(CNN)Secretary of Veterans Affairs Robert Wilkie praised Confederate States President Jefferson Davis effusively in a 1995 speech, calling him a "martyr to 'The Lost Cause'" and an "exceptional man in an exceptional age."
Wilkie, who delivered the speech in front of a statue of Davis at the US Capitol during an event sponsored by the United Daughters of Confederacy, also said that while he was "no apologist for the South," viewing Confederate "history and the ferocity of the Confederate soldier solely through the lens of slavery and by the slovenly standards of the present is dishonest and a disservice to our ancestors."
Wilkie's speech, a transcript of which ran in the United Daughters of the Confederacy Magazine, reveals his belief in the "Lost Cause" theory of the Civil War, which portrays the Southern states who seceded as heroic and denies the central role slavery played as a cause for the conflict.
A KFile review also found Wilkie attended a pro-Confederate event as recently as 2009, giving a speech on Robert E. Lee to a Maryland division of the Sons of Confederate Veterans.
CNN's KFile found references to Wilkie while researching the neo-Confederate movement, which seeks to promote a more sympathetic view of the Confederate states during the Civil War, and obtained copies of the speeches from Edward Sebesta, a scholar on the neo-Confederate movement.
Veterans Affairs press secretary Curt Cashour did not address the content of Wilkie's remarks when asked by CNN but said in a statement that the events Wilkie attended "were strictly historical in nature, and as Secretary Wilkie said at his confirmation hearing in June, he stopped participating in them once the issue became divisive."
"Today marks the 187th anniversary of the birth of Jefferson Davis; planter, soldier, statesman, President of the Confederate States of America, martyr to 'The Lost Cause,' and finally the gray-clad phoenix ---- an exceptional man in an exceptional age," Wilkie, who at the time was a staffer for Republican then-Rep. David Funderburk, said in the 1995 speech, according to the transcript.
Wilkie later said, "I must add, as the distinguished scholar and historian James I. Robertson of Virginia Tech did here last year, I am no apologist for the South, and I have never bought into what Penn Warren and his colleagues called the 'moonlight and magnolia school,' where the decorative past replaces the useable past."
"The South has many warts," he continued. "Chattel slavery and its aftermath is a stain on our story as it is a stain on every civilization in history. But slavery was a collective American tragedy. (President Abraham) Lincoln understood that there was enough guilt to be spread from Maine to Key West. To view our history and the ferocity of the Confederate soldier solely through the lens of slavery and by the slovenly standards of the present is dishonest and a disservice to our ancestors. We can't surrender American history to an enforced political orthodoxy dictated to our children by attention-starved politicians, street corner demagogues, and tenured campus radicals."
Professor David Blight, a Civil War historian at Yale, told CNN in an interview that Wilkie's comments were "right from the neo-Confederate playbook."
"That is standard Lost Cause ideology circa 1890 to 1910," he said. "This man, that language right there, is the standard defense of the Lost Cause built over the period of decades as an ideology explaining confederate defeat, but also as a racial ideology."
Wilkie was confirmed by the Senate as the Secretary of Veterans Affairs in July. Prior to his confirmation hearing, the Washington Post reported that Wilkie was a formerly a member of the Sons of Confederate Veterans and attended memorial ceremonies for Confederate Veterans. Wilkie told the Post that in a statement that the events had become "part of the politics that divide us" and that he no longer attended them.
'Their cause was honorable'
In his 1995 speech, Wilkie said Davis' life was the reflection of "a proud people" and that not all of "man's noble experiments succeed."
"In the case of Jefferson Davis, we must tell America the truth about the complicated man who carried with him the dreams of Southern independence," he said. "His life was the reflection of the simplicity and perseverance of a proud people; men and women who endured the horror of defeat and its equally hellish aftermath; men and women who through their Christian prism understood the fall of man and the imperfection of human institutions -- that not all of man's noble experiments succeed."
He also said Davis' "contempt for the radical abolitionists of the Republican Party" was not about slavery, but rather about out of fear "they would violate any law and abridge any freedom to impose their idea of the just society on others." Wilkie said the radical abolitionists in Congress were "as mendacious as the Jacobins of Revolutionary France" and called those who funded the abolitionist John Brown's raid on Harpers Ferry "enemies of liberty."
Wilkie added Davis' "unbroken spirit" after the war served as a reminder to the southern people "that their cause was honorable and that all would be right in the end."
Wilkie concluded his speech by linking Davis' fight to the fights in the Congress at the time, shortly after Republicans won the majority in the House of Representatives in the 1994 midterm elections.
"Once again the halls of Congress reverberate with odes to rugged individualism, state sovereignty, and contempt for the centralized super-state," Wilkie said in closing. "These are bloodless battles Davis could never fight but, they are no less vital for the future of American civilization. As our cities decay and our standards and spiritual traditions deteriorate, America is searching for a better way. Walker Percy urged us to look South to recover community, stability, and sense of place in God's order which we have regrettably lost. That is a tall proposition but it is certainly one Jefferson Davis would understand and certainly one for which he would fight."
More recent pro-Confederate ties
In 2009, Wilkie spoke to a Maryland division of the Sons of Confederate Veterans -- Jefferson Davis Camp 305 -- which meets in the DC-area.
The group's webpage at the time featured a Confederate proclamation from 1862 calling Union occupation of Maryland "oppression" and "tyranny" and "terrible despotism." The head of that camp at the time, according to reports and archived web pages, was Richard T. Hines, a prominent member of the neo-Confederate movement.
