Hiram's blog: "VA NEWS"

Deputy Defense Secretary Calls for Immediate Fix to Disability Process By Donna Miles American Forces Press Service WASHINGTON – Deputy Defense Secretary Gordon England today called for a new policy that moves wounded troops from Iraq and Afghanistan to the front of the line in the disability rating process while system-wide fixes to the disability and health care systems are put in place. England recommended an immediate measure to speed combat-wounded troops through the DoD disability system and smooth their transition to the Department of Veterans Affairs system. The goal, he said, is “an uninterrupted, seamless continuum of care and support” that ensures nobody falls through the cracks or gets mired down in bureaucratic red tape. Wounded troops represent about 11 percent of the 25,000 servicemembers being processed through DoD’s disability system. The problem, England told the senators today, is that this 11 percent is funneled through the system just as the other 89 percent, many of them career servicemembers preparing to retire. This “one-size-fits-all rating process” bogs down the processing of combat-wounded troops cases, England said. Instead, he recommended that DoD expedite its cases to smooth their transition into VA care. Many of the wounded troops’ cases are relatively clear-cut and can be moved through the system quickly, he said. England acknowledged that this immediate fix is just one step toward improving the way wounded troops are cared for and, when appropriate, processed through the disability system. He said he’s looking forward to hearing what the many studies, reviews, commissions and panels have to say about the matter when they report their findings before the year’s end. What’s needed, he said, is a broad-based system that ensures combat-wounded troops get the care and treatment they deserve. “In my judgment, it is time to step back and take a holistic look at the system instead of just applying fixes to the system,” England told the committees. “We need an integrated, systemic solution with the right mechanisms in place … that makes sense from the soldier’s perspective.” That requires thinking about what the best system would look like if it were being built from scratch and what steps would have to be taken to get it, he said. England said it also may require looking to other national systems associated with disability determination and compensation: the Social Security Administration’s disability payments, the Department of Labor’s workmen’s compensation program and the Department of Veterans Affairs and DoD disability systems, among them. “They are all carried out in different ways, against different systems to achieve different ends,” he said. The differences between these complex programs can be confusing to benefit recipients, England said, suggesting the need for a new national approach for compensating disabled workers. “It may be time to cast a wider net and look at this whole area of disability,” he said.

OPINION What our soldiers really need: Lawyers You’ve heard the stories of injured troops suffering unconscionable indignities and sub par care upon returning from the battlefields of Iraq. What you may not know, though, is that these same soldiers have no recourse when negligence maims or even kills them. Servicemembers have no voice in a court of law. By Jonathan Turley The president and Congress have been falling over themselves to pledge better care for our wounded veterans in the wake of the scandal over "squalid" conditions at the Walter Reed Army Medical Center that included mold, rats, cockroaches, rotting walls and callous treatment of patients. The president has empanelled the perfunctory "blue-ribbon commission." The hospital walls have literally been whitewashed, so politicians can use them again as backdrops for speeches about "nothing being too good" for our troops. Yet no one is talking about the one thing that soldiers and sailors are most desperately lacking: They don't need another spit and polish; they need lawyers. For decades, our military members have been barred from suing for medical malpractice and other forms of negligence by the government. Whether it is a military doctor cutting off the wrong leg or a military gasoline station cutting a brake line, military personnel are not allowed to seek legal relief as other citizens can. The result is that they are victims of grotesque forms of negligence that have not been widely seen in the civilian world for more than a hundred years. In the civilian system, the threat of lawsuit serves a critical deterrence of negligence by the government, companies and others. A rational actor will avoid liability costs by taking measures to minimize accidents. Most Americans do not know that we deny our servicemembers the basic right to sue when they are injured by negligence. They live in a type of tort-free zone where their injuries are subject to relatively minor levels of compensation. With the silent approval of Congress, we have created a system of discount citizens who become easy fodder for incompetent or even criminal actors. Indeed, killing a soldier on an operating table or in a military recreation area is a virtual bargain at a fraction of the cost of a full-value citizen. The military's loss of legal protections is the result of a 1950 Supreme Court ruling on a series of cases that became known collectively as the Feres Doctrine. It was named after Army Lt. Rudolph Feres, who died in a fire allegedly caused by an unsafe heating system in his New York barracks. In this and later opinions, the Supreme Court interpreted the Federal Tort Claims Act to effectively bar any tort actions by servicemembers, even though Congress exempted only "combat-related" injuries. The court unilaterally decided that even injuries in peacetime that are far removed from any combat-related function are still "incident to service." Thus, in one of the Feres cases, a soldier was barred from suing after an Army doctor left a 30-by-18-inch towel inside him marked as property of the "Medical Department U.S. Army." Little deterrence As a result of the Feres Doctrine, there is little deterrence for military negligence beyond self-regulation, bad publicity or a political scandal. Because most accidents are isolated and military personnel tend to stay within the chain of command, these are relatively low risks for military tort-feasors. Moreover, since such accidents are not litigated, there is no reliable system to determine the rate of accidents in the massive military complex. Thus, we cannot reliably compare the accident rates in recreational or medical areas with their counterparts. The military medical system is a prime example of what happens when patients are stripped of their legal protections. The military has long had many talented and dedicated doctors and nurses. Nevertheless, it also has long been plagued by scandals involving everything from doctors without medical licenses to medical treatment that borders on the medieval. Consider a few examples from the military malpractice-free-zone: *Lt. Cmdr. Walter Hardin spent 11 months with red lesions from his legs to his torso that a doctor classified as eczema. It was correctly diagnosed as cancer shortly before he died. *Sailor Dawn Lambert had to have a fallopian tube removed, but military surgeons left five sponges and a plastic marking device in her abdomen. They remained there for months until resulting complications forced a second surgery to remove her other fallopian tube, leaving her infertile. She was given $66 monthly in disability pay. *Linda Branch lost her husband while he was serving in the Air Force after he was turned away twice by a military hospital that told him his intense stomach pains was nothing more than stomach flu. He died of a bowel obstruction. *Navy Petty Officer Joe Cragnotti went to a military hospital with pneumonia, which is treatable with antibiotics. The doctor left it untreated, then Cragnotti suffered brain damage. *Air Force Staff Sgt. Dean Patrick Witt had appendicitis but was repeatedly misdiagnosed and sent home with some antibiotics. When he finally collapsed at home, he was rushed into surgery. He came out brain-dead. It's alleged that a series of malpractice led to his death, including the use of a pediatric rather than an adult device to open an airway when he had trouble breathing. When civilian doctors leave a patient paralyzed or crippled for a lifetime of care, the family members often receive millions in compensation. In the military, the families receive a couple thousand dollars a month and, you guessed it, more military medical care. Dorothy Meagher found herself carrying for her son after he went in to have a cyst removed at a Navy hospital. Her family alleged that, due to an overdose of anesthetics and the failure of a Navy doctor to immediately call for assistance, her son was left a quadriplegic. Unanswered questions Many families in the military never know that they were the victims of malpractice because, without discovery, there is no routine way of forcing such disclosure. For example, Army Staff Sgt. Michael McClaran had a simple surgery for acid reflux. He said he was not told that the surgeon had severed two critical nerves the cause of chronic respiratory and digestive problems. Feres extends beyond medical malpractice. It bars lawsuits in a vast array of activities in such areas as travel, recreation, housing, restaurants, bars and service stations military enterprises often run in competition with civilian businesses. Thus, when a rented water ski loses its brakes or a soldier is raped at a concert, the military invokes Feres and walks away immune from its own negligence. Liberals and conservatives on the court such as Justices John Paul Stevens and Antonin Scalia have denounced the court's continued use of this doctrine, as have dozens of lower court judges. This doctrine has done more harm to military personnel and families than any court-made doctrine in the history of this country. Congress must amend the Federal Tort Claims Act to put an end to this disastrous doctrine. We can no longer afford to leave our servicemembers in the hands of politicians who express shock every 10 years as new scandals regularly emerge. Some lawmakers knew of the appalling conditions at Walter Reed but took no legislative action. The fact is that military hospitals are often treated as little more than a reservoir of human props for political photo ops. The only other part of Reed that members of Congress routinely visit is the VIP floor located on the top floor. Known as the Eisenhower Executive Nursing Suite, it's where high-ranking politicians, jurists, generals, admirals and diplomats are treated. Of course, the politicians, judges and foreign dignitaries are allowed to sue for any negligence. Former senator Bob Dole, who co-chairs the new blue-ribbon commission, was treated there and recently noted that he never saw anything to complain about. That is not surprising since, unlike the vermin-infested and mold-covered rooms of wounded soldiers, politicians are given suites that include fine carpets, antique furniture, separate dining rooms and fine china. If members of Congress truly want the best for our troops, they should start by giving them the same legal protections that the members themselves enjoy. No one is asking for Congress to treat our soldiers as high-value VIPs, but simply full-valued citizens with the same protections as the people they are defending around the world. Jonathan Turley is the Shapiro Professor of Public Interest Law at George Washington University and a member of USA TODAY's board of contributors. He is the author of a three-part study of the military, including its legal and medical systems.

