Veterans More Likely to Delay Seeking Health Care—Possible Link to Long Wait Times for VA Care

Newswise, May 6, 2016--Military veterans are more likely to report delays in seeking necessary healthcare, compared to the US general population, reports a study in theJournal of Public Health Management and Practice. The journal is published byWolters Kluwer.

Such self-reported care delays may be related to having Veterans Administration (VA) health coverage—and to long waiting times in the VA system, according to the study by Doohee Lee, PhD, of Marshall University, South Charleston, W.V., and Charles Begley, PhD, of the University of Texas School of Public Health, Houston.

"Access problems within the VA system may be creating disparities in care for this vulnerable and deserving population that need to be mitigated," the researchers write.

Veterans Report More Delays in Healthcare

Drs. Lee and Begley performed a secondary analysis of data from a nationally representative survey, performed in 2010-11, to assess delays in seeking healthcare, in the US population overall and among military veterans in particular. About 11,000 Americans were asked if they had "put off or postponed getting medical care they thought they needed" anytime in the past year.

The results were compared for groups with different types of insurance coverage. Most respondents had private health insurance; just under two percent (1.72 percent) were covered by veterans' insurance.

"Those in veterans' care were more likely than the rest of the surveyed population to report care delay," the researchers write. Nearly 29 percent of veterans reported they had delayed seeking needed medical care, compared to the national rate of 17 percent.

Reasons for care delays differed between insurance groups. The veterans reported difficulties in making appointments by phone and in getting transportation to the doctor's office (as did Medicare and Medicaid beneficiaries).

After controlling for personal factors and region of the country, veterans were 1.76 times more likely to delay needed medical care, compared to privately-insured individuals. "Such delays may have an effect on veterans' propensity to seek healthcare as well, which could be detrimental to their health," according to Drs. Lee and Begley.

The findings are consistent with recently reported problems accessing care within the VA system. Prompted by reports of lengthy wait times in veterans diagnosed with health problems, investigation found manipulation of waiting times and inappropriate scheduling practices at some VA medical centers.

Delays in seeking care are an important issue in the US healthcare system, working against efforts to improve high-quality, effective healthcare. Previous studies—mainly comparing patients with public (Medicare and Medicaid) with private insurance—have reported that type of health insurance coverage affects delays in receiving care.

The new study finds that delays in seeking health care are common in the US population, and that the problem is most pronounced for veterans. Nearly three out of ten veterans report delays in seeking care over the past year, and there may be a "causal link" with the VA access problems.

Drs. Lee and Begley believe their study has important implications for policies related to reducing care delays—especially among veterans. They conclude, "More studies are needed to expand our understanding on the magnitude and current status of care delay and offer specific steps to rectify related issues on delayed care if reported in military health care."

Click here to read "Delays in Seeking Health Care: Comparison of Veterans and the General Population."

Article: "Delays in Seeking Health Care: Comparison of Veterans and the General Population." (doi: 10.1097/PHH.0000000000000420)

Gleacher Gives $10 Million to Fund Scholarships for Veterans at Chicago Booth

Newswise, April 14, 2016 — University of Chicago Booth School of Business alumnus Eric Gleacher has made a $10 million gift to his alma mater to fund a groundbreaking scholarship program for U.S. veterans seeking a Chicago Booth MBA.

The Gleacher Veteran Scholars Fund will provide a permanent source of scholarship support to help veterans bridge the gap between the benefits they have earned from the government and the remaining costs associated with receiving their MBA degrees from Booth.

The number of veteran students in Booth’s programs has increased substantially over the past several years, and currently, there are 78 veterans enrolled.

“My experience in the Marine Corps gave me a boost in self-confidence, and my Booth education gave me direction, helping me decide which area of business I wanted to pursue,” Gleacher said.

“It was a winning combination, and I want to make it possible for those who have served our country to have the same opportunity.”

Booth has built a reputation for providing veteran support through participation in the Yellow Ribbon Program, a voluntary program that allows universities to enter into an agreement with the U.S. Department of Veterans Affairs to fund tuition and fee expenses that exceed the established thresholds under the Post 9/11 GI Bill.

The Gleacher Veteran Scholars Fund will serve as a permanent source of scholarship support, allowing Booth to sustain and expand its financial support for veterans.

“Military veterans bring a great deal to the Chicago Booth community in terms of their experience, commitment to service, and maturity. I’m delighted we have significantly increased the number of veterans in our programs,” said Sunil Kumar, Booth Dean and George Pratt Shultz Professor of Operations Management. 

“Eric’s gift will make pursuing an MBA at Booth significantly more affordable for many of these veterans, and thus will have a substantially positive impact on the Booth community as a whole.”

After completing his undergraduate work at Northwestern University in 1962, Gleacher served as an infantry officer in the U.S. Marine Corps for three years prior to earning his MBA at Booth in 1967.

Gleacher joined Lehman Brothers in 1968 in New York. He became a partner in 1973 and founded the firm's mergers and acquisitions business. He went on to head the mergers and acquisitions practice at Morgan Stanley, where he played a pivotal role in some of the highest-profile business deals of the 1980s: Revlon, Texaco, Union Carbide, and RJR Nabisco, among others. With others, Gleacher is credited with creating the business of merger advice.

In 1990, he founded Gleacher and Company, a successful mergers and acquisition boutique which he ran and developed until 2009 when he sold it and retired as CEO.

“The Marines taught me a great deal about leadership, which is crucial to the success of every business,” Gleacher said. 

“Most veterans have learned those same leadership skills, which can be successfully applied in a variety of business contexts. A Booth MBA can inspire veteran students as future business leaders, preparing them for successful careers as entrepreneurs and executives in major companies.”