Wilkie began his career as an aide to Sen. Jesse Helms, the North Carolina Republican known for criticizing Martin Luther King Jr. and opposing a holiday in his honor. Wilkie later worked for Sen. Trent Lott from Mississippi, who resigned as Republican Leader in 2002 after praising Strom Thurmond's 1948 segregationist presidential campaign. Wilkie later served in the Bush administration, working for Condoleezza Rice at the White House National Security Council and under Donald Rumsfeld at the Pentagon.
Wilkie's past work with Helms and Lott came under scrutiny at his confirmation hearing in June. Democratic Sen. Mazie Hirono asked Wilkie, citing his past bosses and a Washington Post article, whether he would "welcome the scrutiny that you will probably face based on your past positions to make sure that you are treating women and minorities fairly and with respect as the head of the V.A., should you be confirmed?"
Wilkie responded, "Well, Senator, I will say -- and I say it respectfully -- I welcome a scrutiny of my entire record. The Washington Post seemed to stop at my record about 25 years ago. If I had been what the Washington Post implied, I don't believe I would have been able to work for Condoleezza Rice or Bob Gates or Jim Mattis."
For an estimated 500,000 Veterans, being put out of the military with an other than honorable discharge is a source of shame and an obstacle to employment. "Bad paper," in most cases, means no benefits or health care from the Department of Veterans Affairs — even when the problems that got them kicked out were linked to PTSD, traumatic brain injury or military sexual assault.
But last month, Connecticut opened state VA resources to Vets who can show that one of those conditions is linked to their discharge. For Veterans like Thomas Burke, now a youth minister at Norfield Congregational Church, it's part of a long path to recovery.
"When I first started looking for jobs, I did not want to be a youth minister to kids, because my PTSD stems from a traumatic event where I failed children," says Burke.
Burke did two combat deployments with the Marine Corps within the space of one year. After a rough tour in Iraq, he found himself in southern Afghanistan, based in a tiny village, living close to civilians. Burke had been trained in the local language, and he connected with the village kids. In one photo, Burke is in combat gear, playing with 15 laughing boys on a dusty road. He says local boys helped out — they would tell them where IEDs were. He grew to love them and they loved him back.
"They'd bring us bombs," he says. "On one of those occasions they were bringing us [a rocket-propelled grenade], and it ended up exploding on them."
When Burke heard the blast, he and other Marines rushed out to find eight of the kids from that photo dead.
That sent him into a spiral — the local hashish was plentiful and many soldiers used it. Burke started smoking heavily and got caught.
Suddenly a promising young Marine was getting kicked out with an other than honorable discharge — a sort of scarlet letter for a Veteran, which many say is worse than never having served at all.
Burke was flown to his home base in Hawaii, where a mix of prescriptions and street drugs made things worse. Then, he flew back home.
"I took a plane to Connecticut and slit my wrists in a state park," he says.
Veterans with an other than honorable discharge have higher rates of suicide. They're at higher risk of homelessness. Mental health issues can snowball with economic ones: When employers ask about military service, they also ask about discharge status — so for job prospects, it is worse than never having served.
"These individuals up till now were denied clinical support services and other programs and benefits, and we believe in many cases may have resulted in a worsening of their conditions," says Thomas Saadi, Connecticut's commissioner for Veterans affairs.
Saadi says it makes both moral and practical sense to help these Vets before they're in crisis. And that's what Connecticut is now doing, thanks in part to the efforts of Veterans like Burke.
After Burke's failed suicide attempt, the VA made a rare exception, and he was able to get services. He started down a different path — to become a pastor.
And he joined a push to change the law around other than honorable discharge. He found allies in the state Legislature, like Republican Rep. Brian Ohler, also a combat Vet.
"When we testified before the Veterans Affairs Committee, [Thomas] and I were sitting right next to each other," says Ohler. "And I said the only difference between Thomas and I is a piece of paper — one that says honorable discharge and the other that says other than honorable."
It took years of lobbying, but as of last month, Connecticut Veterans whose other than honorable discharge is linked to PTSD, brain injury or sexual assault will qualify for state health care and benefits, including tuition to state schools.
The national VA is changing too — earlier this year Sen. Chris Murphy, D-Conn., pushed through legislation that makes VA mental health care available nationwide to Veterans with other than honorable discharges, though it has been slow to roll out.
For Burke, helping get recognition and treatment for other bad-paper Vets has been part of feeling whole again. When he hears kids laughing, it still triggers memories of Afghanistan, but he can smile through them now.
"The opportunity to work with children fills me with the spirit and life and joy in a way that I can't even explain, because it also makes me recognize how far I've come from the person who got back from war," says Burke.
The Department of Veterans Affairs gets good grades for effort, but it still has much work to do in the recruitment and retention of physicians to serve those who faced death for their country.
When the Government Accountability Office says “challenges remain,” it means an agency has problems — in this case, too few doctors. Pay is an issue, but so is the department’s personnel management. A recent GAO report about the Veterans Health Administration, the component providing health care through 1,252 facilities, including 170 medical centers, outlines three major management troubles related to its doctor shortage:
- “VHA’s data on the number of physicians that provided care at VA medical centers (VAMC) were incomplete.
- “VHA provided VAMCs with guidance on how to determine the number of physicians and support staff needed for some physician occupations, although it lacked sufficient guidance for its medical and surgical specialties.
- “VHA used various strategies to recruit and retain its physician workforce, but had not comprehensively evaluated them to assess effectiveness.”
These points indicate that part of the problem lies with the agency inadequately diagnosing personnel problems, making it difficult to solve them.
“VHA hires more than 2,800 mission-critical physicians annually,” Debra A. Draper, GAO’s director of health care, told a House Veterans’ Affairs subcommittee hearing last month. “Yet, physicians have consistently been identified by VHA as a critical staffing priority due to recruitment and retention concerns.”