By Dennis Camire, Gannett News Service WASHINGTON — While official Washington scrambles to take care of veterans of the Iraq and Afghanistan wars, many Filipino veterans who fought in the U.S. Army against the Japanese in World War II are still seeking full benefits from the U.S. government. More than 65 years ago, they fought at Corregidor and Bataan, with thousands walking as prisoners on the infamous Death March, which the Philippines will commemorate Monday with a national holiday. For years after the Philippines fell in 1942, many were part of organized guerrilla units in the mountainous jungles, battling Japanese forces and keeping them from being deployed elsewhere in the war. But shortly after the war ended, Congress stripped thousands of the Filipino fighters of their eligibility for full veterans' benefits in the Rescission Acts of 1946, limiting the veterans to compensation for service-related disabilities or death. "I was terribly shocked when I was told that my services in World War II in the U.S. Army forces was, by law, deemed not 'active service for the purposes of any benefit administered by the ... VA,' " said Franco Arcebal, 83, who was a guerrilla fighter in the Philippines. Arcebal of Los Angeles told the House Veterans Affairs Committee in February that he believed the United States did him an injustice. "I felt terribly discriminated upon," he said. Since the 1946 congressional action, Filipino veterans and their advocates battled in the courts and Congress to win some benefits, such as health care, internment in national cemeteries and up to $600 in a burial allowance, but those victories were limited to only some of the veterans. "We survived four and half years of battle with guns, but we are now having a battle of legal minds for the injustice that the U.S. government has given us," said Art Caleda of Waipahu, Hawaii, a former intelligence officer with the guerrillas in the Philippines' northern provinces. Caleda, 83, and other Filipino veterans — an estimated 20,000 in the United States and the Philippines out of the more than 200,000 who fought in the war — are backing legislation again this year to give them full benefits from the Veterans Affairs Department. Caleda, who was wounded in 1944 while helping rescue a downed U.S. pilot, said the aging veterans have pushed the legislation since it was first introduced in 1992. "At this point in time, we need very, very much the well-deserved benefits for the services we have rendered," said Caleda, scheduled to speak on the issue Wednesday to the Senate Veterans Affairs Committee. Under current law, many of the Filipino veterans are denied full VA benefits such as pensions for low-income veterans over 65 — almost $11,000 a year for single veterans — and survivors' death pension — about $7,300 for a spouse with no children. Other denied benefits include some health care, home loans, education benefits, job training and handicap adjustments for a house or car. Bills in both the House and Senate would equalize the benefits with those received by other U.S. veterans. Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, said most Filipino families today include a World War II veteran or son or daughter of a veteran. "Sixty years of injustice burns in the hearts of these veterans," said Filner, a sponsor of the House Filipino equity bill. "Now in their 80s and 90s, their last wish is the restoration of the honor and dignity due them." Alec S. Petkoff who specializes in veterans affairs for the American Legion, called the situation "a shame" and a legal unfairness. "I hope the Senate and House rectify the problem and give the Filipino veterans the equity that they earned through their service and were promised," he said. Patrick Ganio, 86, was part of the Philippines Army in 1941 when President Franklin Roosevelt signed the executive order drafting them into the U.S. Army. By December, Ganio was fighting the Japanese on Bataan and later was on Corregidor when it surrendered in May 1942. Filipino troops, many not properly equipped or trained, made up the bulk of U.S. troops in the Philippines when the Japanese began their invasion on Dec. 8, 1941. Eventually, Ganio, who now lives in Jacksonville, Fla., linked up with the guerrillas on Luzon in the Philippines and fought on through the islands' liberation in 1944. Ganio, who moved to the United States in 1980 after working as a school teacher in the Philippines for 30 years, said he and other veterans have battled for two decades to gain equity with other veterans. "As we think of the supreme sacrifices we paid for serving under the American flag, it is shocking and painful ... in our low moments to feel betrayed from a friend we trust," Ganio said. "This ... is our last cry for justice."

