Union officials representing more than 250,000 Department of Veterans Affairs employees have flatly rejected management proposals for a major overhaul of the collective bargaining agreement, to include drastic cuts to on-the-clock official time spent on union activities.
In calling for the changes, VA Secretary Robert Wilkie is "making a mockery of the collective bargaining process to do the bidding of President [Donald] Trump," J. David Cox, president of the American Federation of Government Employees, said in a union news release Friday.
Cox charged that Wilkie's "sham" proposals would eliminate entirely or in part 42 sections of the existing contract and effectively strip union workers, about one-third of them Veterans, of rights and protections under law.
In its own news release Thursday, the VA said the proposed changes to the collective bargaining agreement, or CBA, are designed to improve medical care and worker accountability while "maximizing value for taxpayers."
The VA claimed that union employees are now spending "more than one million hours per year" of official time on union activities. The proposed change to the CBA would cut that figure to about 10,000 hours, the VA said, resulting in savings of $48 million that could be directed to medical care.
The VA release referred to the Office of Personnel Management definition of "official time," which is authorized under the U.S. Code, as "paid time spent by federal employees performing representational work for a bargaining unit in lieu of their regularly assigned work. In other words, official time is treated as work time, thus is funded by the American taxpayers."
The department also said that the proposed changes include unspecified measures to make sure that the CBA "doesn't interfere with the VA's ability to take action" in implementing the Mission Act to expand private-care options and the Accountability and Whistleblower Protection Act, which made it easier to fire workers.
"It's time for a reset in VA's approach to labor-management relations," Wilkie said in a statement. "A reluctance to challenge the status quo produced the current agreement, which includes many benefits that favor the union rather than the Veterans we are charged with serving."
Cox and other union officials charged that Wilkie's proposals amount to an attack on the workforce, which serves nine million Veterans annually.
"This is all part of the Trump administration's strategy to force the VA to fail, thereby paving the road to privatization," Cox, a registered nurse at the VA for more than 20 years, said in the AFGE release.
"As a Veteran myself, it makes me sick to see how little regard this administration shows to the workers who serve our Veterans day in and day out," said AFGE District 3 National Vice President Phil Glover. "VA employees deserve to be treated with the same respect we expect them to show the Veterans they serve."
In hearings of the Senate and House Veterans Affairs Committees, Republicans have routinely cited the issue of official time as a factor in the VA's failures, such as the 2014 wait-times scandals at the Phoenix VA Medical Center.
Union officials, just as routinely, counter that by saying the attack on official time is a convenient distraction to divert attention from management failures.
VA and Centers for Medicare and Medicaid Services join to strengthen safety surveillance for medications issued to Veterans
The U.S. Department of Veterans Affairs (VA) and Centers for Medicare & Medicaid Services (CMS) recently announced an agreement that greatly improves drug safety monitoring of prescriptions, including opioids.
The agreement, which was formalized March 21, will give VA the ability to monitor medical prescriptions issued outside the VA through Medicare Part D.
“VA is committed to patient safety, and our robust medication surveillance systems are part of that commitment,” said VA Secretary Robert Wilkie. “This agreement greatly enhances medication safety for Veterans by providing better oversight of drugs that Veterans may be able to obtain from both agencies.”
VA currently has a robust system in place for medication surveillance to ensure safe use by Veteran patients and the ability to analyze patient outcomes. This new agreement will enable VA to incorporate up-to-date Medicare prescription information into its safety surveillance operations.
By incorporating prescriptions dispensed through Medicare, VA providers have access to more accurate information about the medications used by its patients.
More than 5 million Veterans receive prescription medications through VA. With the creation of the Medicare Part D benefit, Veterans dually enrolled in VA and Medicare have access to prescription benefits through both VA and Medicare, creating the potential for adverse drug interactions, duplication of use and greater risk of adverse drug events, including overdoses.
“This agreement represents a new level of information sharing between VA and CMS, which will improve care coordination and better protect our beneficiaries,” said CMS principal deputy administrator for Operations and Policy Kimberly Brandt. “Leveraging data is a key element of CMS’ efforts to combat the opioid epidemic, and we look forward to continued collaboration with VA on this important issue.”