She told the panel that the agency didn’t know how many contract doctors it uses and had limited information on the number of its physician trainees. The result — “VHA data underestimated the total number of physicians providing care in its medical centers, leaving it unable to ensure that its workforce planning processes sufficiently addressed gaps in staffing.”
Garry Augustine, Washington executive director of Disabled American Veterans, urged VA to develop a more “systematic approach” to personnel management. “The VA needs to do a better job of determining shortages and developing a plan to fill vacancies,” he said during a telephone interview.
The American Legion called the shortage “a critical issue.”
“By not adequately staffing VHA, VA’s capacity to serve Veterans suffers and forces more Veterans to seek health care in the private sector at greater cost to the American taxpayers,” said Legion spokesman Joseph M. Plenzler. “We strongly urge the Department of Veterans Affairs to fill these vacancies with highly qualified health-care providers as quickly as possible. Our Veterans deserve it, and our overstretched VA employees deserve it.”
There were 1,673 vacant physician positions as of March, according to data that VA provided to the Federal Insider on Friday. In all occupations departmentwide, the personnel shortage was 33,642, about 90 percent in health services.
Peter Shelby, the former assistant secretary of the VA Office of Human Resources and Administration, tried to shine a more favorable light on the vacancies in his testimony. “The scope and scale make vacancy numbers often quoted in the media seem very high,” said Shelby, who since left the VA. “Taken in context, VA’s vacancy and turnover rates are very low. We fluctuate between 9 and 10 percent, which compares very favorably with the private sector.”
Along those lines, Curt Cashour, the department’s press secretary, said by email that the “VA has made phenomenal progress since January of 2017 when it comes to staffing. Overall vacancies are down, VA’s vacancy rate is less than its turnover rate, and our total number of positions has increased by nearly 15,000.”
Beyond the bureaucratic problems of human resource and data management is the age-old issue of pay. VA docs get too little of it.
Officials at one VA hospital told GAO last year that “their chief of cardiac surgery, whose salary was close to $395,000 left to work for a private hospital in the community where his salary was close to $700,000.”
For Max Stier, president and CEO of the Partnership for Public Service, that’s an example of the need to make federal pay more market-sensitive. This is “perhaps the clearest example of the way in which outdated and inflexible personnel systems limit the department’s ability to recruit and hire,” he said.
He cited a new VA Office of Inspector General report that says “outdated OPM [Office of Personnel Management] classifications affected their ability to offer competitive salaries and advancement opportunities within the organization. This resulted in facilities being less competitive in attracting new staff and retaining highly skilled staff.”
Staffing is a widespread problem in the agency, VA Inspector General Michael J. Missal said.
“Our analysis showed that 138 of 140 facilities listed the medical officer occupational series … as experiencing a shortage, with psychiatry and primary-care positions being the most frequently reported,” his testimony said. “Of the 140 facilities, 108 listed the nurse occupational series … as experiencing a shortage, with practical nurse and staff nurse as the most frequently reported.”
Turnover among VA’s human resource professionals also is a big problem because they devise strategies to recruit and retain doctors.
“A large number of relatively new HR specialists,” Stier told the hearing, “means more preparation and work required to make sure the agency implements new rules and programs effectively.”
ST. PETERSBURG, Fla. (WFLA) - Alarmed by an 8 On Your Side investigation of a Veteran mistreated by the VA, Florida Congressman Gus Bilirakis made a beeline to his home state to get answers and offer help.
The Pinellas County Representative wants to know why VA doctors couldn't figure out what is wrong with Veteran Mike Henry.
"This is a Veteran, we've got to give him the best possible treatment you can get," Congressman Bilirakis stated.
Last week, 8 On Your Side revealed Henry languished in pain for months under VA care.
That changed quickly when Henry visited Tampa General Hospital, where he was diagnosed with a neurological disorder within an hour.
Henry suffers from a condition in which nerve cells in his brain trigger uncontrollable muscle contractions in his face, neck and shoulder.
It causes intense pain and swelling.
"It actually feels like somebody has a knife, a steak knife in here, and they're just slowly twisting," Henry said as he pointed to his temple.
According to Henry, one Bay Pines doctor called him a faker and accused him of being after drugs.
"Then he grabs me right here, my neck was swollen and he's shaking me around. And then I said, 'what are you doing? Are you crazy?' He goes, 'oh you're talking normal now, you're just a faker, I told you that's what you were,'" Henry recalled.
Henry explained what he experienced at the VA's C. W. Bill Young Medical Center at Bay Pines to Congressman Bilirakis.
"We want to help them. I told them I'll help them, whether they want to stay with the VA at Bay Pines or transfer possibly to Haley or get private care, I'm here to help," Congressman Bilirakis said.
The home visit left Mike and Shelly hopeful, especially since Bilirakis offered one of his staff to accompany Mike.
"He would like to go with Mike to his next VA appointment and he's going to follow up with us," Shelly Henry added.
Henry has a medical background. He hopes to sit with the VA to discuss mistakes he thinks the Bay Pines made.
"Then maybe that would let them know, 'ah ha, maybe this is something we need to look at,'" Henry explained.
The Henrys are thankful someone is watching out for them.
"I will be forever grateful for you guys for doing this and hopefully you guys aren't just covering my case, you'll help some of the other Veterans and let the people know they have a voice," Henry added.
"You have been wonderful," Shelly Henry said. "Thank you so much, I really hope this helps other Veterans.
Now that a Congressman is watching over Mike Henry's case, he is hopeful a more meaningful dialogue will take place with Bay Pines about his care and treatment.
The facility, which provides mental health and other services, shut down in January because of heating, ventilation and air conditioning issues. It was supposed to reopen in August.
