Testimonies Before the GAO

VA Health Care: Challenges in Budget Formulation and Execution, by Randall B. Williamson, director, health care, before the Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, House Committee on Appropriations. 03/14/09. VA faces challenges formulating its health care budget each fiscal year. As noted in GAO’s 2006 report on VA’s overall health care budget, these include making realistic assumptions about the budgetary impact of policy changes, making accurate calculations, and obtaining sufficient data for useful budget projections. GAO

Information Technology: Challenges Remain for VA's Sharing of Electronic Health Records with DOD, by Valerie C. Melvin, director, information management and human capital issues, before the Subcommittee on Military Construction, Veterans Affairs, and Related Agencies, House Committee on Appropriations. 03/14/09. To share and use health data has required, among other things, that VA and DOD agree on standards. At the same time, they are participating in federal standards-related initiatives, which is important both because of the experience that the departments bring to the national effort, and also because their involvement helps ensure that their adopted standards are compliant with federal standards. However, these federal standards are still emerging, which could complicate the departments’ efforts to maintain compliance. GAO

Stigma of Mental Health Treatment

Military Uses Education to Reduce Stigma Associated With Mental Health Treatment 03/14/09. Stigma is a six-letter word with enormous consequences, a senior health official said. "Stigma kills," said Army Brig. Gen. (Dr.) Loree K. Sutton, special assistant to the assistant secretary of defense for health affairs for psychological health and traumatic brain injury, borrowing a catchphrase she learned from colleagues in the Canadian armed forces. DefenseLink

Shineski Writes to Vets

An Open Letter to Veterans From Secretary of Veterans Affairs Eric K. Shinseki 03/14/09. The link is to a letter from the Secretary of Veterans Affairs Eric K Shinseki. VA

DoD on TBI Myths

Military Looks to Dispel Myths, Advance Treatment for Brain Injuries 03/12/09. ...contrary to popular misconceptions, these physical injuries will heal, said Army Brig. Gen. (Dr.) Loree K. Sutton, special assistant to the assistant secretary of defense for health affairs for psychological health and traumatic brain injury. “One of the myths out there is that mild traumatic brain injuries, or concussions, means that somehow your brain is broken forever. No, it's an injury,” said Sutton, who also is director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. Military Health System

VAOIG Audit of Claim Rating Accuracy

Audit of Veterans Benefits Administration Compensation Rating Accuracy and Consistency Reviews 03/12/09. The Office of Inspector General (OIG) conducted an audit to evaluate selected aspects of the Veterans Benefits Administration’s (VBA) quality assurance program. The objectives for this audit were to determine whether: (1) the Systematic Technical Accuracy Review (STAR) process effectively identified and reported errors in compensation rating decisions and (2) VBA’s rating consistency reviews ensured that rating claims for similar conditions received the same evaluations and benefits, regardless of which VA regional office’s staff completed the rating decision. VAOIG

VAOIG Review of Nashville VA

Combined Assessment Program Review of the Tennessee Valley Healthcare System Nashville, Tennessee 03/12/09. The purpose of this review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we also provided fraud and integrity awareness briefings to 158 employees. This review focused on eight operational activities. The system complied with selected standards in the following five activities: (1) coordination of care, (2) environment of care, (3) pharmacy operations, (4) staffing, and (5) survey of healthcare experiences of patients. We made recommendations for improvements in the following three activities: QM. Emergency/urgent care operations. Medication management. VAOIG

DoD, VA Shared Medical Records

Defense, VA to launch shared e-record system to handle medical benefits 03/12/09. The Veterans Affairs and Defense departments have started work on a uniform registration system that will enroll all service members in the VA upon entry into the military, VA Secretary Eric Shinseki said at a House Veterans Affairs Committee hearing this week. Nextgov

Fear

Can Fearful Memories be Erased? Audio from Talk of the Nation, March 13, 2009 Scientists studying how the brain forms memories have found that by targeting brain cells expressing a certain gene in mice, they can erase a fearful memory association days after the event. Steven Kushner and colleagues describe the research in the journal Science. NPR

The genetics of fear: Study suggests specific genetic variations contribute to anxiety disorders 03/11/09. A new study suggests that individuals with specific polymorphisms may be more susceptible to anxiety disorders by being more prone to developing fear and being less likely to overcome that fear by common cognitive behavioral treatments which are based on the extinction principle. Association for Psychological Science via Eurekalert!

An end to fear 03/11/09. A team of Dutch researchers under the leadership of Vici-winner Merel Kindt has successfully reduced the fear response. They weakened fear memories in human volunteers by administering the beta-blocker propranolol. Interestingly, the fear response does not return over the course of time. Top journal Nature Neuroscience published the findings on February 15, 2009. Netherlands Organization for Scientific Research via Eurekalert!

Increase in Marine Suicides

Corps Sees Dramatic Spike in Suicides 03/11/09. While the Army fights a high-profile battle against suicides, the Marine Corps is quietly upping its effort to combat the malaise following the worst year for suicides in more than a decade. Forty-one Marines committed suicide in 2008, while another 146 tried but failed. Military.com

Veterans Groups Oppose 2010 Budget Proposal

Veterans Groups Protest Proposed Change in Coverage for Injuries, Conditions Related to Military Service 03/10/09. Several veterans groups "are lashing out" at the Obama administration over a policy proposal they say would "dramatically alter" how the Department of Veterans Affairs handles health insurance claims for veterans, The Hill reports. Under the policy, which is included in President Obama's fiscal year 2010 budget proposal, VA would bill health insurers for treatment of injuries and conditions sustained as a result of veterans' military service. Currently, VA covers those costs and bills health insurers only for treatment for conditions unrelated to veterans' military service. KaiserNetwork.org

Veterans Health Care Budget Reform and Transparency Act

Disabled Veterans Leader Presses Issues with Key Lawmakers 03/09/09. The National Commander of the Disabled American Veterans begins a series of meetings with key lawmakers seeking their support for budget reform legislation to ensure sufficient, timely and predictable funding for veterans' health care. He also is urging them to reject a contentious proposal that would shift the cost of treating veterans for service-connected conditions from the government's side of the ledger to insurance companies. PR Newswire

Timing of Mental Disorders Post-Deployment

Relationships between the nature and timing of mental disorders before and after deploying to Iraq/Afghanistan, active component, U.S. Armed Forces, 2002-2008 03/09/09. Th is report describes the natures and frequencies of mental disorder-related medical encounters of active
component U.S. service members before and after their fi rst deployment to Afghanistan or Iraq. In addition, the report assesses relationships between natures and timing of predeployment and postdeployment mental disorder-related medical encounters. Th e findings may inform policies and practices regarding predeployment medical assessments of future deploying service members. AFHSC

An Unorthodox PTSD Treatment (Not To Be Tried At Home)

Ecstasy could help patients with post-traumatic stress disorder 03/09/09. Ecstasy may help suffers of post-traumatic stress learn to deal with their memories more effectively by encouraging a feeling of safety, according to an article in the Journal of Psychopharmacology published today by SAGE. They suggest three possible biological reasons why ecstasy could help individuals with PSTD. SAGE Publications UK via Eurekalert!