Author: Nancy Meredith
Special Counsel Blasts VA Over Whistleblower Treatment
Many of the recent stories about Department of Veteran Affairs mistreatment of veterans have come to light thanks to whistleblowers who revealed VA practices such as the scandal over dangerous delays in patient care. In response to the scandal, legislation was passed that made it easier to fire underperforming VA administrators. But in a letter (https://archive.azcentral.com/persistent/icimages/politics/0918-letter-to-obama.pdf) to President Obama from the U.S. Office on Special Counsel (OSC), OSC points out instances of the VA punishing whistleblowers while failing to discipline VA leadership.
The September 17th OSC letter begins by describing the treatment of Dr. Katherine Mitchell, a VA doctor in Phoenix who revealed that none of the emergency department (ED) nurses at the Carl T. Hayden VA Medical Center had received nationally-recognized, comprehensive triage training and that only 11 of 31 ED nurses had received any triage training whatsoever. Mitchell tied this lack of training to more than 100 specific instances where improper nurse training led to “dangerous delays in care”—an assertion substantiated by the VA’s Office of the Medical Inspector, which found that lapses in ED triage “constitute a significant risk to public health and safety.”
Mitchell, though, rather than being supported by senior VA staff, was “investigated, transferred, and harassed,” reports AZCentral (https://www.azcentral.com/story/news/arizona/investigations/2015/09/17/va-failure-protect-whistleblowers-draws-strong-rebuke-special-counsel/72362888/), while staff leaders went undisciplined.
“I am concerned by the VA’s decision to take no disciplinary action against responsible officials,” writes the OSC. “The lack of accountability for Haden VAMC leaders sends the wrong message to the veterans served by this facility.”
Such lack of action, asserts the OSC, may discourage whistleblowers from coming forward in the future. It also, says OSC, stands in stark contrast to the treatment of VA whistleblowers who “The VA has attempted to fire or suspend for minor indiscretions,” a trend that, “chills other employees from stepping forward to report concerns.”
OSC goes on to describe in its letter to the President other instances of VA misconduct that resulted in no significant leadership discipline, including:
- Falsification of veteran counseling session records by the manager of a VA clinic in Washington State
- Improper monitoring of an OMI investigation of patient care problems by a manager at a West Virginia VAMC
- Inaccurate recording of patient information by a Montgomery, Alabama VA physician
OSC compares these cases with several instances of whistleblowers being fired for minor infractions that include eating expired sandwiches.
The VA Access, Choice, and Accountability Act of 2014—passed in response to the scandal that broke last summer over the patient wait-time crisis at more than 100 VA hospitals—made it easier for the VA to fire or demote senior VA employees. It was revealed this spring, however, that just one person was had been fired in connection with the scandal.
More recently, the Veterans Accountability Act of 2015, which supporters say gives greater protection to whistleblowers, passed the House and is currently being debated in the senate. The Act includes disciplinary provisions for mangers who retaliate against employees, according to an opinion piece published in The Hill (http://thehill.com/policy/energy-environment/235504-boxer-introduces-her-own-chemical-reform-legislation).
Maintenance Worker Blows Whistle on Asbestos Exposure
An earlier letter issued by OSC to the President details how a maintenance worker at a San Antonio VAMC blew the whistle on unsafe asbestos work that exposed him and others to the carcinogenic mineral fiber.
As the letter details, the San Antonio VAMC management “violated procedures governing the safe handling of asbestos-containing materials and failed to provide medical surveillance for employees exposed to asbestos, endangering their health in safety.” Management, for example, knowingly ordered employees to perform maintenance work on asbestos materials without providing appropriate precautions or safety equipment.
Radiographic examination of the whistleblower has revealed chest abnormalities consistent with exposure to asbestos, which can causemesothelioma and lung cancer.
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Mesothelioma Survivor Lou Williams Steps Up Her Drug Advocacy Efforts
Lou Williams wants to make the drug that has helped her survive mesothelioma affordable for her fellow Australians struggling with the asbestos cancer.
Lou lost her father to mesothelioma in 1985 and she has battled the disease herself for nearly 13 years. With the help of a new drug, Keytruda, Lou’s tumors have begun shrinking and she has a new lease on life.