Amy Wascylicia credits her stay last year at the Department of Veterans Affairs' homeless shelter in Northport with helping her get back on her feet.
The former Army soldier said she felt safe from thieves and predators, who she said were a menacing presence at other shelters she stayed at before. And because the shelter is on the grounds of the Northport VA Medical Center, psychotherapists to help her cope with her mental health issues were just a short stroll away.
But because of building code violations, it's unclear when and if the 44-bed Northport shelter will be around to help other Veterans like Wascylicia. The shelter has been closed since January, when frigid temperatures overwhelmed the building’s heating plant, forcing VA officials to send some three dozen residents to shelters run by Beacon House, a nonprofit agency that also ran the Northport facility.
“The Northport shelter was heaven,” said Wascylicia, who on Tuesday tried on donated clothing at a Veterans event in Freeport. “Other shelters I’ve been at have had crackheads or fondlers or people who steal your things. I felt so disrespected.”
Wascylicia now lives in transitional housing in Amityville after having been in and out of homelessness since 2009. Her trip to reach her twice-weekly psychotherapy sessions at Northport from Amityville involves bumming a ride or taking a four-bus, 2½-hour trip on public transportation, she said.
VA officials promised to have a new heating system installed by August, and that the shelter would begin accepting new residents well before winter temperatures arrived. But with temperatures having plunged into the teens this week, Northport officials have not indicated when or whether the shelter will reopen.
The VA declined to provide details on the shelter's future. A statement released by Northport spokesman Levi Spellman said the shelter’s home — Northport’s Building 11 — lost its grandfathered status when the shelter was vacated, and thus became subject to stricter building codes. He said the building failed a fire code inspection Nov. 14 because of inadequate sprinkler coverage.
“Because of the rules and regulations associated with the federal contracting process, renovating Building 11 up to code may take some time,” Spellman said in an email. “That’s why Northport VAMC will begin to solicit bids for on-site temporary emergency housing in the near future.”
Beacon House CEO Frank Amalfitano, whose organization provides temporary housing for some 400 Veterans in about 45 locations in Nassau and Suffolk counties, said its other shelters are near capacity. He said because homeless Veterans often need help with psychological issues and health problems, Northport’s ability to combine homeless services with clinical help made it an asset that cannot easily be replaced.
Amalfitano said the rate of utilization of these services fell sharply among homeless individuals who had to be relocated to as far away as Riverhead when the Northport shelter closed.
“The real tragedy is that participation in the various programs has gone down, and the PTSD program is one of them,” Amalfitano said.
Amalfitano said more than two dozen businesses and organizations donated more than $250,000 to renovate kitchens and bathrooms, paint the interior spaces, install a computer resource room, and make other improvements to the facility.
The closure has alarmed Veterans advocates across Long Island, who said that although Veterans' homelessness has declined, it remains a problem, especially among Veterans with psychological troubles that require the kind of regular attention the Northport center provides.
“We no longer have as many Veterans living on the street, but we still have homeless Veterans who are either sleeping in someone’s garage, or their car, or on someone’s living room couch,” said Morris Miller, a Veterans advocate who sits on a Northport advisory panel. “We have Veterans that need those beds. Immediately.”
But it appears unlikely that the shelter's beds will be available anytime soon.
"We are currently assessing the requirements to bring the building up to current standards . . .," Spellman said in the email. "We are beginning the process of identifying the scope of work for that contract so we can begin soliciting bids as soon as possible."
WASHINGTON – Six Veterans’ groups are calling on the Department of Veterans Affairs to improve the quality of care at its nursing homes following a story by USA TODAY and The Boston Globe detailing “blatant disregard for Veteran safety” at a VA nursing home in Massachusetts.
“Anybody who respects Veterans should be angered by this,” American Legion National Commander Brett Reistad said. “America’s Veterans deserve better.”
The groups, who together represent nearly 5 million members, said Veterans who risked their lives for our country shouldn’t have to risk their lives in VA nursing homes.
In Brockton, Massachusetts, investigators found two nurses asleep during their shifts, even though the facility knew it was under scrutiny and inspectors were coming to visit, looking for potential signs of patient neglect. A whistleblower had reported that nurses and aides did not empty the bedside urinals of frail Veterans, they failed to provide clean water at night and didn’t check on the Veterans regularly. The VA said the napping nurses no longer work at the facility.
The story was the latest in an investigation by USA TODAY and the Globe that revealed care at many VA nursing facilities was worse than at private nursing homes in the agency’s own internal ratings, kept secret from Veterans for years.
The stories detailed disturbing examples of substandard care – a Veteran with undiagnosed scabies for months, another struggling to eat in Bedford, Massachussetts; and a third sitting for hours in soiled sheets and another writhing in pain without medication in West Palm Beach, Florida.
A Navy Veteran was declared dead after he walked out of a supposedly secure VA nursing home and was never found in Tuskegee, Alabama. An Army Vet landed in intensive care suffering from malnutrition, septic shock and bed sores after a stay at a VA nursing home in Livermore, California.
“The stories being reported about the treatment of some individual Veterans at these facilities are nothing short of horrifying,” said Rege Riley, national commander of American Veterans, known as AmVets. He called on VA Secretary Robert Wilkie to “take swift and transparent action to fix this.”
Veterans of Foreign Wars, Disabled American Veterans, Paralyzed Veterans of America and Vietnam Veterans of America joined AmVets and the Legion in calling for action. Together, the groups are known as the “big six” and wield considerable clout in Washington.
“The VA must address and correct these issues,” said Garry Augustine, executive director of Disabled American Veterans.