To learn more about the risks of opioid-related adverse events and overdose among Veteran patients receiving dual prescriptions with VA and CMS, visit www.annals.org/aim/fullarticle/2728200/dual-receipt-prescription-opioids-from-department-Veterans-affairs-medicare-part.
A booming Veteran population and the start of work on a new clinic that will treat them drew the secretary of the U.S. Department of Veterans Affairs to town Friday.
An advocate of giving Veterans options in their health care, Robert Wilkie said the opening of the North Charleston annex is a sign of times to come at the VA.
The site is one of about two dozen being built across the country. For now, the land at 6450 Rivers Ave. is soft mulch and grass. A low fence separates the property from Hanahan Road. Trees still stand on all sides, though dust rises from tractors at work at the neighboring plot.
It’s a rapidly developing area, one that’s expected to be more convenient for many patients that will use the clinic.
More than 400,000 Veterans now live in South Carolina. Joe Cunningham, D-S.C., said during prepared remarks Friday the 1st Congressional District is home to more Veterans than any other in the state.
The 75,000-square-foot clinic is being built by Carnegie Management and Development Corp. It will cost $10 million to complete is expected to serve about 20,000 Veterans annually. Its focus will be primary care, women’s health and mental health.
The idea is that primary care patients will use the centrally located clinic just off Interstate 26, while those with more complex problems will head to the VA’s full-service hospital in the peninsula’s medical district.
Scott Isaacks, director of the local VA medical center, has stressed that he needs more space and staff. With flooding on the peninsula also top of mind, the Charleston VA needs to be able to be agile, Isaacks said during a groundbreaking ceremony for the annex Friday.
But it is run by the federal government, not known for being light on its feet.
Wilkie, secretary of the Department of Veterans Affairs, said he is working on “creative” ways to hire people to jobs in the system by offering competitive salaries, relocation pay and student debt relief. He said the North Charleston clinic is a sign of how VA is beginning to spread out geographically.
Wilkie called the Ralph H. Johnson VA Medical Center in downtown Charleston the second- or third-best agency hospital in the country. Veterans Affairs has 170 hospitals across the U.S.
The Charleston VA Medical Center is among the highest-ranked, most robust VA facilities in the South. It is the fastest growing among its peers, Isaacks said.
At the moment, it is running out of space downtown. Parking is challenging. And flooding is a growing concern.
The federal government does move slowly, Wilkie said, but the North Charleston expansion shows “a way forward,” an example of how VA might move quickly to cope with pressures.
Friday’s groundbreaking is a sign of how health care facilities are dispersing, Wilkie said. The VA is doing what it can to bring services closer to where Veterans live.
How was his 91-year-old father, who served in the U.S. Navy in World War II, fatally injured in a Veterans Affairs nursing home, the institution Ferguson had entrusted to care for him?
Huddled around a computer monitor with managers at the VA in Des Moines, Iowa, Ferguson watched a hallway surveillance video that depicted a chilling blow to his father's head.
“I lost it,” Ferguson told USA TODAY. “I broke down.”
In the video, James “Milt” Ferguson Sr., who had dementia and was legally blind, appears confused. He opens a hallway door, rolls his wheelchair into another resident’s room, then wheels back out. No staff members are visible. He circles around and heads back into the room.
Halfway through the door, his chair flips over backward. Milt Ferguson crashes to the floor, landing on the back of his head. Ferguson said he was told the chair was pushed over by the resident in the room, who can't be seen in the video. As staff members rush to assist him, Ferguson is able to turn over and sit up, but the impact causes a massive brain bleed that will kill him within days.
What later would turn the son’s despair into outrage was what he learned about events leading up to his father wheeling around unsupervised last December, and what happened after he smashed into the floor.
“It’s like my dad died at their hands,” Ferguson said.
Serious problems with resident care have occurred in many VA nursing homes across the nation, including the one where Ferguson was being cared for.
USA TODAY reported in March that inspections by a private contractor hired by the VA found deficiencies that caused "actual harm" to Veterans at more than half of the 99 VA nursing homes reviewed. The inspections found inadequate supervision or hazardous conditions at 53 of them.
In Des Moines – which received the lowest one star out of five in the VA's own ratings, based on surprise inspections – inspectors found managers did not ensure staff treated residents with dignity or followed basic infection-control and prevention measures.