In 1996, Gleacher gave $15 million to Booth to help finance its downtown Chicago riverfront Gleacher Center, which houses Booth’s evening and weekend programs, as well as its North American executive program.

A legacy for female Veterans since WWII

February 19, 2016--Back in September, we mentioned that the oldest living female WWII Veteran had turned 108. We noted that Corporal Alyce Dixon, affectionately known as “Queen Bee” by those who knew her and cared for her at the Washington, D.C., VA Medical Center (VAMC), had quite a story and quite a personality. Rocking a tiara on top of her head for the occasion, she was queen for the day. Fellow Veterans, volunteers, staff and family members celebrated her life at a special ceremony held Sept. 11.

A few weeks ago, we received word that Ms. Dixon had passed away. Shortly thereafter, VA Secretary Bob McDonald honored her in a special Black History Month message.

We also couldn’t help but think of how she had pioneered the way for the many female Veterans of all races that the VA is now serving – a number that will reach 10 percent of all Veterans in just a few years.

 She joined the military in 1943 and was stationed in both England and France with the postal services. She was one of the first African-American women in the Army as part of the “Six Triple Eight” (6888^th Central Postal Directory Battalion) – the only unit of African-American women in the Women’s Army Corps to serve overseas during WWII.

They amazed one and all by beating the standards in the speed and thoroughness with which they kept the frontlines in touch with the home front. After the war, she continued serving America, working for the federal government as a civilian, retiring in 1973. Now 1973 to 2016 – that’s a long retirement to stay healthy and keep active, which Alyce Dixon did.

Alyce Dixon appreciated the care and goodwill she received as the Queen Bee of the VAMC. With the number of female Veterans using VA health services increasing dramatically, up 80 percent between 2003 and 2012 according to VHA, we recognize that there is much more to be done. In future blogs, we will talk about how VA is working toward accommodating the needs of today’s female Veterans. One resource to consider is the Center for Women Veterans (CWV).

This increase in female Veterans, of course, calls for an increase in female professionals throughout VA. So I’d like to invite you to take a look at all of the job opportunities available and Join VA. When you work here, you’ll have an excellent salary, outstanding benefits and great work-life balance, plus, like Alyce Dixon, an opportunity to serve beyond your days in uniform.

VA care at home, Veterans choose the medical foster home program instead of a nursing home

February 19, 2016--Elderly Veterans and Veterans who require around the clock care have numerous options available to them through VA. Annually, thousands of Veterans turn to VA for care, whether it in a community residential care center, adult family home, community living center or a community nursing home partner.

Most Veterans do not want to go in to an institution for their aging care, so VA has been working to expand its medical foster home program that allows caregivers to care for Veterans in their own home. 

It’s a win-win situation for both VA and the Veterans that chose the option, as they are able to receive personalized care in a home setting and it is less expensive than institutionalized care.

“Veterans love this program because it gives them an opportunity to be apart of a loving family,” said Beau Williams, one of the Medical Foster Home Program coordinators for the Tampa, Florida area.

Beau is charged with not only marketing the program and placing the Veterans in these loving homes, but also interviewing and approving the caregivers.

“I look for caregivers with not only the qualifications required, but most importantly that they have a good heart,” Williams said.

Many caregivers are already medically trained and VA provides classes and specialized training such as spinal cord injury care for their live-in patients. VA then sends home-based care specialists to the Veterans on a weekly basis for any additional assistance they require.

Caregiver Tammy Norton moved to Florida to care for her father through the VA Medical Foster Home Program. She also took in two additional Veterans, Clayton and Nat. Her father recently passed away, but she continues to care for her “new family,” as she put it.

The Veterans use their VA benefits to pay Tammy for the home based care, which includes everything from meals to bathing, but it’s so much more than that. The three go on outings together, attend church, even vacation together. They are a family.

Depending on the level of care required, some Veterans do miss the opportunities to socialize with others outside of their home that they may receive in a nursing home. VA organizes regular foster care socials where all foster home Veterans and their caregivers are invited to spend time together.

These ‘Vet-togethers’ are loved by not only the Veterans, but also the caregivers as it gives them a chance to learn from each other’s experience.

Make a Difference Day

Even though most of the Veterans in the foster home program are somewhat limited to their home, they are still involved with their community.

The Tampa VAMC Voluntary Services team saw the benefit of bringing community partners and the foster home Veterans together and organized the event in conjunction with Make a Difference Day.

Make a Difference Day is a national service day where volunteers look for opportunities to enrich the lives of others. 

The Hillsborough Bar Association has supplied and distributed the Veteran gift bags for the past four years.

“My father is Veteran so this is very near and dear to my heart. It’s amazing to see the love in those homes, so wonderful to give them a little bit a joy in their day,” said Kathy Gilbert of the Hillsborough Bar Association who has participated in this event for three years.

While many volunteers spend days gathering and creating the gift bags and strive to fulfill the Veteran’s wish lists, the most rewarding part are the home visits. The Veterans and foster care providers open their doors with wide eyes and giant smiles. They visit, laugh and enjoy the company of their new friends and visitors.

Clayton and Nat both showed off their rooms with pride, pointing to picture after picture. Nat has a picture of the iconic Mount Suribachi flag raising on Iwo Jima to honor his grandson who is in the U.S. Marine Corps. He also shared his experience flying over the island on his way to Japan.

“You’ll find the Veterans greatly appreciate the support. I’ve heard them say that it is their home; it gives them an opportunity to be apart of a loving family,” said Tampa’s Beau Williams. “They are very happy with that.”

To learn more about the VA’s Medical Foster Home Program 

visit http://www.va.gov/geriatrics/guide/longtermcare/medical_foster_homes.asp#

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.