VA 'striving to improve'
VA spokesman Curt Cashour said the residents the VA typically cares for are sicker than those in private nursing homes, making “achieving good quality ratings more challenging.” He said that overall, VA nursing homes “compare well” with the private sector.
“We look forward to briefing each of these groups in the near future regarding these crucial facts,” Cashour said, adding that the VA is “continuously striving to improve all of its health care facilities.”
The VA has 133 nursing homes across the country that serve 46,000 Veterans annually.
Newly released VA data show that 95 of them – about 71 percent – scored worse than private nursing homes on a majority of quality indicators, such as rates of infection, serious pain and bed sores.
Roughly the same number, 93, received only one or two stars out of five for quality in the agency’s own ratings.
In a scathing statement declaring those facilities “failures,” VFW National Commander Vincent “B.J.” Lawrence said the VA “must improve its delivery of quality care at these facilities.”
"(Veterans') families deserve to know that their loved ones – their heroes – are not being abandoned or abused, and America needs to be reassured that the VA is honoring our nation's promise to those who have borne the battle," he said.
Call for transparency
Reistad, the Legion's commander, added, “We not only expect VA to fix these problems immediately, but we want transparency.” On Sunday, after his group met with VA officials, he said he is confident they will work with the Legion and the other groups to “institute needed improvements.”
The VA released the quality information on its nursing homes only after learning in June that USA TODAY and the Globe planned to publish it. The agency still has not released the results of inspections.
“Why not?” asked Rick Weidman, co-founder of Vietnam Veterans of America. He said his group often has to “fight like hell with VA in order to get information.”
The reports can include instances of neglect or poor conditions that can be a tip-off to current and prospective residents about problems at a facility.
“I don’t see how Veterans are best served by the VA not being open about the level of care it’s providing,” AmVets spokesman John Hoellwarth said.
Cashour said the VA is working with an outside contractor who conducts the inspections, Wisconsin-based Long Term Care Institute, to remove patient information from its reports before they are released, maybe by the end of the year.
Private nursing homes have three years’ worth of inspection reports posted on a federal website, Nursing Home Compare.
Lawmakers demand answers
In September, Congress passed and President Donald Trump signed into law legislation requiring the VA to publish quality ratings going forward. The law does not mention inspection reports.
The Republican-led House VA Committee launched an investigation of VA nursing home care after the initial USA TODAY and Globe reports, but a spokeswoman, Molly Jenkins, said the probe won’t be finished in time to hold a hearing this year as anticipated. The Democrat poised to take over the committee in January, Rep. Mark Takano of California, said it is a “critical issue that will continue to be a priority.”
In Massachusetts, home to two, one-star VA nursing homes – in Bedford and Brockton – lawmakers are demanding to know what steps the VA has taken to improve patient care there and at other facilities around the country.
“The continued care lapses at VA facilities raise questions about whether concrete, lasting measures are being implemented to prevent misconduct from occurring again – or whether certain VA facilities are unable to institute changes necessary to provide our Veterans with the care befitting their service to the country,” Sens. Ed Markey and Elizabeth Warren, both Democrats from Massachusetts, wrote in a letter to Wilkie.
They demanded the most recent report from the Long Term Care Institute inspection of the Brockton VA nursing home.
“The fact that we can’t treat Americans who put their lives on the line with dignity when their lives are on the line here at home later in life is disgusting,” said Rep. Seth Moulton, D-Mass, a Veteran who receives his medical care at the Bedford VA.
Parties and special occasions usually involve games, music, and alcoholic beverages. They are times of festivity and fun. For someone concerned about alcohol intake or battling substance abuse, social events may seem threatening. But it is possible to participate in activities that include alcohol.
Get the Facts about Risky Drinking
The first step to understanding your alcohol limits is to know the facts, signs, and symptoms about alcohol abuse. The Psychological Health Center of Excellence (PHCoE) gives examples of alcohol misuse and facts about risky driving:
- Drinking more or for a longer time than you intend
- Continuing to drink even though it makes you feel depressed or anxious
- Experiencing symptoms of withdrawal when you don’t drink
- Experiencing interference with daily activities, family, friends, and work
- Having to consume more drinks than you once did to get the same effect
Set Your Limits
If you’re not practicing abstinence, but want to be mindful of your drinking behavior, there are ways to set limits. Tracking your daily drink intake may be a helpful way to manage substance use, but can be difficult to practice in social situations. Before going to the party, have a plan and remember to be S.M.A.R.T:
- Specific. Set a drink type and number limit for yourself. If you decide to drink a beer, ask yourself what type of beer, stick to that brand and style, and don’t go over your limit. Every alcohol beverage has a different alcohol content, which changes your body’s response.
- Measurable. Understand how your body processes alcohol to determine your specific limitations. Look at the standard drink calculator to see how different types of drinks will affect your body.
- Attainable. Is your goal realistic for your lifestyle? Set a goal that you are confident and positive about achieving.
- Relevant. Ask yourself if your goal applies to your current surroundings. If you are at a wine-tasting event, know how much wine is enough for you.
- Time-based. Set a drinking cut-off time and length of time between each drink. Determine how many drinks is a safe number for you.
Choose Your Surroundings
Choosing your surrounding can be the best way to combat pressure. If you are battling substance abuse, consider attending an alcohol-free holiday party or host your own alcohol-free small gathering. Suggest ideas to the host that don’t involve drinking. Fun ideas include:
- Board, card and trivia games
- Dance competitions
- Holiday-themed relays
- Arts and crafts
- Gift exchanges
It’s also OK not to go to a party if you feel it could harm your sobriety. When it’s impossible to avoid functions with alcohol, make sure you have a way to leave if you’re feeling uncomfortable. Share that you’re limiting your drinking or not drinking at all. Purposefully voicing your concerns can help eliminate potential peer pressure to join or overindulge in drinking.