The story of what happened to James Ferguson in Des Moines provides a deeper picture of the care one elderly Veteran received. Medical records provided to USA TODAY by his son and legal guardian outline what specialists say was a concerning series of decisions by VA staff, before and after his deadly head injury.
Nine days before, VA caregivers determined Ferguson was a danger to himself and others because his dementia caused him to wander around, agitated. They had him on continuous one-on-one observation with an aide, but took him off the strict monitoring when he entered the VA nursing home. There, staff didn't reinstate the heightened observation, despite his repeatedly straying dangerously into other residents' rooms.
After his injury, staff put him back in his wheelchair but did not report the incident to a supervisor for 40 minutes, the records and surveillance video indicate. Ferguson wasn't transported to an emergency room for two hours after that. Then, it took 2½ hours more to send him to a trauma hospital. The time stamp on the video showed the fall occurred at 3:49 p.m. and it wasn't until just before 9 p.m. that Ferguson was transported to the trauma facility.
'A disaster waiting to happen'
Specialists who reviewed Ferguson's medical records at the request of USA TODAY expressed concern about the quality of his care.
"It was definitely a disaster waiting to happen, and it did," said Robyn Grant, director of public policy and advocacy at The National Consumer Voice for Quality Long-Term Care, a Washington-based nonprofit advocacy organization.
"I just am really struck by the predictability with his repeated episodes of going into other people's rooms," she said. "They should have had some intervention so they could provide him with adequate supervision and address the wandering."
Grant said the length of time it took afterward to adequately evaluate and diagnose the severity of his injury and get him to a trauma facility also raises questions. "What was happening there, in terms of those delays?" she said.
VA nursing homes: Feds find 'blatant disregard' for Veteran safety
Richard Mollot, executive director since 2005 of the Long Term Care Community Coalition, a New York City-based nonprofit advocate of nursing home care improvement, said the shortfalls indicate there was "very likely" a lack of skilled or adequately trained staff to meet his needs.
"The point of being in that environment is that you have skilled nursing care and monitoring," he said.
Mollot said the reporting delay is particularly concerning. "How often does this happen that no one's looking at? That's what is so upsetting."
'All staff acted properly'
A spokesman for the Des Moines VA, Timothy Hippen, said in a statement that a review after the "untimely death" concluded "all staff acted properly."
"Any time an unexpected death occurs, VA Central Iowa Health Care System reviews its policies and procedures to see if changes are warranted," he said. "We did that here, finding that all staff acted properly."
In response to questions about the case, national VA spokesman Curt Cashour accused USA TODAY of focusing on "isolated complaints" and "cherry-picking the experiences of a handful of Veterans to create the impression of a broad problem."
Cashour maintained that, overall, VA nursing homes "compare closely" with non-VA facilities. More than 40,000 Veterans rely on care at the agency’s 134 nursing facilities each year.
USA TODAY reported last year that about 70% of VA nursing homes scored worse than non-VA nursing homes on a majority of quality indicators tracked by the agency, which include rates of infection, serious pain and bed sores.
Hippen declined to respond to detailed questions about Ferguson's case.
"We will not be addressing the specifics of this case publicly, but we have been in direct contact with the Veteran’s family to discuss their concerns," he said.
Jim Ferguson said he remains upset even though VA officials shared the surveillance video with him and said they were sorry about what happened to his father.
He wants VA staff held accountable. He wants to make sure policies are in place so it doesn't happen to anyone else.
“No one should live their life like that and have what happened to him in the end,” he said. “I want this to be the last person this happens to.”
A gambler called ‘booger’
Even as his dementia worsened, Milt Ferguson flashed glimmers of his younger self.
The former deckhand on the heavy cruiser U.S.S. Pensacola was affectionately known as “booger” at the Des Moines Register, where he worked bundling newspapers for 23 years before retiring in 1995. He loved to play the slots and the horses.
On a note in his medical record, a nurse practitioner wrote: “Patient laughs when his nickname is mentioned.” Jim Ferguson had come for a visit that day, as he did most days. “He was smiling and appeared to be enjoying his son’s company,” the medical record said.
The decision to place him in a nursing home had been a gut-wrenching one, Ferguson said. He had moved in with his parents and cared for them for three years. But in April 2018 his mother died. He said a VA social worker told him his father needed more intensive, round-the-clock care and supervision.
