Why we honor Veterans of Pearl Harbor 74 years later

Posted in Honoring Vets  by James W. Killen

December 14, 2016--On December 7, 1941, a foreign force launched a surprise attack that killed 2,403 American Service members

America has hundreds of epic and hard fought battles in the history books, but battles like Belleau Wood, Arnhem, Inchon, Hue and the too many others to list are not widely known, despite having profound and significant impact on the United States military and the study of warfare.

So why, with so many significant battles, do we all know about the attack on Pearl Harbor?

Ask any adult about the Battle of Inchon and you’re likely to get a blank stare, but ask any fourth grader about Pearl Harbor and you’re likely to get a history lesson about the attack that thrust America into World War II.

On December 7, 1941, a foreign force launched a surprise attack that killed 2,403 American Servicemembers. The event effectively etched into the American psyche because it was not only an attack on Pearl Harbor, it was an attack on the decency and on the soul of the American people.

Americans were stunned by the attack, and suddenly all opposition to our active involvement in World War II was ended. Americans resolved to avenge what the Tokyo Trials would eventually call a war crime.

Seventy-four years later we still remember the event with the moniker “We Will Never Forget.” 

Four generations after the attack, school children gather in remembrance, news outlets run feature stories on the survivors who are still with us, Sailors, Marines, Soldiers and Airmen don dress uniforms and attend ceremonies from Pearl Harbor to Washington D.C., and the world takes just a moment to commemorate “the date which will live in infamy.”

Following the attack, Japanese Admiral Isoroku Yamamoto feared it awakened a sleeping giant, referring to the resolve of the American people. We may have our differences, our conflicts with one another, and our opinions on the direction of the country, but when attacked by an outsider we pull together as one powerful and steadfast opponent.

We remember Pearl Harbor because it was an attack on our heart; it was an assault on our national soul.

We remember because to forget is to dishonor the memory of those who gave their lives that day and those who would eventually give their lives in the defense of liberty and freedom.

We remember because our unity stands as a staunch reminder to potential foes that an attack on the American people will be avenged. That our resolve is our strength.

The Department of Veterans Affairs, ASTRO and Washington University Combine Forces to Drive Better Care for Veterans with Cancer

Newswise, November 19, 2015 — Washington, District of Columbia, November 18, 2015—The Department of Veterans Affairs (VA) today announced a new Radiation Oncology Practice Assessment (ROPA) program to leverage recent advances in information technology to improve radiation therapy cancer care for our nation’s Veterans.

VA is working with the American Society for Radiation Oncology (ASTRO) and Washington University to provide radiation oncologists for the first time with continuous feedback on the progress of cancer therapy.

“We are pleased to be working with this country’s leading-class organizations on this innovative program, the first of its kind nationwide. Our Veterans deserve nothing less,” said Dr. Maureen McCarthy, VA acting assistant deputy undersecretary for health and patient care services.

Radiation is one of the three major treatments for cancer along with surgery and chemotherapy, with about 60% of cancer patients receiving radiation therapy. In recent years, there have been substantial clinical and technical advances in radiation oncology, resulting in new regimens with increased survival and improved quality of life.

Under ROPA, data will be abstracted from the VA’s highly-sophisticated electronic medical record (EMR) system and the treatment management systems used to control radiation therapy delivery. Feedback reports will be provided to VA radiation oncologists with a detailed analysis of each patient treatment compared against national standards.

Combined with the traditional cancer outcome measures of recurrence and patient survival, this assessment will provide the oncologist with a complete picture of the accuracy of each patient’s therapy and the patient’s response to therapy.

Washington University is excited to take the lead role in managing the program. “We have significant experience working with the National Cancer Institute to provide the platform we will use for these assessments. We are excited to bring that experience to bear on this landmark project on behalf of our nation’s Veterans,” said Jeff Michalski, MD, Washington University’s vice-chair of radiation oncology.

“We are also pleased to engage a local radiation oncology informatics company, Radialogica LLC, who will provide a platform and services for data security, extraction and management.”

In the first year of the project, ASTRO’s disease-site specific experts will review measures for prostate and lung cancers, identifying metrics from the EMR to assess each one.

“ASTRO is deeply committed to improving the quality of cancer care for our Veterans and all Americans. Our cancer experts are enthusiastic about this new opportunity to better measure and enhance radiation delivery with the goal of producing high quality patient outcomes,” said Bruce D. Minsky, MD, FASTRO, chair of ASTRO’s Board of Directors.