“Keytruda has given me back my life, as my body was literally shutting down,” Lou told MesotheliomaHelp via email.
Expert Insight
“I am now once again living my life with quality, strength and determination.”
As her strength returns, so does her resolve to fight for other mesothelioma victims. She is now focused on making Keytruda available to Aussies at a reasonable cost.
On Sept. 3 Lou will have her eighth dose of Keytruda, an immunotherapy drug from Merck approved in the U.S. and Australia for melanoma, but not yet approved in either country for mesothelioma. For Australians, that means a mesothelioma patient must pay thousands of dollars per dose, administered every three weeks—a deal breaker for many.
Lou Working With Australia’s Pharmaceutical Benefits Scheme
Keytruda is being touted as one of the biggest breakthroughs in mesothelioma treatment. In the simplest of explanations, Keytruda enhances the body’s immune response to cancer, allowing natural defense mechanisms to kick in and fight mesothelioma tumors. A recent U.S. clinical trial found Keytruda to be effective in controlling mesothelioma tumors in three-fourths of patients, leading researchers to say the results are “encouraging.”
After having exhausted all of her treatment options earlier this year and being at death’s door, Lou has, with regular Keytruda doses, rebounded beyond what she and others thought was possible. She said in an August 20 Examiner article that her palliative care nurse, husband and oncologist all say her recovery has been “miraculous.”
It has also been expensive. Lou acknowledged in a recent blog post that having quality of life back is priceless, but “Our credit card is taking a battering.”
To make Keytruda more accessible for other mesothelioma sufferers, Lou’s goal is to get the drug added to the Pharmaceutical Benefits Scheme (PBS). This would allow Australian oncologists to offer the treatment to mesothelioma patients free of charge or for a negligible amount.
The PBS is a government run service available to all Australian residents who hold a current Medicare card. Through the PBS, the Australian government subsidizes the cost of medicine for most medical conditions.
“We need to have Keytruda in the PBS list alongside melanoma so others diagnosed with mesothelioma can have another treatment option to discuss with their oncologist,” Lou said.
Lou and her husband met with their local Federal Member of Parliament in late July to get the PBS to accept Keytruda on the mesothelioma treatment list. She reported in her August 4 post that her local Member Parliament’s office told her that they have made initial contact with the drug company and are anticipating discussions later this month, a development Lou described as “very promising”.
Lou is passionate about seeing asbestos banned globally. Her work with the Asbestos Diseases Foundation of Australia, Asbestos Disease Awareness Organization of the U.S., and countless other organizations, as well as her non-stop media tour to get the word out about the dangers of asbestos, has impacted people worldwide.
But for Lou, it still is not enough.
“It would mean the world to me knowing that those diagnosed with mesothelioma can have freedom and peace of mind choice without the worry of cost to consider,” said Lou.
Follow Lou’s mesothelioma and advocacy battle on her blog at “Asbestos – Living with Mesothelioma in Australia – Louise (Lou) Williams.”
You can contact Lou at [email protected].
Photo Credit: The Examiner
Sources:
- Pharmaceutical Benefits Scheme
http://www.pbs.gov.au/info/about-the-pbs#What_are_the_current_patient_fees_and_charges
Study Shows That Asbestos Risks Remain Decades After Industry Departs
An Italian study published back in May found that malignant mesothelioma cases tend to be concentrated around industrial facilities that use asbestos. A new Italian study finds that mesothelioma incidence near industrial areas remains high long after an asbestos-using industry ceases operations.
Asbestos is the only known cause of mesothelioma, an incurable cancer affecting the membranous lining of the lungs and abdomen. Most cases of mesothelioma are related to occupational asbestos exposure. Cement factories, shipyards, automotive plants, food processing facilities, power plants, and steel plants are among the major sources of occupational asbestos exposure.
Not all asbestos exposure, however, is directly attributable to a person’s work activities. People can also be environmentally exposed to asbestos in areas where asbestos industries operate.