“They made it sound like, well, if he got hurt, I could be charged with a crime,” Ferguson said. “So that’s when I decided to place him in a nursing home.”
‘His dementia was acting up’
Ferguson moved his father to Bishop Drumm Retirement Center, a private facility just outside Des Moines, where his mother worked as a nursing assistant in the Alzheimer’s unit for more than 20 years before retiring.
The center took in Milt Ferguson last August. But three months later, his condition worsened.
"The day before Thanksgiving, I got a call from Bishop Drumm – his dementia was acting up," his son said.
He hit two staff members, was “agitated all day” and was “wandering into other residents room(s), causing distress,” a nurse later noted in his medical record. “He is generally ‘sweet’ so this is a departure from his usual behavior.”
Ferguson was taken by ambulance to the Des Moines VA Medical Center, where he was admitted to the acute psychiatry ward. He was put on one-on-one observation with a sitter – an aide tasked with intervening if he lashed out or tried to stray into other patients’ rooms.
They adjusted his medications, and, after a few aggressive outbursts, he appeared calm enough after three weeks to transfer into the VA nursing home on the medical center’s campus.
But there was a catch, a psychiatric nurse wrote in his record: "Veterans are not put on sitter status over there."
‘Help me, help me’
After a 22-hour trial period without a sitter, Milt Ferguson moved in to the VA nursing home.
Problems began within hours.
He hardly slept, he hallucinated, he called out "help me, help me" over and over again. He was agitated and again, he "wandered into and out of peers rooms" day after day, nursing staff wrote in his record.
They gave him medication. Sometimes he calmed down. Sometimes he didn’t.
A psychiatrist was managing his case remotely. According to public records, the doctor worked at a VA facility a few hours away in Lincoln, Nebraska. Through virtual appointments, the psychiatrist advised changes to Ferguson's medication.
On December 19, a week after Ferguson moved in, nursing home staff noted he was still restless and anxious, pacing and screaming and yelling. His care team – psychiatrist, primary care doctor, nursing staff and social workers – met to discuss the case.
The psychiatrist said a review of his records showed "increased confusion with wandering" during the past week. The doctor prescribed higher dosages of a mood-stabilizing drug and a sedative. There was no discussion of closer supervision or reinstatement of one-on-one observation, the records show.
“Will ask RN to contact this MD in one week with update,” the psychiatrist wrote.
By then, Ferguson would be dead.
‘A golf ball-sized lump’
On December 20, when two aides rushed to help Milt Ferguson, his head on the floor and legs crumpled to the side, the time stamp on the hallway surveillance video reads 3:49 p.m. But in a report filled out an hour later, a nurse recorded the time of the accident as 4:30 p.m.
His records do not indicate what the staff did with Ferguson during the 41 minutes in between, aside from putting him back in his wheelchair.
By that time, he had a “golf ball-sized lump on the back of his head.” The nurse notified the manager on duty, a nurse practitioner, who wrote at 5:06 p.m. that he had ordered an immediate CT scan of his head.
That didn’t happen until about 6:30 p.m., when Ferguson arrived in the emergency department of the medical center on the Des Moines VA campus, on a bed wheeled by a nursing home aide. The aide said Ferguson had earlier been taken for a CT scan but was uncooperative.
An emergency room doctor quickly had a sedative administered and the scan was completed. By that point, the World War II Veteran had a “large bleed” in the back right side of his brain that was so acute, the CT report says his brain had shifted to the left inside his skull.
Sent 'to scanning’
The doctor notified MercyOne Des Moines Medical Center, a trauma hospital, at 7 p.m. For nearly two hours, the doctor tried to keep Ferguson comfortable and his blood pressure under control until an ambulance arrived and took Ferguson to Mercy at 8:55 p.m.
The doctor also kept calling Ferguson’s son, leaving voicemails.
But Jim Ferguson had himself been admitted to a hospital and had provided the VA nursing home with a consent form authorizing staff to contact a close friend if anything happened to his father. That form had been sent "to scanning” that morning.
But Jim Ferguson had himself been admitted to a hospital and had provided the VA nursing home with a consent form authorizing staff to contact a close friend if anything happened to his father. That form had been sent "to scanning” that morning.
"One would argue that could have been prevented," she said. "There should have been somebody, somewhere who could have seen that this happened and – particularly when he wheeled himself – to have gone in and intervened, 'Let me help you, let's go to your room.'"