Once ROPA is fully implemented, VA radiation oncologists will receive continuously updated electronic peer reviews of each patient’s cancer evaluation, treatment and treatment outcome.

Currently, VA hospitals, similar to community hospitals, use traditional, sporadic peer-reviews in a process referred to as On-going Professional Peer Evaluation (OPPE). ROPA peer reviews go well beyond the traditional OPPE and practice accreditation to create comprehensive, patient-centered reports in a web-based environment. VA radiation oncologists will see how changes in their clinical practice impact the success of each Veteran’s cancer treatment. 

ABOUT ASTRO

ASTRO is the premier radiation oncology society in the world, with nearly 11,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals, International Journal of Radiation Oncology • Biology • Physics (www.redjournal.org), Practical Radiation Oncology (www.practicalradonc.org) and Advances in Radiation Oncology (www.advancesradonc.org); developed and maintains an extensive patient website, RT Answers (www.rtanswers.org); and created the Radiation Oncology Institute (www.roinstitute.org), a nonprofit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit www.astro.org.

Caregivers of Veterans Benefit from Purple Heart Homes Aging In Place Program

November 18, 2015 /PRNewswire/ -- November is National Caregivers month and Purple Heart Homes adaptations made to Veterans' homes helps make life easier for caregivers by creating safer barrier free environments both inside and out.

According to a March, 2014 Rand study entitled 'Hidden Heroes:  America's Military Caregivers', there are 5.5 million caregivers across the US.  Of that, 1.1 million care for Veterans that served in Afghanistan and Iraq.  

The remaining 4.4 million are caring for WWII, Korea, Vietnam, Desert Storm or those that were injured during training missions.

Staff Sergeant Cory Collins, two-time Purple Heart Recipient, was the sole survivor of an IED explosion on November 2, 2005 that left him with 30 broken bones in his body.  His hip is held together with what his wife Paula calls two lag bolts.  He suffers from PTSD, TBI and had his left leg amputated above the knee. 

Paula Collins says getting Cory up each morning is her biggest challenge because he is on 10 different pain medications.

Purple Heart Homes adapted the Collins home making doorways wider, a bathroom handicap accessible, installed hardwood floors throughout the first floor, replaced all the round door knobs with lever handles and built a handicap ramp and deck.

"Before the home was handicap accessible Cory would watch TV. He would skin his knuckles in narrow doorways, and helping him get into a bathroom was a major issue," said Paula Collins.  "The adaptations made to our home has given me time so I can take an hour for myself to workout at a gym, because I know he can move safely throughout the house with ease," Collins added.

Vietnam Veteran Joe Recupero suffers from severe Parkinson's disease as a result of exposure to Agent Orange.  Recupero had to climb 12 steps from his driveway to get into his home.  His existing bathroom floor was rotting out.  Getting in and out of the tub shower with no grab bars was dangerous and difficult.

Debbie Fiori, Joe's caregiver and significant person in his life said, "when Purple Heart Homes moved the driveway and built a ramp to the front door it made it easier for both Joe and me." 

Purple Heart Homes built an addition on to Recupero's home so he could have a handicap accessible bathroom, higher toilet seat and grab bars. 

Debbie Fiori said, "I have been a nurse for 38 years and the adaptations made to Joe's home enables me to continue to work and have peace of mind that he can move about safely in the home. His Parkinson's has not advanced that he needs his wheelchair, but when he does he will have no problem going from room to room and using the bathroom, which eases my future caregiving responsibilities."

Caregivers of Veterans experience loss of employment, thus loss of needed income when care is given 24/7.  They suffer from emotional and physical stresses.  According to the Rand study, military caregivers consistently experience more serious health issues, have greater strains in family relationships and more workplace problems than non-caregivers, and post 9/11 military caregivers fare worst in these areas.

"We have expanded our Veterans Aging in Place program to be able to help more Veterans and their caregivers with the creation of chapters to do less costly projects that make a world of difference – like a simple ramp, wider doorways, grab bars, lever door handles and handicap accessible bathrooms," said John Gallina, Executive Director of Purple Heart Homes.  The majority of applications received for needed renovations come from Veteran Caregivers.