Researchers in Utah to Focus on Healing Power of Stem Cells Ed Yeates Reporting British scientists announced this week they have successfully grown parts of a human heart from stem cells. Utah researchers are on the brink of yet another stem cell project here in Salt Lake. Five Utah hospitals and a lab at the University of Utah have become partners to see if stem cells can repair a failing heart. The healing powers of stem cells are the focus of research across the country including here in Utah. "This is like Star Wars medicine. It's incredibly exciting, and it's also incredibly humbling," said Dr. James Long at LDS Hospital. If clinical trials are approved for Salt Lake's Veterans Hospital, stem cells pulled from bone marrow or discarded umbilical cords will be screened and processed. For the trial itself, stem cells from bone marrow will be injected back into the patient's failing heart. Doctors James Long at LDS Hospital, Linda Kelley at the University of Utah Cell Therapy Lab, and Russell Reiss at Salt Lake's Veterans Hospital are key players. Though LaDell Atkinson won't be part of these clinical trials, patients like him will. Atkinson said, "The heart to repair itself and make it stronger. Geez, I'm all for it." As an artificial left ventricular heart pump temporarily takes the burden off the failing heart, letting it rest, injected stem cells just might begin repairing the damaged muscle. Stem cells could regrowing heart muscle cells and possibly blood vessels, kidneys and even a damaged nervous system. Long said, "The cells that we put in somehow trigger a process whereby the heart can heal itself and remodel itself." British scientists announced this week they have grown a three-centimeter-wide heart valve disc on protein scaffolding. This disc is now a duplicate, a clone - and a stepping stone to the future. Long said, "I think 10 years from now, I think we're going to have biologically generated substitutes for parts of our heart and ultimately perhaps, the whole heart itself." The U.S. government has allocated $80 million to set up a certified network of cord blood stem cell banks across the country.

What the VA Does Right BY BETSY McCAUGHEY The average hospital patient is given the wrong medication or the wrong dose at least once a day, according to the Institute of Medicine, a research organization that advises Congress. The good news is that these mistakes are less likely to happen in a hospital run by the Department of Veterans Affairs. Surprised? Recent news accounts might lead you to believe that VA hospitals are a national embarrassment. That may have been true at one time. Not any more. VA hospitals have undergone a remarkable turnaround in the last decade. On average, they earn higher marks for patient safety and quality of care than most other hospitals in America. The shameful conditions of Walter Reed, which is an Army hospital unaffiliated with the Department of Veterans Affairs, have misled the public. The situation has been exacerbated by attacks from politicians in both parties who are excoriating the VA without knowing the facts. The VA system is well ahead of most hospitals in protecting patients from medication errors. How? By adopting bar coding. The nurse scans the barcode printed on the patient's bracelet, indicating the name and dose of each medication the patient should be getting. Then the nurse scans the barcode on the pre-packaged medication to make sure it's a match. Another new technology — computer physician order entry — is designed to stop doctors from prescribing the wrong medication. With CPOE, the doctor enters the prescription at a computer terminal instead of scribbling it on a pad. The computer is programmed to identify incorrect doses or a medication that conflicts with other meds the patient is already taking. If the computer sounds an alarm, the physician has to override it. In Australia, Great Britain, New Zealand, and much of Western Europe, hospitals have already adopted CPOE, but most American hospitals have resisted it. The exception is the VA hospital system, which has installed CPOE nationwide. The VA has also pushed ahead of most hospitals in America by investing in electronic medical records, allowing a patient's medical history to be accessed in a few seconds. The VA database is a resource for medical researchers and the envy of the private sector. The director of the National Center for Patient Safety at the Department of Veterans Affairs, Dr. James Bagian, points out that the VA is ahead on a wide range of other safety initiatives. One is preventing injuries related to falls, by providing fragile patients with easy to wear padded hip protectors. Mr. Bagian is zealous about patient safety. He described the difficulties of getting older patients in and out of hip-protectors and the importance of preventing life-altering fractures. VA hospitals are also ahead of the industry in fighting one of the most feared, drug-resistant hospital infections, methicillin-resistant Staphylococcus aureus or MRSA. In 2002, the VA Pittsburgh Healthcare System launched a pilot program that reduced MRSA infections by a stunning 85%. How? By enforcing meticulous hand hygiene, screening to identify patients carrying the bacteria, and taking precautions to prevent the bacteria from spreading