Mollot, the executive director at the Long Term Care Community Coalition, said meeting the standards of care means staff identifies risks and needs and ways to meet them and mitigate them and then does so consistently.
"This is exactly the kind of thing that happens when those standards are not followed," he said.
'A safe place'
The spokesman for the Des Moines VA, while declining to answer detailed questions about what happened, said that in general, "caring for nursing home residents involves balancing patients’ independence with the need for supervision, as appropriate."
"While tight scrutiny and strict limits on residents’ activities and freedom of movement could possibly lower the risk for adverse events, it would also severely degrade patients’ quality of life, which is precisely what we are trying to preserve for as long as possible," he said.
Jim Ferguson still has his father’s wheelchair in the garage. He keeps the sweatshirt his father was wearing when he last used the chair. Ferguson has retained a lawyer, Brad Biren, to help him figure out next steps and how to hold the VA accountable.
“Somebody didn’t watch my dad and let him die,” he said. “It’s supposed to be a safe place.”
A pair of prominent freshman lawmakers offered sharply different views about the future of the Department of Veterans Affairs health care this week, bringing the ongoing debate over fears of department privatization to the next generation of elected leaders.
The duo — Democratic New York Rep. Alexandria Ocasio-Cortez and Republican Texas Rep. Dan Crenshaw — have both built national followings since their elections last fall, and recently have sparred directly over social media concerning rhetoric surrounding Muslims and the Sept. 11 attacks.
But this week marked each legislator’s first focused entry into VA policy discussions, and their comments suggested both will make those issues a key focus in months to come — with very different positions on the issue.
In her home district on Wednesday, Ocasio-Cortez took part in a rally organized by National Nurses United and other advocates who warned that current administration plans are taking the department on a path towards privatization by dramatically expanding community care eligibility for Veterans.
“They’re trying to ‘fix’ the VA for pharmaceutical companies, they’re trying to ‘fix’ VA for insurance corporations, and ultimately they’re trying to ‘fix’ the VA for a for-profit health care industry that does not put people or Veterans first,” she told an applauding crowd advocates who have lobbied against the changes for months.
“We have a responsibility to protect (VA). Because if there is any community that deserves Cadillac, first-class health care in the United States of America, it is our military servicemembers and Veterans.”
"If Congress wants to #ProtectTheVA, we shouldn’t starve it + then sell it off for parts, forcing Vets into for-profit emergency rooms + to providers who aren’t used to working w/their unique medical needs.
We should fight to fully fund the VA + hire to fill its 49,000 vacancies. https://t.co/v25R2UNanW— Alexandria Ocasio-Cortez (@AOC) April 18, 2019"
The U.S. Department of Veterans Affairs (VA) recently published a Code of Integrity, which sets the ethical standards and obligations of every employee in VA’s Veterans Health Administration (VHA).
Centered upon VA’s I CARE values of Integrity, Commitment, Advocacy, Respect and Excellence, the VHA Code of Integrity, which was published April 22, makes VA among the first handful of federal departments or agencies to implement such an action.
“The response by VHA staff in reaffirming our shared values and strengthening our culture is outstanding,” said VA Secretary Robert Wilkie. “We’re proud to help set a standard for other federal departments and agencies to follow.”
A “go to” resource for finding high-level guidance and contact information, the Code covers a wide range of ethical conduct and concerns, from protecting confidential Veteran information to ensuring the accuracy of reported statistics to making the workplace environment safer. Further, the Code emphasizes VHA’s common culture of integrity and its responsibility to operate with the highest principles and ethical business standards in striving to care for patients, as well as treating fellow colleagues with dignity, respect, integrity, honesty, compassion, teamwork and excellence.
As government employees, all VHA employees adhere to a federal employee code of conduct. The VHA Code of Integrity takes this commitment further by underscoring the unique role VHA staff plays in Veterans’ care.
“Creating a culture that’s conducive to the highest ethical standards is critical not only to assuring high quality health care, but also to assuring public trust in VA,” Wilkie said.
Additionally, the Code aligns with the agency’s priority to ensure the efficient use of government resources and address underlying management issues previously identified by the Government Accountability Office.
To learn more about the Code of Integrity, visit the Office of Organizational Excellence website.