One such area is Casale Monferrato in Northwest Italy, the former home of the Eternit asbestos-cement plant, which closed in 1986. An Italian court in 2012 convicted the plant’s owners of causing the asbestos-related deaths of more than 3,000 people. While many of those people worked at the Eternit plant, others merely lived near the plant.
Casale Montferro is the subject of a study published recently in Occupational & Environmental Medicine. The study authors identified 200 cases of pleural mesothelioma diagnosed in Casale Montferro residents between 2001 and 2006 in an effort to quantify the association between pleural mesothelioma and asbestos exposure.
They discovered that the odds ratio (OR, a measure of association between an exposure and an outcome) of an asbestos-exposed individual developing mesothelioma ranged from 4.4 to 62.1, with increased exposure over time resulting in a higher OR. Subjects never occupationally exposed to asbestos had a mesothelioma OR of 3.8 to 23.3, while an OR of around 2 was observed for people living in homes near buildings with large asbestos cement parts.
The findings draw attention to the fact that asbestos health risks linger in the environment long after asbestos industries vacate. In addition, they serve as a reminder that asbestos disease can occur in people who never directly handled asbestos on the job.
“Risk of [pleural malignant mesothelioma] increased with cumulative asbestos exposure and also in analyses limited to subjects non-occupationally exposed. Our results also provide indication of risk associated with common sources of environmental exposure and are highly relevant for the evaluation of residual risk after the cessation of asbestos industrial use,” write the study authors.
The Italian study has implications for America and other countries with a history of industrial asbestos use. U.S. asbestos use peaked in the mid-70s, but asbestos diseases, which have a latency period of 10-40 years or more, continue to kill an estimated 12,000-15,000 Americans.
But the United States, unlike Italy, has not banned asbestos. While both countries deal with the residual presence of asbestos-containing materials from a bygone industrial era, the United States is unique among industrialized nation for its ongoing importation and use of asbestos.
Anyone interested in taking part in the fight against asbestos should visit the EWG Action Fund website.
House Votes to Cut VA Workplace Protections Amidst Budget Shortfall
The House voted this week to make it easier to fire ineffective Department of Veterans Affairs (VA) employees, a measure that White House officials threatened to veto. Meanwhile, a plan to reallocate funds from the Veterans Choice program to fund a VA budget gap moved closer to fruition with an amendment tucked inside a highway spending bill.
It’s been a tough year for the Department of Veteran Affairs. Congress passed a $16.3 billion reform law last summer to shore up a scandal over long patient wait times and a VA cover-up of them, but problems persist. A June report indicated that, compared to a year ago, wait times for appointments longer than 30 days are up 50 percent. The department has fired practically no one despite receiving Congressional authority to more easily let go underperforming VA workers. And just weeks before the fiscal year ends, the VA announced that they have a $2.6 billion budget shortfall.
VA Secretary McDonald says that the shortfall is the result of increased demand for VA services, including expensive hepatitis C treatments. To close the gap, he wants to move funds from the Veterans Choice program, which provides funding for vets to see a private doctor if they cannot secure a VA appointment within 30 days or live more than 40 miles from a VA facility. The VA claims that hospital closures could occur if the funding gap is not closed.
House Veterans Affairs committee chair Jeff Miller reluctantly agrees with McDonald’s plan and sponsored an amendment to divert $3.35 billion from the Choice Program, according to ABC News. But as he explained, some veterans could suffer as a result.
https://abcnews.go.com/Politics/wireStory/emergency-bill-fund-veterans-affairs-department-32742493
“This is going to negatively impact the longevity of the Choice Program that we worked so hard last year to pass and have the president sign into law, that gives the veterans the opportunity to choose where they get their health care and when they get their healthcare,” said Miller.
The Choice Program is slated to run through august 2017 or until its $10 billion is used up.
The same legislation that created the Choice Program also made it easier to fire senior VA executives linked to scandals or found to be underperforming. Only a handful of administrators, however, have been fired. Around 190 lower-level workers associated with the scandal of last summer have faced disciplinary action, but only a few have been fired.
