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Strengthening Collaborations With the U.S. Department of Defense and U.S. Department of Veterans Affairs: Effectiveness Research on Mind and Body Interventions

February 23, 2015 Comments off

Strengthening Collaborations With the U.S. Department of Defense and U.S. Department of Veterans Affairs: Effectiveness Research on Mind and Body Interventions
Source: National Center for Complementary and Integrative Health (NCCIH)
From press release:

The feasibility of conducting larger-scale research studies on nondrug approaches for pain management in cooperation with the U.S. Department of Defense (DoD) and the U.S. Department of Veterans Affairs (VA) should be assessed by the National Center for Complementary and Integrative Health (NCCIH) at the National Institutes of Health (NIH). This recommendation was delivered in a report by a working group of the Center’s Advisory Council.

“Chronic pain is a major public health problem that affects more than 100 million Americans, and research shows that it may disproportionately affect military personnel and Veterans,” said Lloyd Michener, M.D., professor and chair, Department of Community and Family Medicine, Duke University, Durham, North Carolina; chair of the working group. “The high rates of chronic pain in the military and Veteran populations are alarming. New strategies for managing this widespread condition are urgently needed.”

The working group recommended that the proposed research should:

  • Assess the impact of pain on patient function and quality of life as primary outcome measures, with changes in the use of opioids and other drugs as a secondary outcome;
  • Evaluate an integrated package of nondrug treatments, an integrative model of care, or a holistic approach to care rather than focusing on individual complementary health approaches;
  • Focus on patients in the early stages of chronic pain;
  • Leverage natural experiments and existing resources whenever possible; and
  • Be pragmatic and embedded in the delivery of care.

In-state tuition policies under the Veterans Access, Choice and Accountability Act

February 23, 2015 Comments off

In-state tuition policies under the Veterans Access, Choice and Accountability Act (PDF)
Source: Education Commission of the States

Ensuring access and affordability to a postsecondary education for veterans and their dependents has long been a focus of federal and state education policy. Developing policy to support educational attainment among these individuals has required state policymakers to address residency requirements for veterans to determine eligibility for in-state tuition benefits. Yet recent revisions to federal statute — changes that go into full effect in July 2015 — have shifted the policy landscape in a significant and meaningful way.

Beginning July 1, 2015, the Veterans Access, Choice and Accountability Act (Choice Act) requires that all public postsecondary institutions offer in-state tuition rates to qualified veterans and their dependents, regardless of state residency status. This ECS Policy Analysis provides state and postsecondary leaders with a review of the Choice Act requirements, key information on deadlines, considerations for evaluating state policy for compliance and examples of policy actions.

CRS — Health Care for Veterans: Suicide Prevention (January 30, 2015)

February 9, 2015 Comments off

Health Care for Veterans: Suicide Prevention
Source: Congressional Research Service (via Federation of American Scientists)

This report focuses on suicide prevention activities of the Veterans Health Administration (VHA) within the Department of Veterans Affairs (VA). The VHA’s approach to suicide prevention is based on a public health framework, which has three major components: (1) surveillance, (2) risk and protective factors, and (3) interventions.

Audit of VHA’s National Call Center for Homeless Veterans

February 5, 2015 Comments off

Audit of VHA’s National Call Center for Homeless Veterans (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General

Veterans Health Administration’s (VHA) National Call Center for Homeless Veterans (the Call Center) is VA’s primary vehicle for communicating the availability of VA homeless programs and services to veterans and community providers. OIG has assessed the effectiveness of the National Call Center for Homeless Veterans in helping veterans obtain needed homeless services.

We determined that Homeless and at-risk veterans (Homeless Veterans) who contacted the Call Center often experienced problems either accessing a counselor and/or receiving a referral after completing the Call Center’s intake process. Of the estimated 79,500 Homeless Veterans who contacted the Call Center in fiscal year (FY) 2013: Just under 21,200 (27 percent) could only leave messages on an answering machine—counselors were unavailable to take calls; almost 13,000 (16 percent) could not be referred to VA medical facilities—their messages were inaudible or lacked contact information; and approximately 3,300 (4 percent) were not referred to VA medical facilities, despite having provided all the necessary information.

Referred Homeless Veterans did not always receive the services needed because the Call Center did not follow up on referrals to medical facilities. Of the approximately 51,500 referrals made in FY 2013, the Call Center provided no feedback or improvements to ensure the quality of the homeless services. We noted that 85 percent of the 60 veterans’ records we reviewed lacked documentation to prove the veterans had received needed support services.

Finally, the Call Center closed just under 24,200 (47 percent) referrals even though the VA medical facilities had not provided the Homeless Veterans any support services. In total, we identified 40,500 missed opportunities where the Call Center either did not refer the Homeless Veterans’ calls to medical facilities or it closed referrals without ensuring Homeless Veterans had received needed services from VA medical facilities.

We recommended the Interim Under Secretary for Health stop the use of the answering machine, implement effective Call Center performance metrics to ensure Homeless Veterans receive needed services, and establish controls to ensure the proper use of Call Center special purpose funds. The Interim Under Secretary for Health concurred with our recommendations and provided responsive action plans. We will follow up on these actions.

OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages

February 2, 2015 Comments off

OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General

The VA Office of Inspector General (OIG) conducted a determination of Veterans Health Administration (VHA) occupations with the largest staffing shortages as required by Section 301 of the Veterans Access, Choice, and Accountability Act of 2014. We interpreted “largest staffing shortage” to encompass broader deliberation than simply the number needed to replace or backfill vacant positions. We performed a rules-based analysis on VHA data to identify these occupations. We determined that the five occupations with the “largest staffing shortages” were Medical Officer, Nurse, Physician Assistant, Physical Therapist, and Psychologist. This determination is the first of several OIG determinations on VHA occupational staffing shortages. We plan to incorporate additional data in future OIG determinations to provide more detailed recommendations. We recommended that the Interim Under Secretary for Health continue to develop and implement staffing models for critical need occupations.

Building the Evidence Base for Complementary and Integrative Medicine Use among Veterans and Military Personnel

January 7, 2015 Comments off

Building the Evidence Base for Complementary and Integrative Medicine Use among Veterans and Military Personnel
Source: Medical Care (Supplement Five)

Articles include:

  • Physical Health, Mental Health, and Utilization of Complementary and Alternative Medicine Services Among Gulf War Veterans
  • Perceptions of Providers and Administrators in the Veterans Health Administration Regarding Complementary and Alternative Medicine
  • CAM Utilization Among OEF/OIF Veterans: Findings From the National Health Study for a New Generation of US Veterans
  • US Veterans Use Vitamins and Supplements as Substitutes for Prescription Medication
  • Complementary and Alternative Medicine Among Veterans and Military Personnel: A Synthesis of Population Surveys
  • Variations in the Implementation and Characteristics of Chiropractic Services in VA

The Top 10 Most Viewed DoD Inspector General Reports of 2014

January 6, 2015 Comments off

The Top 10 Most Viewed DoD Inspector General Reports of 2014
Source: U.S. Department of Defense, Office of Inspector General

The Department of Defense, Office of the Inspector General issued 153 reports in calendar year 2014. The reports include audits, assessments and evaluations covering a wide array of topics, but serving a common purpose of supporting the warfighter and promoting accountability, integrity and efficiency in the Department.

Here is a review of the top 10 reports from the past year, based on web views:

  1. Defense Logistics Agency Aviation Potentially Overpaid Bell Helicopter for Sole-Source Commercial Spare Parts
    July 7, 2014 – We determined whether the Defense Logistics Agency (DLA) was purchasing sole-source commercial parts at fair and reasonable prices from Bell Helicopter Textron (Bell).
  2. An Assessment of Contractor Personnel Security Clearance Processes in the Four Defense Intelligence Agencies
    April 4, 2014 – Our objective was to assess: a) how, or if, substantiated investigations of misconduct were reported to Agency Clearance Adjudication Facilities (CAF) and to the DoD Consolidated Adjudication Facility (DODCAF); b) if the referred investigations had been adjudicated; and c) the results of those security adjudications.
  3. Inspection of the Armed Forces Retirement Home
    July 23, 2014 – Section 1518 of the “Armed Forces Retirement Home Act of 1991,” November 15, 1990, as amended by Public Law 112-81, “National Defense Authorization Act for FY 2012,” December 31, 2011 (24 U.S.C. § 418) requires that the Inspector General of the Department of Defense perform a comprehensive inspection of all aspects of the AFRH every three years.
  4. Review of Audits Issued by the Defense Contract Audit Agency in FY 2012 and FY 2013
    September 8, 2014 – As part of our continuous oversight responsibility of DCAA, we reviewed a cross section of 16 DCAA audits completed between October 2011 and February 2013, including 5 audits of forward-pricing proposals and 11 audits of incurred cost proposals and other audit types.
  5. Hotline Allegations Regarding Defense Contract Management Agency Contracting Officer Actions on Several Business System Audit Reports
    June 20, 2014 – We conducted this review to determine the validity of a DoD Hotline complaint alleging that a Defense Contract Management Agency (DCMA) contracting officer did not take timely or appropriate action on several Defense Contract Audit Agency (DCAA) audit reports covering the business systems of a large DoD contractor.
  6. Policy Changes Needed at Defense Contract Management Agency to Ensure Forward Pricing Rates Result in Fair and Reasonable Contract Pricing
    October 10, 2014 –We reviewed Defense Contract Management Agency (DCMA) forward pricing rate policy and practice for indirect rates for compliance with the Federal Acquisition Regulation (FAR) and DoD policy. DCMA forward pricing rate policy covers the 353 contractor locations where DoD contracting officers use DCMA forward pricing rates to negotiate at least $70 billion in Government sales.
  7. Navy Needs to Improve Contract Oversight of Its Financial Improvement and Audit Readiness Program Contracts
    January 13, 2014 – The objective of the audit was to determine whether the Navy is performing effective oversight of the contracts for its Financial Improvement and Audit Readiness Program.
  8. Navy and Marine Corps Have Weak Procurement Processes for Cost-Reimbursement Contract Issuance and Management
    July 11, 2014 – Our objective was to determine whether the Navy and Marine Corps complied with interim Federal Acquisition Regulation (FAR) revisions on the use of cost-reimbursement contracts.
  9. Opportunities for Cost Savings and Efficiencies in the DoD Permanent Change of Station Program
    May 21, 2014 – The objective of the audit was to determine whether DoD could implement potential cost savings and efficiencies throughout the DoD Permanent Change of Station (PCS) Program.
  10. The Army Needs To Improve Property Accountability and Contractor Oversight at the Redistribution Property Assistance Team Yards in Afghanistan
    March 4, 2014 – We determined whether Redistribution Property Assistance Teams (RPATs) in Bagram and Kandahar, Afghanistan, have effective procedures in place to process equipment, to include preparation for shipment.
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