WASHINGTON — A Green Beret’s terminal Stage IV cancer. An airmen’s routine appendectomy turns fatal. A judge advocate general suffers multiple miscarriages.
These are samples of medical cases gone awry under the care of military doctors.
But it doesn’t stop there: Patients and their families aren’t allowed to sue for medical malpractice. A special legal shield, known as the Feres Doctrine, blocks military servicemembers and their relatives from seeking recourse in court.
“The hardest thing I have to do is explain to my children when they ask me, ‘This doesn’t make sense, how is this happening?’ And I have no good answer,” Army Sgt. 1st Class Rich Stayskal, who is battling terminal Stage IV metastatic lung cancer, said Tuesday in congressional testimony. “I say ‘That’s why I am coming up here to help convince these folks in Congress to change this.’ This doctrine has effectively barred hundreds of servicemembers and their families any chance to be made whole for receiving negligent medical care.”
Stayskal was one of several witnesses called before a subpanel of the House Armed Services Committee to recount their stories of military medical care.
In Stayskal’s case, doctors missed signs of his cancer for months, until finally catching it in 2017. It’s since spread to his neck, lymph nodes, spleen, liver, spine, hip joint and other areas of his body.
Now, the Green Beret with 17 years of service is being separated from the military.
“The failure to detect my cancer … is a mistake that allowed an aggressive tumor to double in size and rob me, rob my life of my family, without any recourse,” Stayskal told members of the subpanel on military personnel issues. “My children are definitely the true victims, along with my wife.”
'Dean would still be alive'
Alexis Witt painfully recounted to lawmakers the 2003 death of her husband, Air Force Staff Sgt. Dean Patrick Witt, following a surgical procedure.
Following Witt’s appendectomy at Travis Air Force Base in California, a nurse administered a lethal dose of fentanyl and incorrectly inserted a breathing tube into his esophagus. Witt subsequently suffered from respiratory and cardiac arrest and died after being left in a vegetative state for three months.
Witt’s wife said the same nurse was linked to at least three other deaths, including one before her husband died.
“If the appropriate action had been taken on this nurse during her first lethal, negligent episode, Dean would still be alive today,” Witt told lawmakers.
Despite his terminal illness, Stayskal has lobbied Congress for months, between bouts of chemotherapy, to reverse the Feres rule, inspiring Rep. Jackie Speier, chairwoman of the House Armed Services subpanel, to call for Tuesday’s hearing.
Speier, D-Calif., said servicemembers deserve the same right to sue their medical providers as their spouses, other federal workers and even prisoners can.
“When our servicemembers suffer from medical malpractice — when doctors fail to perform or woefully misread tests, when nurses botch routine procedures, when clinicians ignore and disregard pain — servicemembers deserve their day in court,” Speier said. “When lives are disrupted, ruined, and cut short by negligence, servicemembers deserve a chance to receive just compensation.”
Rep. Trent Kelly of Mississippi, the panel’s ranking Republican member, urged the House Judiciary Committee to address the Feres Doctrine issue since it is under that panel’s jurisdiction. He also said ongoing revisions to the military health care system could address a series of new fixes.
“Our servicemembers, who sacrifice so much, deserve the best medical care that we can provide,” Kelly told the servicemembers and relatives. “And we as an institution let you down.”
The Feres Doctrine can be traced back to1950 when the Supreme Court issued a ruling in Feres vs. the United States. Four years earlier, Congress had enacted the Federal Tort Claims Act allowing for citizens to sue the government for damaging acts of negligence. However, the court in 1950 — combining three cases of harmed servicemembers — determined the act was not applicable for military members “in the course of activity incident to service.”
Since then, the court has interpreted the Feres Doctrine to mean that no active-duty servicemember can sue the federal government regardless of the circumstances.
“In our country, we rightfully revere servicemembers for their bravery and sacrifice,” Speier said. “It is disrespectful and shameful that for 69 years Congress has refused to give them the same rights as everyone else.”
'I was suicidal'
Rebecca Lipe, a former Air Force judge advocate general, was left with debilitating abdominal pain, 10 related surgeries and permanent damage to her reproductive organs after wearing ill-fitting body armor during a 2011 deployment in Iraq.
Initially, doctors accused her of having an extramarital affair and contracting sexually transmitted diseases, Lipe recalled. That was followed by a series of medical mistakes, unnecessary surgeries and an ordeal that would consume her health and family for years to come.