All needed adaptations for approved older Veterans are done at no cost to the Veteran or family thanks to generous support received from foundations, in-kind donations of materials and generous support from communities and individual donations.

Purple Heart Homes salutes all caregivers providing comfort, support and daily assistance to our Veterans.  They work quietly behind the scenes and deserve not only our support, but also our entire nation.

To learn more about Purple Heart Homes Aging in Place program, to submit an application, to form a chapter and to make a donation see: www.phhusa.org.

Physician Anesthesiologists Oppose Legislation Risking Veterans’ Lives

Doctors Should Not Be Replaced with Nurses for Anesthesia Care during Surgery

Newswise, November 16, 2015– To protect our nation’s Veterans, the American Society of Anesthesiologists (ASA) urges extreme caution when considering the “Veterans Health Care Staffing Improvement Act,” S. 2279. 

As currently drafted, this legislation contains a misguided provision that removes physician anesthesiologists from surgery and replaces them with nurses.

Veterans will receive a lower standard of care, jeopardizing their safety and lives, if physician involvement is eliminated from anesthesia care in surgery.

Although the purpose of the legislation, introduced Nov. 10 in the U.S. Senate, is admirable, proposing to ease the transition of military health care providers to the Department of Veterans Affairs (VA); it also includes provisions abandoning the physician-nurse team-based model of care for all advanced practice registered nurses (APRN), including nurse anesthetists, in the VA.

Senators sponsoring the legislation note the act proposes “common-sense” changes in staffing policies to improve Veterans’ care at health care facilities by addressing the shortfall of medical staff. However, there is no shortage of physician anesthesiologists or nurse anesthetists in the VA system.

Surgery and anesthesia care inherently contain risk, and this is true even more so for Veterans, who often have complex medical conditions that pose a heightened risk of complications during surgery. Physician involvement when performing surgery on our Veterans is much more critical than providing typical primary care or treating chronic health conditions.

The legislation would eliminate the existing and proven model of care where physician anesthesiologists and nurse anesthetists work together as a team to ensure our Veterans receive the highest quality and safest anesthesia care.

“Taking physicians out of surgical care is not a common-sense solution for our VA patients who are often sicker, older and have multiple medical conditions that put them at greater risk for complications,” said ASA President Daniel J. Cole, M.D.

“The team-based model of care ensures all Veterans have access to a physician anesthesiologist should an emergency or complication occur. This legislation will place our Veterans at increased risk. There can be no compromise on the highest-quality, safest medical care for those who have served our country”

Similar dangerous proposals have been considered, and when it comes to the subject of substituting nurses for physicians in anesthesia care, the VA’s own experts on surgical anesthesia care, the Chiefs of Anesthesiology, have told VA leadership that a policy substituting nurses for physicians “would directly compromise patient safety and limit our ability to provide quality care to Veterans.” (Letter from VA Chiefs to Secretary Shinseki, Dr. Petzel, and Dr. Jesse - Oct 1, 2013.)

Physician anesthesiologists receive 12 to 14 years of education, including medical school, and 12,000 to 16,000 hours of clinical training to specialize in anesthesia care and pain control, with the necessary knowledge to understand and treat the entire human body. By comparison, nurse anesthetists have only about 1,650 hours of clinical training.

The Veterans Health Care Staffing Improvement Act was introduced by Senators Merkley (Oregon) and Rounds (South Dakota). The bill has also been co-sponsored by Senators Tillis (North Carolina), Warner (Virginia), Shaheen (New Hampshire), Wyden (Oregon), Tester (Montana) and Brown (Ohio). ASA strongly urges reconsideration of the provisions that lower the standard of care for Veterans and puts their health and lives at risk in surgery.

More information about the proposed legislation and the importance of physician-led, anesthesia care is available at www.asahq.org.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS®
Founded in 1905, the American Society of Anesthesiologists (ASA®) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves. 

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit www.asahq.org/WhenSecondsCount

Timely Health Care for Veterans Supported in Bipartisan Senate Bill

CRNAs and Other APRNs back Veterans Health Care Staffing Improvement Act

Newswise, November 13, 2015—Bipartisan legislation introduced in the U.S. Senate on Nov. 10 expands access to timely, quality healthcare for America’s veterans by directing the Veterans Health Administration (VHA) to allow Certified Registered Nurse Anesthetists (CRNAs) and other advanced practice registered nurses (APRNs) to provide patient care to the full extent of their education and abilities.

