs I have out will be gone by tomorrow morning and the rest into storage."
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Longtime resident Johnny C is among those evacuating. He said this isn't his first rodeo. 
“I was in the Isleton flood in 72' and I remember doing all of that there,” Johnny C said.
He was calm, cool and collected, just like his neighbor Mike Shread. 
“I got my TV in here. I am going to hunt and shoot and fish and kill and have fun. I’m ready," Shread said. 
Shread said he wants to stick around and watch the "carnage". He said after the state told them it was serious he grabbed a spot on the levy with some neighbors. Others we spoke to decided to leave town because they did not have room on the levy or feared the levy could collapse. 
Many of the residents were concerned about bathrooms, pumps, power, generators, but management said they will take care of everything. 

Sunday, December 25, 2016

Fairness for Veterans Act Signed Into Law

WASHINGTON -- With President Barack Obama's signature of the annual defense policy Friday, the Fairness for Veterans provision becomes law.
The Fairness for Veterans Act was featured in the TEGNA investigative docu-series, Charlie Foxtrot. The bill requires military discharge review boards to consider post-traumatic stress disorder and traumatic brain injury.
More than 12,000 people signed a petition calling for Congress to pass the provision after watching the series. The provision was included in the National Defense Authorization Act.
Earlier this month, Charlie Foxtrot was shown on Capitol Hill as part of a discussion with participants of the docu-series, as well as several bills aimed at safeguarding veterans' mental health.
As a result of the passage of this bill, the military will now be required to consider mental health conditions for troops who receive less than honorable discharges.  If a service member does something the military considers undesirable, their mental health will now factor in to any discharge review. Now, thousands of veterans will now be eligible for at status upgrade and VA medical care.

Thursday, December 22, 2016

New Delta Research Vessel Takes Maiden Voyage

Florence Low / California Department of Water Resources / Courtesy
California Department of Water Resources' new research vessel, Sentinel, sails along the Sacramento River, toward the Tower bridge in Sacramento, Calif. on December 16, 2016.
(AP) — The California Department of Water Resources will commission a new research vessel next week.
The department will hold a ceremony and display the vessel Sentinel to news media on Monday in Sacramento.
The department says the floating laboratory is critical to maintaining water quality in the Sacramento-San Joaquin Delta and San Francisco Bay.
The Sentinel is a 60-foot aluminum catamaran. Its predecessor, the San Carlos, dates to 1976.

Tuesday, December 13, 2016

VA Study Confirms High Cure Rates Of Hepatitis C

Image result for hep c drugs

VA Study Confirms High Cure Rates With New Hepatitis C Drugs

Virus undetectable in high percentage of patients after treatment.

WASHINGTON – A Department of Veterans Affairs (VA) database study shows that new drug regimens for hepatitis C have resulted in “remarkably high” cure rates among patients in VA's national health care system.
Of the more than 17,000 Veterans in the study, all chronically infected with the hepatitis C virus at baseline, 75 percent to 93 percent had no detectable levels of the disease in their blood for 12 or more weeks after the end of treatment. The therapy regimens lasted 8 to 24 weeks, depending on patient characteristics.
“This promising news comes as VA is dedicating significant funds to help greater numbers of patients with hepatitis C,” said David Shulkin VA Under Secretary for Health. “In March, we announced our ability to fund care for all Veterans with hepatitis C for fiscal year 2016 regardless of the stage of the patient’s liver disease. VA has long led the country in screening for and treating hepatitis C. As of mid-September 2016 alone, the Department treated more than 100,000 Veterans infected with the virus. More than 68,000 of these patients had been treated with these new highly effective antivirals.”
The VA researchers analyzed data from four subgroups of patients infected with hepatitis C—genotypes 1, 2, 3, and 4—and found that genotype 1 patients showed the highest cure rates and genotype 3 the lowest. Genotype 1 was by far the most common type of infection among the four subgroups.
The study group of more than 17,000 Veterans included more than 11,000 patients with confirmed or likely cirrhosis, a liver disease that can result from hepatitis C, among other causes. The study team found "surprisingly high" response rates of around 87 percent in this group.
The overall results were consistent with those from earlier clinical trials that led to FDA approval of the three new drug regimens in the study: sofosbuvir (SOF), ledipasvir/sofosbuvir (LDV/SOF) and paritaprevir/ ritonavir/ ombitasvir and dasabuvir (PrOD).
The drugs, introduced in 2013 and 2014, have been credited with revolutionizing hepatitis C treatment, which means a cure is now in reach for the vast majority of patients infected with the virus. Previously, using earlier drug regimens, most patients could expect, at best, only a 50 percent chance of a cure.
"Our results demonstrate that LDV/SOF, PrOD and SOF regimens can achieve remarkably high SVR [sustained virologic response] rates in real-world clinical practice," VA researchers wrote.
The new drug regimens examined in the study do not contain interferon, which has troublesome side effects such as fever, fatigue, and low blood counts. The newer drugs are considered far more tolerable than the older interferon-based antiviral regimens, although they are far more expensive.
The researchers extracted anonymous data on all patients in VA care who received HCV antiviral treatments between January 2014 and June 2015 using the VA Corporate Data Warehouse, a national, continually updated repository of data from VA's computerized patient records.
The study's optimistic finding is a source of optimism for Veterans and others infected with the hepatitis C virus, according to coauthors Dr. Lauren Beste and Dr. George Ioannou, specialists in internal medicine and hepatology, respectively, with the VA Puget Sound Health Care System in Seattle.
According to the researchers, modern, direct-acting antiviral drugs for hepatitis C far outperform our older options in terms of efficacy and tolerability. With older drugs, most patients could not undergo antiviral treatment because they had contraindications or medication side effects. With newer options, almost anyone can safely undergo treatment for hepatitis C.
VA research continues to expand knowledge of the disease through scientific studies focused on effective care, screening, and health care delivery. Some studies look at particular groups of hepatitis C patients—for example, female Veterans, or those with complicated medical conditions in addition to hepatitis C.
For more information on VA care for hepatitis C, visit and Information about the database study may be found in the September 2016 issue of the journal Gastroenterology.