On-the-go Support: Mobile Apps
There are several mobile apps that can help you assess and manage your alcohol use. Some mobile apps can help you learn healthier ways to cope with certain triggers, such as stress. Here a few to consider:
- Pier Pressure, developed by Navy Alcohol and Drug Abuse Prevention, offers resources to help practice responsible drinking behaviors in real life to include: a blood alcohol content (BAC) calculator; calorie and alcohol content calculators for beer, wine, spirits and popular cocktails; safe drinking tips; and direct access to local taxi searches and popular ride-sharing apps
- VetChange, developed by the Department of Veterans Affairs, is for Veterans and service members who are concerned about their drinking and how it relates to post-traumatic stress after deployment, and for all people who are interested in developing healthier drinking behaviors.
- Learn about more DHA mobile apps, developed by the Connected Health branch, such as Virtual Hope Box, LifeArmor, and Breathe2Relax on the mHealth Clinical Integration webpage.
Learn More from Online Resources
- Defense Health Agency alcohol and drug abuse self-assessment (confidential)
- TRICARE Alcohol Awareness (featuring “That Guy” public awareness campaign)
- Military Health Podcast: “Next Generation Behavioral Health,” episode 17, “Substance Use”
- “Life Without Liquor” one service member’s personal story of how he overcame a drinking problem
- Military OneSource: Military Policy and Treatment for Substance Use
- “Rethinking Drinking: Alcohol and Your Health” publication with research-based information from the National Institutes of Health
- “Harmful Interactions: Mixing Alcohol with Medicines” publication from National Institute on Alcohol Abuse and Alcoholisim
You can overcome substance abuse by knowing the facts, sticking to your goals, informing others of your intentions, having good support, and creating a positive environment for long-lasting change.
VA takes key step to improve its website to provide Veterans an enhanced digital customer experience
This week the U.S. Department of Veterans Affairs (VA) took a key step in its digital modernization effort by revamping its website accessed by 10 million customers per month who use VA’s tools and content online.
To improve this experience VA’s Veterans Experience Office and VA Digital Service gathered feedback from more than 5,000 Veterans, service members, their families, caregivers and survivors.
Many customers said they were having a frustrating experience, encountering a complicated collection of websites, forms, logins and tools. Through feedback, VA learned that many of them struggled to find what they needed. By listening to Veterans and working across VA organizational boundaries, the new VA.gov website shifts from a “VA as an organization” to a “customer-first” platform.
“Veterans, their families, caregivers and our many customers have successful online transactions in their day-to-day lives,” said VA Secretary Robert Wilkie. “They should expect the same exceptional digital experience when coming to VA. Our customers will receive a more simple and intuitive experience when accessing our online front door – the new VA.gov.”
The new site contains homepage content that focuses on the top 20 tasks that 80 percent of VA’s customer’s need, the ability to login to receive a personalized experience and easy to understand plain language content. Logged in customers will find a dashboard summarizing the current status of services they receive from VA, whether those services are provided by the Veterans Health Administration – such as prescription refills or the Veterans Benefits Administration – such as claim status. Customers can also update their contact information in one location rather than visiting multiple VA websites or making multiple calls.
VA is demonstrating that it is possible for Federal agencies to give the American people the online experience they expect and deserve. VA has been identified as the “co-lead” of the White House cross-agency priority goal on improving customer service.
Bridget Villegas, a medical support specialist, at an operating room in a Veterans Health Administration medical center in Aurora, Colorado. Colorado had one of the nation’s highest rates of staffing vacancies for VHA facilities.
As the nation prepares to honor its Veterans Nov. 12, many Veterans in rural areas and some cities still face long wait times for health care because there aren’t enough doctors, nurses and support staff to provide it.
Almost 40,000 of the 335,000 positions in the Veterans Health Administration are vacant, according to the Department of Veterans Affairs, which oversees the VHA. The VHA serves about 9 million Veterans.
The VHA’s turnover rate is less than half the rate for the health care industry overall.
However, a Stateline analysis of recently released federal figures shows the VHA has a severe vacancy problem in high-cost urban areas such as Los Angeles and Washington, D.C., and in largely rural states, such as Montana and Colorado.
Montana and Colorado have the highest state job vacancy rates at more than 20 percent, followed by Utah, Oklahoma and Maryland. At the other end, vacancies in Connecticut, Hawaii, Michigan, Minnesota, New Mexico and Rhode Island are less than 8 percent.
Veterans Health Administration Struggling to Fill Vacancies
There are nearly 40,000 job vacancies, mostly medical and dental workers, at Veterans Health Administration health centers around the country. As a percentage of filled jobs, the vacancy rates range from more than 20 percent in Montana and Colorado to 2 percent in Hawaii.
In some ways, the challenges facing the VHA are the same ones facing the health care workforce as a whole, especially in rural areas like Montana, said Kristin Mattocks, a Montana native and associate professor at the University of Massachusetts Medical School who has studied VHA efforts to improve care for Veterans.
Nationally, job openings in the health care sector have nearly tripled to 1.1 million since 2010, according to Bureau of Labor Statistics data. Most of the communities with shortages of health care workers are in rural areas, according to the Health Resources and Services Administration. There are also shortages in Honolulu, Hawaii, Los Angeles and Washington, D.C.
As more doctors and other providers in the VHA and elsewhere have been retiring, there’s more pressure on the remaining doctors to absorb more patients and speed up appointments.
“Now the pressure is put on physicians, which is probably driving some folks” away, Mattocks said.