The “Veterans Health Care Staffing Improvement Act” was introduced by Sens. Jeff Merkley (D-OR), Mike Rounds (R-SD), and other co-sponsors from both parties, and is supported by the 49,000-member American Association of Nurse Anesthetists (AANA).

In addition to directing the VHA to extend full practice authority to CRNAs and other APRNs, the bill also removes bureaucratic barriers to healthcare professionals’ privileging and credentialing within the VHA, and encourages former military healthcare personnel to join the VHA for healthcare services. 

“Veterans are waiting too long for quality healthcare that they deserve and have earned,” said AANA President Juan Quintana, CRNA, DNP, MHS. “The AANA strongly supports this legislation which will reduce veterans’ wait times for high quality healthcare by recognizing CRNAs and other APRNs to their full practice authority.”

The legislation is the result of an independent assessment that Congress ordered of the VA and published last month, which recommended that allowing CRNAs and other APRNs to practice to the full extent of their education and abilities would increase veterans’ access to care, reduce wait times, and save money.

The proposal is also consistent with recommendations made previously by the Institute of Medicine, and is supported by more than 40 veteran and healthcare professional organizations, including the Vietnam Veterans of America, the Military Officers Association of America, the Veterans of Foreign Wars, and the Iraq and Afghanistan Veterans of America.

Additional cosponsors include Sens. Jeanne Shaheen (D-NH), Thom Tillis (R-NC), Mark Warner (D-VA) and Ron Wyden (D-OR).

About the American Association of Nurse Anesthetists

Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization for more than 49,000 nurse anesthetists across the United States.

As anesthesia specialists, Certified Registered Nurse Anesthetists (CRNAs) safely provide approximately 40 million anesthetics to patients each year for surgical, obstetrical, pain management, and trauma stabilization services.

CRNAs deliver essential healthcare in thousands of communities and are able to prevent gaps in access to anesthesia services, especially in rural, inner-city, and other medically underserved areas of the country.

They are highly valued in today’s healthcare environment because they deliver the same safe, high-quality anesthesia care as other anesthesia professionals but at a lower cost, helping to control rising healthcare costs. Additional information about the AANA and CRNAs is available at www.aana.com and www.aana.com/future-today.

Veterans Deserve More Than Just Another "Thank You"

Delays in healthcare unacceptable for Veterans

Newswise, November 11, 2015 — While it isn’t possible to say “thank you” enough times to our military veterans, sometimes actions speak louder than words.

This Veterans Day, in addition to saying “thank you” to our veterans, each one of us can take action on their behalf to solve the ongoing healthcare service challenges confronting Veterans Administration hospitals, clinics, and other facilities across the country.

Long wait times for appointments—sometimes a month or more just to receive basic health services—are the unacceptable norm veterans routinely encounter.

Even though Congress has expanded resources for the Veterans Administration, the problem persists, often putting veterans’ lives at risk, because more veterans are coming to the VA for care. Delays are hard to justify after these honorable men and women already put their lives on the line while serving our country.

And they are even harder to justify when the solution to the problem is right there waiting to be implemented.

Behind the scenes, the VHA has been seeking to change existing policy that would allow the nearly 6,000 advanced practice registered nurses (APRNs) already working in the VHA to have full-practice authority to serve veterans.

Utilizing APRNs to their full scope of practice, including Certified Registered Nurse Anesthetists (CRNAs), nurse practitioners, nurse midwives, and clinical nurse specialists, would ensure veterans timely access to healthcare that is high-quality, safe and cost-effective. No more waiting in pain and discomfort until “the doctor will see you now.”

APRNs are more than qualified to take on additional responsibilities. To become an APRN, one must earn both an undergraduate and graduate level degree, have extensive clinical experience, and take numerous training programs and continuing education. And every CRNA is nationally certified.

The VHA’s proposal would mirror existing Department of Defense policy, which already uses APRNs to their full capabilities.

CRNAs, for instance, are the anesthesia professionals on the front lines caring for troops in every U.S. military action, and have been since World War I.

The soldiers, sailors, Marines and airmen they take care of—many horribly injured—require the attention of confident, talented, educated, and experienced caregivers to ensure their survival and wellbeing.