to other patients via gloves, wheel chairs, stethoscopes, nurses uniforms, and doctors' lab coats. Now the VA is instituting the same approach nationwide, including providing rapid MRSA testing equipment. Patients in VA hospitals are also more likely to receive optimal care than patients in other hospitals. In the late 1990s, the VA re-engineered its health care system using information technology to track and measure the care each patient was given. The result is significantly higher compliance with best practices. According to a study in the May 2003 edition of the New England Journal of Medicine, patients in VA hospitals, compared to Medicare-eligible patients in nongovernment hospitals, received better care in 12 out of 13 measures. Measures included care for diabetes, depression, congestive heart failure, and preventive cancer screenings. A RAND study of 12 VA hospitals published in 2004 in the Annals of Internal Medicine showed similar results, though it also found a higher mortality for coronary bypass procedures in those hospitals. Not all 1,400 hospitals operated by the Department of Veterans Affairs are models of excellence. A recent internal VA report acknowledges that some hospitals are in need of repair, with mold, leaky roofs, and defective plumbing. Also, the department's inspector general recently cited the James A. Haley Medical Center in Tampa, Fla., for serious shortcomings, and another report cited substandard conditions at the Nashville and Murfreesboro, S.C., facilities. Physical shortcomings aside, the VA delivers better care than most hospitals. It shouldn't be a surprise that the American Customer Service Satisfaction Index, based at the University of Michigan, shows that patients in VA hospitals are more satisfied with their care on average — 84% to 74% — than patients in private sector hospitals. Ms. McCaughey, the former lieutenant governor of New York State, is the founder and chairman of the Committee to Reduce Infection Deaths, www.hospitalinfection.org , a nonprofit campaign to improve hospital hygiene and procedures.

Researchers tested pot, LSD on Army volunteers By Richard Willing, USA TODAY Army doctors gave soldier volunteers synthetic marijuana, LSD and two dozen other psychoactive drugs during experiments aimed at developing chemical weapons that could incapacitate enemy soldiers, a psychiatrist who performed the research says in a new memoir. The program, which ran at the Army's Edgewood, Md., arsenal from 1955 until about 1972, concluded that counterculture staples such as acid and pot were either too unpredictable or too mellow to be useful as weapons, psychiatrist James Ketchum said in an interview. The program did yield one hallucinogenic weapon: softball-size artillery rounds that were filled with powdered quinuclidinyl benzilate or BZ, a deliriant of the belladonnoid family that had placed some research subjects in a sleeplike state and left them impaired for days. Ketchum says the BZ bombs were stockpiled at an Army arsenal in Arkansas but never deployed. They were later destroyed. The Army acknowledged the program's existence in 1975. Follow-up studies by the Army in 1978 and the National Academy of Sciences in 1981 found that volunteers suffered no long-term effects. Insider's account Ketchum's book, Chemical Warfare: Secrets Almost Forgotten, appears to be the first insider's account of experiments performed on about 2,000 soldier volunteers, says Steven Aftergood, a government-secrecy expert for the Federation of American Scientists in Washington, D.C. Ketchum self-published the book, which he sells on his website. In an interview, Ketchum, 75, said he wrote the book to trigger a debate about the potential uses of non-lethal chemicals to incapacitate terrorists who take hostages or use human shields. "Incapacitating agents are designed to save lives," he said. "Isn't it at least something we should be thinking about?" Such research, says chemical weapons opponent Edward Hammond, would not only be illegal under current international law but probably never should have been performed. "There are things that have taken place in the past that should probably stay there," says Hammond, director of the Sunshine Project, an Austin group that opposes biological warfare. Ketchum's memoir draws from previously classified files, including filmed experiments, and notes of tests given subjects before, during and after they were fed, sprayed or injected with mind-altering chemicals. He says: •LSD was rejected for weapons use because even soldiers on prolonged trips could carry out violent acts. •Even especially powerful marijuana lacked "knockdown effect." It was rejected because its effects could be overcome simply by lying down and resting. •Soldier volunteers were willing participants who knew the program's potential risks. Drugs given to soldiers were described in general terms but not named though "many seemed to find out through the grapevine." •Intelligence reports of the time showed that Soviet researchers were planning a large-scale LSD program. •The CIA ran a parallel program that sometimes gave hallucinogens secretly to unwitting citizens. The agency persuaded two Army doctors to carry out experiments for the CIA that the Army would not have authorized. Ketchum says the Army phased