The vacancy rates, detailed in a new report required by legislation Congress approved this year, can cause long wait times for appointments, create waitlists for artificial limbs and lead to unsanitary conditions.
Most of the nearly 40,000 vacancies are for medical and dental staff such as doctors and nurses. Those professionals are hard to find and keep because VHA’s hiring process is time-consuming and the pay is lower than in the private sector.
And because there isn’t sufficient support staff, many VHA doctors say they are frustrated by having to do more paperwork and even clean offices, federal audits have shown.
In Colorado last year, the Denver Post found that the VHA postponed surgeries because it didn’t have enough anesthesiologists. Understaffing led to dirty storage rooms and canceled surgeries for anesthetized patients at the VHA’s flagship hospital in Washington, D.C.
And Veterans in Connecticut had a hard time getting appointments for counseling because four key jobs were vacant earlier this year. U.S. Sen. Richard Blumenthal, a Democrat from Connecticut, in a September hearing called the vacancy figures “really staggering.”
Blumenthal added that leaders of the local Veterans of Foreign Wars chapter had complained that care was held up at a Norwich, Connecticut, clinic because the local office lacked a director, a case manager, an outreach coordinator and a counselor.
At the same hearing, Secretary of Veterans Affairs Robert Wilkie also expressed alarm about the number of vacancies. And he said hiring for mental health centers such as the one in Connecticut is a priority.
“On its face it is staggering,” Wilkie said. “If we tried to fill all 40,000 we’d never get where we need. … We have to concentrate on, I think, four areas: primary care, internists, mental health workers and women’s health.”
He added that this year’s Mission Act legislation, which President Donald Trump signed in June, will give him more power to raise pay and forgive student loans to attract more medical professionals.
The agency has stepped up hiring in the past two years, Wilkie said, in response to a 2016 Government Accountability Office report that found that VHA lost an increasing number of employees each year between 2011 and 2015.
In the five clinical occupations with the worst shortages, including physicians, registered nurses and psychologists, VHA’s employee losses grew from about 5,900 in 2011 to about 7,700 in 2015. Voluntary resignations and retirements were the primary drivers.
“VHA remains fully engaged in a fiercely competitive clinical recruitment market,” the agency said in a statement about the vacancy data. The VA did not respond to requests from Stateline for further comment.
Staffing vacancies have contributed to recent scandals involving long wait times for care — some Veterans died while waiting for appointments — and the falsifying of wait-time data to deflect scrutiny.
Hiring woes continued into 2017, a GAO report said, in part because a federal hiring freeze ordered by Trump limited the agency’s ability to hire doctors. Doctors were exempt from the freeze, but there weren’t enough personnel workers to recruit and hire them, the report concluded, and some were not well-trained to do the job.
The shortage of trained recruiters undermines the VHA’s effectiveness, the report stated, and “impedes its ability to improve delivery of health care access to Veterans.”
A 2016 report from the congressionally appointed Commission on Care found that VHA doctors and nurses were cleaning offices and doing paperwork because of inadequate numbers of support staff. The commission also detailed a scandal over employees falsifying wait times for service, and some deaths of Veterans on waitlists. An understaffed Phoenix administration system struggled to meet a target of 14-day maximum wait times for appointments.
The report pointed to “staffing shortages and vacancies” at every level. It also said VHA salaries aren’t competitive, and that the agency “continues to use a talent management approach from the last century.”
Other reports have described the effects of those shortcomings. In Washington, D.C., the VA inspector general found conditions so chaotic that sometimes doctors had to borrow equipment from other hospitals during treatment, and surgery was postponed because equipment was discovered missing or broken after the patient was anesthetized. Employees told inspectors the problems were caused by a support staff shortage.
U.S. Sen. Jon Tester, a Montana Democrat, this fall called VHA staffing shortages the most critical issue facing the agency, saying the high rate of vacancies in Montana and elsewhere is hurting care for Veterans.
“I continue to hear from Veterans across Montana and elsewhere that vacancies and constant turnover in VA facilities impacts how quickly they can get appointments and prevents them from building quality doctor-patient relationships,” Tester, who is running for re-election, wrote in a September letter to Wilkie.
U.S. Sen. Patty Murray, Democrat of Washington state, told Wilkie at the hearing that the fast-growing Seattle area has been particularly hard hit by service shortages. A clinic on the Kitsap Peninsula, west of Seattle, took years to approve and build and will likely be at capacity when it opens next year, Murray said.
Nearly a quarter of the staff positions were vacant at VHA facilities in Washington, D.C., and Augusta, Georgia, as of July. But U.S. Sen. Johnny Isakson, the Georgia Republican who sponsored the Mission Act, said this fall that things seem to be improving.
“I’ve gotten letters from my district, unsolicited, Veterans who used to write me about how we weren’t worth anything because we couldn’t get anything done, [now] thanking me for the efficient way the operation works now,” Isakson said at the September hearing.
Wilkie, who was confirmed this year, called the job vacancy data “an important step in transparency” but stressed that some vacancies are normal and that some represent new positions created to anticipate future growth. Also, Wilkie said, time to complete a specialist referral has fallen from 19 days in 2014 to about one day this year.
The agency publishes current wait times for appointments, and some facilities with high vacancy-rates have long waits for appointments: The Augusta, Georgia, Veterans hospital had a 34-day wait for primary care. Chillicothe, Ohio’s hospital, with one of the country’s lowest vacancy rates, had only a six-day wait.
But average wait times are high even in some hospitals with low vacancies — the Honolulu hospital has only about a 2 percent vacancy rate, the lowest in the country, but its average wait time — 39 days — is one of the highest.