Nothing should prevent these highly qualified anesthesia experts from providing the same level of care to critically ill veterans back home in the states.

The VHA oversees nearly 2,000 facilities serving approximately 9 million veterans every year, which is why it’s not all that surprising the administration struggles to reduce long wait times. About 120 of those facilities offer procedures requiring anesthesia.

The solution to better care and shorter wait times is right there. It can be implemented immediately. It’s time to say thank you to our veterans by taking action to improve their access to excellent healthcare services, simply by recognizing CRNAs and other APRNs to their Full Practice Authority.

Our veterans have more than earned it.

Juan Quintana, CRNA, DNP, MHS
President
American Association of Nurse Anesthetists

Prison Camp Liberators of WWII: Baylor University Finds New Way to Pay Tribute to Heroes

‘In this digital age, we asked, “What can we do to navigate history?’” oral historian says

Newswise, November 9, 2015 — The firsthand accounts of 19 Texas veterans who helped liberate World War II Nazi concentration camps now can be seen and heard on Baylor University’s Institute for
Oral History (IOH) website using a new video indexing tool that allows a rare type of access to their compelling stories.

The videos in the online exhibit, synched to printed transcripts, range from the story of a chaplain who conducted a worship service for newly liberated Jewish survivors at Buchenwald camp to the combat engineer who helped bulldoze mass graves for victims at Mauthausen to the engineer who witnessed the liberation of slave laborers in a secret German bomb factory.

When visitors go to the “Texas Liberators of World War II” project on the IOH website, they can launch the just-installed OHMS (Oral History Metadata Synchronizer) portal, which allows them to simultaneously engage audio/video with an index and printed transcript. The project is the first at IOH to fully employ the technology, said Stephen Sloan, Ph.D. IOH director and associate professor of history in Baylor’s College of Arts & Sciences.

OHMS is a relatively new software developed by the University of Kentucky's Louie B. Nunn Center for Oral History.

“In this digital age, we asked, ‘What can we do to navigate history?’” said Steven Sielaff, IOH senior editor and collection manager, who created trailer clips, preserved the video and constructed OHMS records.

When interacting with an OHMS record, “you can simply click on a topic or transcript timestamp to advance to that point in the narrative,” said Sloan, the project’s principal investigator and interviewer. 

“The built-in search engine provides even greater discoverability while engaged with the video. OHMS records for this project exhibit what is termed ‘Level 1 Indexing,’ which are simple correlations between topic and time.”

The two-year Texas Liberators project, funded by the Texas Holocaust and Genocide Commission in Austin, captures the veterans’ stories in interviews done from 2011 to 2013. Interviews were conducted in the liberators’ homes, and site visitors are able to digitally step into their living rooms.

Many of the veterans wear caps bearing the insignia of the units they served in, and “many of them have items from the war — knives, bayonets and medals, as well as maps on the wall showing the places they served,” Sielaff said.

“You get the voice, the language and those expressions that you just don’t get in a transcript,” said Lois Myers, IOH’s associate director. 

“Two of the veterans are Jewish and helped liberate other Jews from camps. It’s very moving.”

Another powerful tale is that of a veteran and native of Germany whose family came to the United States before Hitler came into power. 

He conducted translation and intelligence operations, and after helping liberate Nordhausen slave labor camp, he had the grim task of transcribing accounts of some of the experiments that Germans conducted on prisoners in concentration camps.

“We have already lost four of these veterans,” Sloan said. 

“The best way we can honor our veterans is by giving them the opportunity to not only tell, but retell to this generation and the next, their story. Oral history allows these contributions to be recognized far into the future in the words and manner in which they themselves wanted it told."

IOH also recently published a collection of 17 riveting interviews in “Tattooed on My Soul: Texas Veterans Remember World War II,” an anthology that offers an overview of the war and how it was lived out by the men and women who served their country on land, in the air and by sea.

ABOUT BAYLOR UNIVERSITY

Baylor University is a private Christian University and a nationally ranked research institution, characterized as having “high research activity” by the Carnegie Foundation for the Advancement of Teaching. The University provides a vibrant campus community for approximately 16,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. Baylor sponsors 19 varsity athletic teams and is a founding member of the Big 12 Conference.