out the hallucinogen project in about 1972, in part because disclosure of such research would have caused a "public relations problem." Ketchum's notes suggest the Army's fears were not imaginary. They describe soldiers on "red oil," an especially powerful form of marijuana, who smirked for hours and found even routine spatial reasoning tests to be hilarious. Soldiers under the influence of hallucinogens ate imaginary chickens, took showers in full uniform while smoking cigars and chatted with invisible people for two to three days at a time. One attempted to ride off on an imaginary horse while another played with kittens only he could see. Another described an order of toast as smelling "like a French whore." Some of the researchers also took LSD "as a matter of curiosity," Ketchum says. His lone trip, he adds, was "something of an anti-climax." Colors seemed more vivid and music more compelling, he remembers, but "there were no breakthroughs in consciousness, no Timothy Leary stuff." At least two soldiers who received LSD in the 1950s later sued the Army, alleging that the drug later caused them to suffer memory loss, hallucinations and occasional outbursts of violence. The claims were denied. After leaving the Army, Ketchum saw patients in a private psychiatric practice. The experiments on human subjects ended in 1975, according to Jeff Smart, historian for the Army's Research, Development and Engineering Command at Aberdeen Proving Ground, Md. The United States signed a United Nations-sponsored chemical weapons ban in 1993 that outlawed incapacitating agents. Calmative agents Even so, the U.S. military has remained interested in researching non-lethal chemicals. In 2000, the Joint Non-Lethal Weapons Directorate, a Quantico, Va., group run by all four major military branches, commissioned a study of the possible military uses of "calmative" pharmaceuticals such as anesthetics and serotonin reuptake inhibitors. The Sunshine Project's Hammond, who obtained the study through the Freedom of Information Act, says using calmatives as weapons would also be outlawed by the 1993 chemical weapons ban. Ketchum says that is not clear. In October 2002, Russian special forces used a calmative agent to subdue Islamist Chechen terrorists who were holding about 850 hostages in a Moscow theater. More than 120 hostages died from the drug's effects.

Military prepares to share medical records By WILLIAM R. LEVESQUE TAMPA - Soldiers wounded in Iraq or Afghanistan are often treated by a battlefield doctor or medic who inputs medical information in a handheld computer the same way another generation's physicians used ink and clipboard. If the same soldier later visits a nonmilitary hospital back home, that health data often proves as elusive and unreachable to private doctors as a stealth fighter over Baghdad. The Pentagon is trying to knock down those electronic walls. Pentagon and state health officials Wednesday announced a pilot program to share the military's huge medical database with health care providers in the Tampa Bay area, a project defense officials hope one day will catch on across Florida and the nation. It's the Pentagon's first effort to link its medical records to the private sector. Local doctors and nurses using some of the same software and handheld devices developed for special operations forces in battle zones will be able to share with the military information on both active-duty personnel and retired veterans. The information initially passed back and forth might seem modest: allergies, prescriptions, surgical history, lab results. In coming years, more detailed data will be part of the network, from dental and eye exam records to radiology reports. "It will lead to better, safer care," said Dr. Andrew Agwunobi, secretary of the Florida Agency for Health Care Administration, during a short ceremony at MacDill Air Force Base. "This is especially true in emergency situations when a person might be unable to give their own medical history and in which every second counts." At first, roughly 500 area doctors and three area hospitals will participate. They are All Children's Hospital in St. Petersburg, H. Lee Moffitt Cancer Center & Research Institute in Tampa and Tampa General Hospital. The hope eventually is to connect to all area hospitals and additional doctors. Officials said they had no specific timetable on when shared information will first become available or when the network will be expanded. "We are on the first step of a very difficult journey," said Dr. Stephen Jones, principal deputy assistant secretary of defense for health affairs. Setting up an electronic health care information network "will be akin to building America's cross-continental railroad. It's just as monumental an undertaking," Jones said. The Pentagon already has a system to share medical data with the Department of Veterans Affairs, reducing some legwork as officials transition to an enlarged network that includes state doctors. The Pentagon's internal database links 70 military hospitals and 400 clinics and temporary medical facilities in Iraq and Afghanistan. Information on 9-million people, both active-duty military and some though not all retired veterans, is part of that network and will soon be available to participating Tampa Bay doctors.