“I was suicidal,” she told lawmakers Tuesday.
Eventually, Lipe, who now works as a civilian, saw doctors in private practice who diagnosed her with injuries connected to her ballistic gear worn during deployment. The private doctors were able to correct eight areas of damage along her abdominal wall.
“The civilian doctors …attempted to reverse the unnecessary medical treatment I received at the hands of the military medical providers,” Lipe said. “But the damage was already done. I now deal with chronic abdominal pain and complications due to that medical treatment.”
Lipe and her husband could no longer conceive a child as a result of the damage, and underwent seven rounds of in vitro fertilization at a cost of $60,000. However, Lipe was still under military care when doctors at Andrews Air Force Base in Maryland missed her ectopic pregnancy, which resulted in an emergency surgery and loss of her fallopian tube.
Following a subsequent miscarriage, Lipe had to wait four days for Walter Reed National Military Medical Center in Bethesda to remove the remains rather than undergo an emergency procedure immediately. Then, the hospital lost the remains of the baby, Lipe said.
After she left the Air Force, the couple saw a civilian doctor for a sixth round of IVF. Lipe finally delivered a healthy baby girl in July 2017.
“I received a level of care I had never received while on active duty,” she said.
During a final round of IVF, Lipe suffered near-fatal complications and can no longer have children.
The Feres Doctrine could also come before the Supreme Court in the near future. The court could soon decide whether it will hear a petition tied to a military medical malpractice case that looks to overturn the rule that bars servicemembers from suing the government.
The petition is tied to the death of Navy Lt. Rebekah Daniel, who died after childbirth at Naval Hospital Bremerton in Washington state in 2014. Her husband, Walt Daniel, filed the petition targeting the Feres rule.
Rebekah Daniel, a labor and delivery nurse at the same hospital who was known as Moani, bled to death after giving birth to a baby girl, Victoria.
Daniel’s Supreme Court petition was filed in October after the 9th U.S. Circuit Court of Appeals upheld a district court dismissal of the case. In the Supreme Court petition, Daniel’s attorney argued she was not engaged in her military duties at the time of her death or while she was being treated at Bremerton.
As Daniel and others have learned, there are only two paths to changing the Feres Doctrine: the Supreme Court or Congress.
“This isn’t just a matter of justice,” Speier said. “It’s a question of accountability. Because behind the shield of Feres, DOD’s health providers act with impunity.”
Secretary of Veterans Affairs Robert Wilkie struck back at Rep. Alexandria Ocasio-Cortez, D-N.Y., on Wednesday, calling her accusations that the Trump administration wants to privatize the VA "nonsense."
"I won't be rude to the congresswoman and say that it is nonsense, but I will say it's nonsense," Wilkie said on "Fox News @ Night with Shannon Bream."
"If we are privatizing VA, we are going about it in a very strange way," Wilkie said. "I presented to the Congress a $220 billion budget, the largest budget in the history of the department. We are undergoing basic reforms to make the VA a modern, 21st-century health care administration. But what we are doing is opening the aperture on choice, so that our Veterans remain at the center their own health care, and if VA can provide what they need, we will give them the opportunity to go out into the private sector."
Ocasio-Cortez claimed during a New York town hall event last week that the VA “isn’t broken” despite the scandals that have plagued the agency over the last decade and claimed the Trump administration aimed to "privatize" health care for Veterans.
"That is the opening approach we have seen when it comes to privatization, it's the idea that this thing that isn’t broken, this thing that provides some of the highest quality care to our Veterans somehow needs to be fixed, optimized, tinkered with until we don’t even recognize it anymore," Ocasio-Cortez said, in comments first reported by the Washington Examiner.
"They are trying to fix the VA for pharmaceutical companies, they are trying to fix the VA for insurance corporations, and, ultimately they are trying to fix the VA for a for-profit health care industry that does not put people or Veterans first," Ocasio-Cortez said.
“And so we have a responsibility to protect it.”
The congresswoman's comments were aimed at Trump administration efforts to expand choice and private health care options in the VA health care system.
President Trump reacted to the congresswoman's comments by taking credit for turning around the VA.