ABOUT THE INSTITUTE FOR ORAL HISTORY

Through dynamic, recorded interviews, the Institute for Oral History preserves the stories of individuals who helped create the fabric of history and whose lives, in turn, were shaped by the people, places, events and ideas of their day. The Institute has recorded and preserved oral histories since 1970, earning along the way a strong reputation for multidisciplinary outreach to both academic scholars and community historians by providing professional leadership, educational tools, and research opportunities. For more information, visithttp://www.baylor.edu/oralhistory/.

See more at http://www.baylor.edu/mediacommunications/news.php?action=story&story=163045

Dying Veteran opts to spend his final days at VA

  A Vet’s final three weeks

November 6, 2015--Lewis Violanti, a 92-year-old Veteran of the Army Air Corps, was dying. During the final three weeks of his life, he chose the hospice unit at the Buffalo VA as the place where he wanted to live out his final days.

His wife Sarah is glad he did.

“What a place,” she said. “He was treated like royalty. They took care of him like he was their father. It made me so happy.”

Sarah said she and her daughter Gail and her son Bruce were there with Lewis every day and witnessed first-hand the care and attention he received.

“Every person there was so kind to him,”      Lewis and Sarah Violanti, not all                                                                                     that long ago

Sarah observed. “One time I saw a

nurse talking to him very low. Then she put her hand on his cheek. I have no idea what she was saying, but she was saying something to him, talking very softly.”

Then one day something unexpected happened, something you don’t normally see on a hospice unit.

“On July 28 I mentioned to a nurse that the following day was our 65th wedding anniversary,” said Sarah. “The next day the staff gave us a beautiful party with a cake. They gave everyone there, and whoever passed by, a slice of cake. And they gave me a dozen roses! Boy, was I surprised. I was absolutely flabbergasted.”

“They made a terrible time very tolerable,” said Sarah’s daughter Gail. “They made it bearable. Especially toward the end, they were coming in to check not just on my dad, but on me. Every half hour, someone would come along and ask if I needed anything.

“And every night when I had to go home, I was afraid because I didn’t want my dad to die alone. But they told me don’t worry, that he’d be okay, that they would check on him. So when I left at night I felt comfortable, because I knew he was going to be okay, that he wasn’t going to be alone.

“He was treated like royalty. They took care of him like he was their father.”

“He was a good guy,” she added. “He was a sweet man. And he was very proud of being a Vet.”

Lewis Violanti died on August 4 with his daughter and two nurses at his side.

“When he died they gave him a procession,” Gail said. “They had all the Veterans wheeled out into the hallway and they were all saluting him. He would have liked that.”

She added, “When I retire I’m going to volunteer there at the Buffalo VA. It’s just a nice place. I want to see if I can help them. My dad would have liked that.”

Learn more here about hospice care at VA.

VA releases plan to consolidate community health care programs

By Dr. David J. Shulkin, Under Secretary of Health for the U.S. Department of Veterans Affairs.

November 6, 2015--Every day at VA, we try new approaches to work smarter so that we can meet Veterans’ changing health care needs while drawing closer to achieving VA’s goal to deliver world-class health care to Veterans.

On October 30, 2015, VA delivered to Congress the department’s Plan to Consolidate Community Care Programs, its vision for the future outlining improvements for how VA will deliver health care to Veterans.  

The plan outlines VA’s approach to adapt and evolve to meet the health care need of Veterans in the community. It is VA’s response to the bill passed in July 2015 after VA sought the opportunity to consolidate its multiple care in the community authorities and programs.  

The plan seeks to consolidate and streamline existing community care programs into an integrated care delivery system and enhance the way VA partners with other federal health care providers, academic affiliates and community providers.  

It simplifies community care and gives more Veterans access to the best care anywhere through a high performing network that keeps Veterans at the center of care.

VA is working with our partners in Congress to ensure VHA receives funding and authorities necessary to move forward with this plan. VA recognizes the problems happening right now.  The plan describes how we think VA can fix the problem and serves as a place where we can start discussions to define the future state of VA community care.

The plan strives to make it easier for Veterans and community providers to know how and when a Veteran can access community care. We are asking Congress to support these proposed changes so VA can increase Veterans’ access to care in the community and make it easier for community providers to help us in our goal.  

We understand that a change of this size will take long-term commitment and support from our partners, like you. In the interim, VA continues to operate existing community care programs, including the Choice Program, while we also make improvements to access. VA reaffirms its long-term commitment to continually working to make improvements and plans to implement any congressionally approved changes gradually, responsibly, and transparently.