Fitzsimons will become home to state-of-art facility By Chris Barge, Rocky Mountain News AURORA - When Jim Nicholson took over as U.S. secretary of veterans affairs two years ago, plans for replacing his home state's aging veterans hospital were "looking pretty dim," he said Wednesday. Nicholson, by contrast, was beaming as he stood on a stage next to an open field on the east flank of the Fitzsimons medical campus and announced that the state-of-the-art hospital would be built after all. Nicholson said he signed a deal last Thursday with the Aurora Redevelopment Authority to buy the first 18 acres of the planned 31-acre site for $11.15 million. The VA will acquire the rest of the property during the next year, while an architect draws up plans, Nicholson said. The veterans hospital campus is scheduled to open in 2011 with 1.4 million square feet of usable space. "This is a red-letter day for Colorado," Nicholson said. "It's a red-letter day for Denver and it's a red-letter day for Aurora. But most importantly, it's a red-letter day for veterans." The hospital's future became doubtful the year before Nicholson took over, when then-VA Secretary Anthony Principi announced that he wanted more than 30 acres to build a free-standing hospital to replace the aging veterans facility near East Ninth Avenue and Colorado Boulevard in east Denver. What Principi proposed conflicted with a long-standing vision of building a VA hospital on 13 acres that would abut the new University Hospital at Fitzsim-ons so the two could share services. Fitzsimons property owners said they couldn't come up with the additional land, prompting local, state and federal officials to work on salvaging an agreement. Nicholson recalled how Aurora Mayor Ed Tauer flew to Washington, D.C., soon after Nicholson replaced Principi in 2005. "We said, 'How can we put this together? Because it's needed and it makes sense,' " Nicholson said. " 'Let's forget about what's happened so far and look forward and get this done.' And he said, 'I think that's a great idea,' and we have done that." In all, the redevelopment authority, led by Tauer, plans to sell 24 acres on the northeast corner of East Colfax Avenue and Fitzsimons Parkway to the VA for an estimated $15 million. The redevelopment authority, which had planned hotels and office buildings for the property where the hospital will now go, will use proceeds from the land sale to buy a new parcel for those projects, Tauer said. The VA found seven additional acres on three adjacent parcels, including the new University Physicians Inc. building on East Colfax Avenue. The new hospital property will be bounded by East Colfax Avenue to the south, Fitzsimons Parkway to the east, East 19th Place to the north and Wheeling Street to the west. Money in President Bush's 2008 budget will pay for two of the initial structures, Nicholson said. The balance of the $658 million VA medical center will be paid for out of the 2009 budget, he said. The design will take about 12 months to complete, keeping the project on track to be put out for construction bids by mid-2008. It will have medical, surgical and in-patient wards, mental health in-patient treatment facilities, special units for spinal cord injury patients and a new nursing home. Once complete, it will bring the total amount invested in facilities at Fitzsimons to $4.3 billion. New VA medical center, by the numbers • Planned opening......2011 • Cost......$658 million • Total land......31 acres • Size......1.4 million sq. ft. • Jobs created......1,800

By MARTIN J. KIDSTON FORT HARRISON — The Department of Veterans Affairs opened a new $4.5 million regional claims office here Tuesday, touting the facility as the VA’s first energy efficient and environmentally certified building. The facility, an appealing one-story structure, will process health-care claims for Montana veterans, including those returning from duty in Iraq and Afghanistan. Gov. Brian Schweitzer and Lt. Gov. Jon Bohlinger, along with representatives from Montana’s congressional delegation, gathered for the ribbon-cutting ceremony, officially opening the 22,000 square-foot building, which sits east of the larger VA Hospital. Mike Walcoff, the associate deputy undersecretary for benefits with the Department of Veterans Affairs, said the new office currently employs 48 people. In the future, the office could grow to serve as a resource center for other states. Montana is home to 107,000 veterans, the most per capita of any other state in the union. The Department of Veterans Affairs operates 57 regional offices scattered around the country. “The vast majority of veterans are receiving quality care and the type of services they deserve,” Walcoff said. “It’s not to say that we’re perfect. We have to continue to strive to make it better.” Walcoff said it