That’s still a considerable improvement from 2014 when it was the nation’s worst at 130 days, a statistic that prompted Hawaii lawmakers to call for a shakeup. An inspector general report in 2016 said the Honolulu facility hired more doctors and extended clinic hours to get most new appointments scheduled within 30 days.
BOSTON – Staffers at the Department of Veterans Affairs nursing home in Brockton, Massachusetts – rated among the worst VA nursing homes in the country – knew this spring that they were under scrutiny and that federal investigators were coming to visit, looking for signs of patient neglect.
Still, when investigators arrived, they didn’t have to look far: They found a nurse and a nurse’s aide fast asleep during their shifts. One dozed in a darkened room, the other was wrapped in a blanket in the locked cafeteria.
The sleeping staffers became a focal point of a new, scathing internal report about patient care at the facility, sparked by a nurse’s complaint that Veterans were getting substandard care, according to a letter sent late last month to President Donald Trump and Congress by the agency that protects government whistleblowers.
“We have significant concern about the blatant disregard for Veteran safety by the registered nurses and certified nurse assistants,” agency investigators wrote in a report about the 112-bed facility. The Brockton facility is a one-star nursing home, the lowest rating in the agency’s own quality ranking system.
VA spokeswoman Pallas Wahl said officials took “immediate corrective action,” and the employees caught sleeping no longer work there.
The problems at the Brockton nursing home are the latest to surface in a review of VA nursing home care by USA TODAY and The Boston Globe.
In June, the news organizations revealed the VA’s secret quality ratings showed that care at more than 100 VA nursing homes across the country scored worse than private nursing home averages on a majority of key quality indicators last year.
In response to questions from USA TODAY and the Globe, the VA released nursing home ratings that had been kept secret for years, potentially depriving Veterans and their families of crucial health care information.
At the time, the VA said it was releasing inspection reports the agency withheld from the public for nearly a decade. Five months later, none has been released.
VA spokesman Curt Cashour told USA TODAY that the agency is working with an outside contractor to remove patient information from reports. He said the VA expects to release "publicly redacted versions of the most recent reports" around Christmas.
That's not good enough for Leslie Roe, whose husband of 38 years walked out of a supposedly secure unit at the VA nursing home in Tuskegee, Alabama, last year and was never found.
Roe, who had Navy Veteran Earl "Jim" Zook declared dead this year, wants the VA to immediately release three years' worth of inspection reports – the standard for private-sector nursing homes whose reports are posted on a federal website, NursingHomeCompare.
"It's just a shame the way the VA is," she said. "It can't help Jim, but maybe it can help just one other person."
The reports can include incidents of poor care and conditions that can be a tip-off to prospective or current residents and their families about problems with staffing or neglect at a facility.
"What are they hiding? Why wouldn’t you release it?" asked Amy Leise, whose uncle, Vietnam Veteran Don Ruch, suffered from malnutrition and bedsores last year at a VA nursing home in Livermore, California.
"It feels like the government is immune from accountability and responsibility, where in other settings that wouldn't be the case," she said.
VA releases new nursing home ratings
The VA released an updated set of star ratings. They show 45 of its nursing homes received the lowest one out of five stars for quality as of June 30. That’s down from 58 in March. The VA has 133 nursing homes that serve 46,000 infirm Veterans each year across the country.
At the nursing home in Brockton, residents were, on average, more likely than residents of other VA nursing homes to deteriorate, feel serious pain or suffer from bedsores, according to agency data. They were nearly three times as likely to have bedsores than residents of private nursing homes.
Licensed practical nurse Patricia Labossiere said she complained to the Office of Special Counsel, a federal whistleblower agency, this year after supervisors in Brockton ignored her alerts.
“I am a no-nonsense nurse who took a vow to take care of patients,” said Labossiere, who quit in July. “We are there to be kind and treat others as we would want to be treated. I could not believe that this was how we treat the people that fought for our country.”
Labossiere said she saw instance after instance of poor patient care at the facility within days after she started working there last December. She told the federal whistleblower agency that nurses and aides did not empty the bedside urinals of frail Veterans. Nurses failed to provide clean water at night and didn’t check on the Veterans regularly, as required, she said. They often slept when they were supposed to be working.
She offered some specific examples: One patient had trouble breathing because his oxygen tank was empty. Another fell – his feeding tube got disconnected, and the liquid splashed onto the floor – and didn’t appear to have been monitored by staffers for hours.
The VA investigators did not substantiate those allegations, saying the patient with the empty oxygen tank suffered no ill effects. Investigators couldn’t confirm that the patient who fell had been neglected because the records were shredded “in accordance with the local policy.”
'Routinely receiving substandard care'
Wahl, the VA spokeswoman, noted that the investigators “did not find evidence of Veteran harm or neglect.” She said the facility’s one-star rating is undeserved and not an “accurate reflection of the quality of care delivered to our patients."
The Office of Special Counsel ordered the VA’s Office of Medical Inspector to investigate Brockton after Labossiere’s complaint. The office turned over its report in September to special counsel Henry Kerner, who sent the findings to Trump and Congress on Oct. 23.
“Because a brave whistleblower came forward, VA investigators were able to substantiate that patients at the Brockton (nursing home) were routinely receiving substandard care,” Kerner said in an emailed statement.
This is not the first time the Brockton facility has come under fire by the Office of Medical Inspector.
In 2014, a doctor at the nursing home alleged that three Veterans with significant mental health issues received “inappropriate medical and mental health care.”
Two of them went years, he alleged, without appropriate treatment. A third allegedly received psychotropic drugs for more than two years against written instructions.
Investigators largely substantiated the allegations, finding that two Veterans with significant psychiatric issues did not receive adequate treatment for years. They did not substantiate the allegation that a third received improper medication.