To learn more, visit this link to access the full report submitted to Congress.

Veterans Use Shakespeare to Heal at UW-Milwaukee

Production of Julius Caesar helps veterans talk about their own concerns.

And Crispian shall ne’er go by,
From this day to the ending of the world,
But we in it shall be remembered-
We few, we happy few, we band of brothers…
— Henry V, Act 4, Scene 3

Newswise, November 2, 2015 — Carissa DiPietro puts Shakespeare’s thoughts into her own words, but the meaning is similar: “I felt like I was surrounded by people who understood me and some of the things I’ve been through.”

DiPietro is one of a group of military veterans who are using Shakespeare to work through their own challenges, under the guidance of two University of Wisconsin (UWM) theater professors. Their troupe, Feast of Crispian will be performing “Julius Caesar,” the weekend of Oct. 30-Nov. 1 in Milwaukee.

Bill Watson, associate professor of theater, Nancy Smith-Watson, an actor and somatic body therapist, and Jim Tasse, senior lecturer in theater, founded the group as a way of helping veterans deal with depression, post-traumatic stress, addiction and reintegration into society. The name comes from the speech in Shakespeare’s “Henry V,” in which the king reminds his soldiers of their lasting bonds.

Watson and Tasse, a veteran himself, volunteered their services to the Clement J. Zablocki Veterans Affairs Medical Center (VA), using rehearsal techniques developed and tested three decades ago by Shakespeare and Company in Massachusetts. The Watsons and Tasse, though, added their own unique approach to the use of Shakespeare’s texts -- a therapeutic intervention.

They held their first workshop nearly three years ago, and have worked with more than 250 veterans since then, doing weekend theater boot camps and small presentations for family and friends. The current production of “Julius Ceasar” is the group’s first performance for the general public.

“We wanted to try out the idea…to see if performing Shakespeare had any benefits, and we found that indeed it was having great benefit,” Tasse said.

The statistics on challenges veterans face are eye opening: Each day, 22 veterans commit suicide and one-quarter of veterans end up homeless, said Watson.

The Shakespeare approach works on a number of different levels. The veterans, who come from all branches of the service and range in age from early 20s to seniors, build a community of trust.

“In acting, as in the military, everybody is important to the production,” Tasse said. “Everybody has to do their job. They are a brotherhood and sisterhood.”

On another level, acting gives the veterans a chance to explore their own feelings through another character.

“It’s an opportunity to tell our stories, safeguarded by the script,” said Johny Sherwood, a senior UWM theater major and veteran of Afghanistan.

He volunteered to take part in the program after hearing about it while he was at the VA for non-combat related surgery. “You can go to the dark places within, but your own secrets are secure.”

The very words of Shakespeare give the veterans a chance to contemplate their own issues. Many of the plays and scenes used in workshops look at conflict and violence.

Jan Masalewicz, a Vietnam veteran who found Shakespeare boring in high school, has developed a new appreciation of the plays. “Things he wrote about in his plays are still true today… war and betrayal and love … all that stuff.”

The veterans and the professionals who work with them spend time exploring the themes of the plays, talking about how they relate to their lives, sharing their own emotions when they feel comfortable doing that, and learning to express some of their feelings through acting.

The professionals work with the veterans, explaining the Shakespearean language and going on stage with them to give them the lines so they can focus on conveying the characters’ emotions.

While not everyone in the group suffers from trauma and stress, all find a level of comfort in working together with a group of fellow veterans on a challenging project.

Chris Nickrant, who served in the Air Force from 1970-74, has been with the group through almost every workshop. “It’s definitely expanding my horizons. I’m learning to reach out to other people.” The current play has also inspired him to read more about Shakespeare, Julius Caesar, Brutus and the assassination, he added.

“You can go through counseling for years and years and not really reach into the emotional aspect until you do something like this,” said DiPietro. “I’m not really a crier, but I’ve cried in this group. That’s how safe I feel. It’s absolutely incredible.”

“With this play, I have a purpose. Something I look forward to. Something to be excited about… I haven’t felt that way in a long time.”

Teachers, are you ready to celebrate Veterans Day?