"Rep. Alexandria Ocasio-Cortez is correct, the VA is not broken, it is doing great. But that is only because of the Trump Administration. We got Veterans Choice & Accountability passed," Trump tweeted.
Wilkie defended the Trump administration and supported the president's response on Twitter.
"The other part of our comments or they were answered by the president, who said that under this administration, the VA isn't broken. The scandals that she referred to happened in another administration," Wilkie said.
"I can say, as someone who's been accused of being a historian, no president in the post-World War II era has put the Veterans at the center of his campaign and administration until President Trump did it. We are seeing this in the way the VA's moving forward."
Calling the U.S. Department of Veterans Affairs a recognized leader in pain management and opioid safety, VA Secretary Robert Wilkie today underscored the department’s innovative approaches to chronic pain management.
Wilkie’s response followed President Trump’s speech April 24 at the annual Rx Drug Abuse & Heroin Summit in Atlanta, where stakeholders gathered to discuss prevention, treatment and actions to curtail the opioid crisis.
“More than 100 million Americans suffer from some form of chronic pain, and the overuse and misuse of opioids for pain management in our country is taking too many lives,” Wilkie said. “Veterans who have served our nation are particularly challenged by chronic pain. VA has demonstrated success in reducing opioid use, while addressing the challenge of living well with chronic pain.”
Over the past six years, VA’s Opioid Safety Initiative (OSI) has reduced opioid dispensing more than 50%. Most of this reduction is attributable to not starting new, long-term opioid therapy in Veterans with chronic pain.
Specifically, VA is not starting Veterans with chronic, noncancer pain on long-term opioid therapy, but is instead offering them complementary pain management strategies. These treatments include use of complementary therapies, such as acupuncture, yoga, chiropractic medicine, tai chi and bio-feedback, among other modalities, and have proven to be more effective for Veterans long term. Veterans are 40 percent more likely to have severe, chronic pain than non-Veterans.
VA has employed four broad strategies to address the opioid epidemic: education, pain management, risk mitigation and addiction treatment. VA addressed the problem of clinically inappropriate high-dose prescribing of opioids, while developing an effective system of interdisciplinary, patient-aligned pain management to provide safe and effective pain control. In the process, VA trained hundreds of clinicians on this approach to pain management.
VA’s approach is Veteran-centric and whole health. By understanding the Veteran’s goals and lifestyle and incorporating a variety of therapeutic treatments, Veterans are now achieving success in managing chronic pain.
VA continues to offer full transparency of its efforts to reduce opioid prescribing. To learn about the VA Opioid Safety Initiative or for more information on VA pain management, go to www.va.gov/painmanagement.
Available to Veterans, their families, caregivers, and survivors
The Code of Support Foundation provides essential and critical one-on-one assistance to struggling service members, Veterans and their families with the most complex needs. One of their goals is to integrate service members, Veterans and families into a searchable, Vetted, on-line platform called PATRIOTlink that makes direct connections to resources and services.
PATRIOTlink enables any user free access to Vetted, direct, cost-free, Veteran services. PATRIOTlink users can login, browse, and use hundreds of resources available to them. Veterans, caregivers, family members and providers can sign up for a Free Account and start searching today!
The Department of Veterans Affairs, Veterans Experience Office signed a Memorandum of Understanding with Code of Support in December 2018.
Together, VA and Code of Support hope to improve the access to and navigation of resources in local communities to best serve Veterans, families, caregivers, and survivors. Code of Support provides case coordination, education and engagement, and a navigation platform that allows service providers to reduce the amount of time it takes to find resources to meet their clients needs. VA cannot do it alone and partnerships like Code of Support help to augment and supplement VA services and benefits where needed.
VA is providing Code of Support the most up to date resource and contact information to access and navigate VA services and benefits that includes caregiver support services, suicide prevention and homeless coordinators, Vet Centers and domiciliary units. One of VA’s goals is to ensure that access to services and benefits is easy, efficient, and creates positive experiences in receiving care and support where they live.
Veterans and their families should not have to struggle with finding resources and services, so VA encourages Veterans and their families to use the free services from partners like the Code of Support Foundation for easier access and navigation support.
“When I called Code of Support my back was up against the wall. I was struggling with my VA Claim and just days earlier had lost a close friend to suicide. They did something that hadn’t happened in years: they listened.”— Zachary Bell, Marine Combat Veteran (from Code of Support website)