Critics, according to the Military Times, allege that the department is disinclined to fire workers due to complex federal labor rules. In response, House Republicans passed rules this week that shorten fired or demoted workers’ appeals process and limit paid worker suspensions.
https://www.militarytimes.com/story/military/capitol-hill/2015/07/29/house-new-va-reforms/30845137/
Rep. Jeff Miller, who sponsored the VA Accountability Act of 2015, said that, “Bad employees mean bad customer service. If we truly want our veterans to have the very best care and services, status quo is no longer acceptable.”
Rep. Donna Miller (D-MD) called the bill an attempt at “union busting,” while White House officials publicly threatened a veto, saying that the bill could “have a significant impact on VA’s ability to retain and recruit qualified professionals and may result in a loss of qualified and capable staff to other government agencies or the private sector.”
Senate Republicans are expected to take up the measure after their August recess.
Veterans suffering from asbestos disease who have questions about VA compensation or legal questions related to their illness should contact Belluck & Fox, LLP for a free consultation.
Vets can also use our veterans benefits tool to find out whether they qualify for VA financial assistance.
VA Secretary Wants to Use Choice Program Funds for Budget Shortfall
The Department of Veterans Affairs is facing a $2.6 billion financial shortfall that it says is caused by increased veteran demand for healthcare. Deputy VA Secretary Sloan Gibson plans to ask Congress for permission to use money from the Veterans Choice program to cover the funding gap, a measure that could hurt veterans with mesothelioma who seek treatment at a non-VA care facility.
The Veterans Choice program is the centerpiece of a $16.3 billion VA reform law approved by Congress last year in response to a VA scandal over long patient wait times and falsified records. Of the $16.3 billion, $10 billion was put into a fund that allows veterans who are unable to secure an appointment at a VA medical facility within 30 days or who live more than 40 miles from the nearest VA facility to seek care at a private hospital.
More recently Congress amended the legislation to define the 40-mile rule as actual driving distance, not “as the crow flies” distance. And the House is currently considering another amendment to the Choice program that would allow veterans living within 40 miles of a VA facility to seek care at a private facility if their local VA hospital does not offer the specific services they require, such as mental health or cancer treatment services. This would be very beneficial to veterans with mesothelioma who are only able to receive the specialized care they need at a handful of VA mesothelioma centers as well as those unable to get an appointment with a VA oncologist within 30 days.
Secretary Gibson, according to The Columbus Dispatch, says that the program got off to a rocky start, but has expanded significantly in recent months and is likely to expand even more. The ability of the program to meet the health needs of veterans with private care, however, whether they live in rural areas or simply cannot secure a timely appointment, would be hampered by the appropriation of $2.6 billion to other VA health care costs.
That’s more than one-quarter of the entire budget of the Choice program, which runs through August 2017 or until the $10 billion is used up. Using up $2.6 billion of that budget to adjust for what some are calling yet another example of VA mismanagement doesn’t add up for veterans helped by the Choice program.
While Gibson attributes the budget shortfall to increased demand at VA medical facilities—which he says has increased by 7 million appointments in the past year—others have been more critical of the VA.
“The VA’s problem isn’t funding—it’s outright failure,” said House Speaker John Boehner at a news conference. “Absolute failure to take care of our veterans.”
Wait times longer than 30 days for VA appointments have gone up by 50 percent in the last year, a clear sign that, whether due to bureaucratic missteps or more veterans seeking care, the Choice program is needed now more than ever.
Rep. Jeff Miller, chairman of the Veterans Affairs Committee, says that he is prepared to give the VA Choice program funds to pay for daily health care expenses, according to Stars and Stripes, but in return will demand changes to the way the VA manages its finances.
Veterans who need help paying for mesothelioma medical services at a non-VA facility are encouraged to contact Belluck & Fox for a free case review. A lawsuit against the companies responsible for your asbestos exposure could provide funds for medical care, lost wages and other expenses related to your illness.
Veterans may also be available for monthly compensation from the VA. Use our VA Benefit Tool to find out whether you qualify.
Sources
- The Columbus Dispatch
https://www.dispatch.com/content/stories/national_world/2015/06/25/0625-va-budget-shortfall.html - Stars and Stripes
https://www.stripes.com/news/veterans/house-panel-supports-closing-va-s-2-6-billion-funding-gap-1.354590
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