Veterans Day history, teachers guide, gallery and other resources

November 2, 2015--Check out the U.S. Department of Veterans Affairs Veterans Day Web page, which is full of resources for observing this special day, whether through learning about its background, or planning community or school-related events. Teachers looking for materials to help educate their students on the history and traditions of this observance can download and use our annually updated teacher’s resource guide.

The teacher’s guide includes tips on planning a school assembly, suggestions for classroom activities, information on available scholarships, and opportunities to learn through the Veterans History Project. 

Additionally, the Veterans Day poster gallery provides the option to download and print the latest Veterans Day themed poster for the classroom or other facility.

The VA’s Veterans Day page can help everyone learn more about the legacy of Veterans Day. 

Organizations can find out about membership in the Veterans Day National Committee, which oversees the national planning and coordination of the Veterans Day observance. 

And those who feel inspired to volunteer their skills with VA can connect with the VA Voluntary Service.  Volunteers are a priceless asset to the nation’s Veterans and to VA.

Lastly, travelers with plans to visit the Washington, D.C., area during this time can find out more about the Veterans Day National Ceremony held each year at Arlington National Cemetery.

Finding inspiration in sports – injured Veteran hopes to compete in 2016 Paralympic Games in Rio

VA allowance helps ease financial burden of competition

Tom Giannettino was in a dark place. And he knew it.

“I hit rock bottom and it was horrible,” says the Air Force Veteran, describing his recovery from a traumatic injury he suffered in 2010 while working undercover for the New York state police.

During the next few years, he lost his job, his identity and his purpose, and no matter how hard he tried he just couldn’t shake the burdens of guilt and anger that consumed him. 

Then one day he stumbled upon an image of a young woman, an Army Veteran, who was a world-class athlete competing in triathlons. She was an amputee. 

“That was the moment,” says Giannettino. “It just inspired me to see her and I thought if she can do a triathlon with one leg, then why can’t I do it with one arm.”

Dare2tri co-founder Melissa Stockwell

In 2013, he attended a triathlon camp hosted by Dare2tri, a non-profit paratriathlon club based in Chicago that helps and encourages athletes of all ability levels from beginner to elite. 

Although he didn’t realize it at the time, one of the co-founders of Dare2tri was Melissa Stockwell, the young Army Veteran whose image inspired his recovery.

And so began his journey; not necessarily through the doors of a hospital or through prescription pills; but through the grueling process of swimming 750 meters, biking 20 kilometers, and running 5 kilometers. 

“I soon learned that this was the mechanism that was helping me manage my daily life and gave me my inspiration to get up every day and set new goals and aspirations,” Giannettino wrote in an essay chronicling his journey titled Rock Bottom to Red, White and Blue.

As he became more and more involved with the sport, Giannettino contacted USA Triathlon and learned about the high performance development program and the monthly assistance allowance VA pays to military Veterans who meet performance standards in their particular sport.

Beginning in 2010, Congress authorized VA to pay a monthly allowance to Veterans training for or selected to compete on the U.S. Paralympic Team. The payment rates are based on VA’s vocational rehabilitation rates: roughly $600 a month for a single Veteran plus extra for dependents. 

That first year, about 50 Veterans qualified for allowance payments in a handful of sports.

For Giannettino, the VA benefit served two purposes: it helped with the financial burdens of preparing for competition, like travel and coaching, and it gave him additional inspiration to reach for the highest level of competition.

 Paratriathlon was only recently sanctioned for Paralympic competition and will debut at the 2016 Paralympic Games in Rio.

Giannettino is not guaranteed a spot on Team USA, and he knows he still has a long way to go. But looking back on his journey, he recognizes just how far he’s come. And that’s reason enough to celebrate.

He recently e-mailed VA to express his gratitude for the monthly allowance. 

“Every single dollar helps to fulfill the obligations of constant traveling and training. I can’t thank you enough for the continued commitment of helping us Veterans reach for new goals and aspirations. Most importantly representing our country, the United States of America,” he wrote.

Today, paratriathlon is one of about 30 sports recognized for international Paralympic competition and VA pays allowances to some 150 Veterans each month who are hoping to represent their country in international competition.

A full list of sport governing bodies and points of contact is available for review athttp://www.va.gov/adaptivesports/docs/Paralympic_Sport_POCs.pdf

If you are a military Veteran and interested in learning more about VA’s monthly allowance for elite athletes, visit http://www.va.gov/adaptivesports/ and click on the “Training Allowance” tab.