was difficult to read about the issues plaguing the Walter Reed Army Medical Center in major newspapers, and to hear it discussed on national television. Despite the setbacks at the Army hospital, he said, the VA healthcare system remains one of the best providers in the country. “This is a job where, everyday that you come to work, you can make a difference in people’s lives,” he said. “You have the responsibility of seeing to it that veterans get the care and attention they deserve.” Maj. Gen. Randy Mosley, adjutant general of the Montana National Guard, said the relationship between the VA and the Guard remains strong. The Montana VA has made the processing of claims for veterans of Iraq and Afghanistan its top priority. Mosley also addressed the Guard’s effort to expand care to veterans who not only suffer physical wounds from the war, but also suffer post-combat stress. “I spend a lot of my time reviewing statistics,” Mosley said. “The statistics show only those who have been physically wounded. They don’t show the statistics for those who have come back with behavioral problems or mental wounds.” Nearly 80 percent of the Montana National Guard has deployed since 2001. Missions have included operations in Iraq and Afghanistan, post-hurricane relief in New Orleans, and border patrol in New Mexico. While the Montana Guard is experienced in preparing and ultimately sending soldiers off for duty, Mosley said, it now needs to address its post-deployment care. To do so, the Guard has established a new task force, which meets today for the first time. The group will provide Mosley with an assessment on what needs to be done, and how to do it. “I look forward to seeing that assessment,” Mosley said during the ceremony. The new VA facility provides compensation, pension, and rehab benefits, among others. It includes interview rooms, offices for various divisions, a conference center, and a room for veteran’s service organizations. The cubicles are comfortable and plush, and the filing system is expansive. Claims filed by veterans of Iraq and Afghanistan have been made a priority. Dean Bjerke, president of Diamond Construction, which won the contract for the project, promoted the facility as state of the art. It’s the VA’s first building certified as a Leader in Energy and Environmental Design. “It pushed the envelope for us,” said Bjerke. “But we have a very special group of people we have to serve here. It was an honor to provide some small contribution to that community.”

VA Vet Centers Coming to 23 More Communities 7 Nicholson: Vital Services More Accessible for Returning Veterans WASHINGTON -- The Department of Veterans Affairs’ (VA) vet center program, which provides readjustment counseling and outreach services to combat veterans, is expanding into 23 new communities across the nation in the next two years, the Department announced today. These facilities are an important resource for veterans returning from the Global War on Terror and their families. “Our vet centers lead the world in helping combat veterans successfully readjust to life at home,” said Secretary of Veterans Affairs Jim Nicholson. “It’s an important service which combat veterans have earned. VA continues to expand into more communities with our vet centers to bring our services closer to the veterans who need them.” New vet centers will be located in Montgomery, Ala.; Fayetteville, Ark.; Modesto, Calif.; Grand Junction, Colo.; Orlando, Fort Myers, and Gainesville, Fla.; Macon, Ga.; Manhattan, Kan.; Baton Rouge, La.; Cape Cod, Mass.; Saginaw and Iron Mountain, Mich.; Berlin, N.H.; Las Cruces, N.M.; Binghamton, Middletown, Nassau County and Watertown, N.Y.; Toledo, Ohio; Du Bois, Penn.; Killeen, Texas; and Everett, Wash. During 2007, VA plans to open new facilities in Grand Junction, Orlando, Cape Cod, Iron Mountain, Berlin and Watertown. The other new vet centers are scheduled to open in 2008. All vet centers are community-based. They provide counseling on mental health and employment, plus services on family issues, education, bereavement and outreach, to combat veterans and their families. They are staffed by small teams of counselors, outreach specialists and other specialists, many of whom are combat veterans themselves. The vet center program was established by Congress in 1979 in recognition that a significant number of Vietnam veterans were still experiencing readjustment problems. Today, all veterans who served in combat are eligible for care at a VA vet center at no cost, as are their families for military-related issues. Also eligible are veterans who were sexually assaulted or harassed while on active duty and the families of service members who die on active duty. Currently, VA maintains 209 vet centers in all 50 states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands.