Veterans Affairs Archives

Gen. Peter Chiarelli, the Army's vice chief of staff, has acknowledged that 106,000 soldiers take psychotropic medications. But the Military Health System cannot track the use of those drugs, the Senate Armed Services Committee said in its report on the 2011 Defense Authorization Act released in June.

The final version of that 924-page bill, which Congress sent to President Obama for his signature yesterday, contains language requiring Defense to find a way to track the use of these medications when troops return from deployment.

The Pentagon evaluates the health of troops when they return from the field through Defense's Post-Deployment Health Reassessment (PDHRA) program, which was set up in 2005 and places an emphasis on mental health assessment.

Until now, the PDHRA did not take a look at psychotropic drugs prescribed to troops during their deployment. The 2011 Defense bill (page 269 of the PDF, if you're looking for the language) mandates that Defense include an assessment of prescribed head drugs in the PDHRA, seemingly a simple exercise for one of the most computerized outfits on the planet.

The Pentagon has a habit of ignoring congressional mandates, something I hope does not happen in this instance, because as Chiarelli said, there is a relationship between overuse of head drugs and the epidemic of soldier suicides.

I can't do this job without the help of a lot of people, and this is the time of the year to thank them -- and they deserve it, because sometimes I can get cranky.

So, kudos to the following folks who exhibit true grace when dealing with me:

• Katie Roberts, Veterans Affairs Department press secretary
• Roger Baker, VA CIO
• Art Wu, Republican Deputy Staff Director, Oversight and Investigations Subcommittee, House VA Committee
• Laura Williams, public affairs officer, Defense Information Systems Agency
• Air Force Lt. Col. April Cunningham, Pentagon press desk
• Lt. Col. Lee Packnett and Lt. Col. Steve Warren, Army Pentagon media relations
• Paul Mehney and Dave Hampton, Army public affairs officers who help me my trips to Ft. Bliss/White Sands Missile Range
• Lt. Myers Vasquez, Navy public affairs, Pentagon
• Warren Suss, Suss Consulting
• John Garing, DISA/Suss Consulting
• Bernie Skoch, Consultant and fellow radio geek
• Army Brig. Gen. Loree Sutton, former director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, and Dr. Greg Reger, Army psychologist with the National Center for Telehealth and Technology, for their insights into PTS/TBI at the Government Executive Leadership Breakfast in April

Tomorrow is Veterans Day. Here are my reflections, and suggestions on how to mark the occasion.

Silence

Veterans Day used to be called Remembrance Day, which harks back to the World War I armistice, which occurred on the 11th hour of the 11th day of the 11th month.

For years it has been marked by silence. Let's try to continue this tradition in an overly plugged-in world.

Put down the Blackberry, pull out the earbuds, turn off the iPad, embrace the hush, and reflect.

Poetry

If you live in the Washington area, drop in at the semi-annual gathering of The Memorial Day Writers' Project, organized by a bunch of my veteran friends, including fellow Marine Mike McDonell.

These are veterans who dare to declaim and you can find them in a tent behind the sidewalk facing Constitution Avenue near 21st Street in Washington. The offerings range from the profane to the profound, and I guarantee a laugh, and possibly a tear or too.

Read

Check out The War I Always Wanted: The Illusion of Glory and the Reality of War, by Brandon Friedman, an Iraq 101st Airborne veteran and director of new media at the Veterans Affairs Department.

The reviews say Friedman nails combat, along with the absurdity that goes along with any endeavor managed by the Pentagon.

Visit

Walk the lines of tombstones at Arlington, become embraced by the walls of the Vietnam Memorial, and be one of the few people to visit the District of Columbia War Memorial, the closest thing in the Capital City to a World War One Memorial, in West Potomac Park, just off Independence Ave.

Wear

A flower poppy sold by VFW members to commemorate the poppies that Canadian poet John McRae used to evoke the fallen in his World War I poem, "In Flanders Fields":

In Flanders Fields the poppies blow,
Between the crosses, row on row,
That mark our place; and in the sky,
The larks, still bravely singing, fly,
Scarce heard amid the guns below.
We are the dead.
Short days ago,
We lived, felt dawn, saw sunset glow,
Loved and were loved and now we lie,
In Flanders Fields.
Take up our quarrel with the foe:
To you, from failing hands, we throw,
The torch, be yours to hold it high.
If ye break faith with us, who die,
We shall not sleep, though poppies grow
In Flanders fields.

Honor

Compose your own honor roll and send it here for posting.

Here's mine:

• My comrades from 2nd Battalion, 9th Marines and 3rd Battalion, 3rd Marines, Vietnam, 1965/1966 including Herbierto Gonzalez, Mike Metzger, Bill Schwartz, J.T. King, Larry Leal, Tom Wilmot and Mile Gullingsruud.
• Abigail Friedman: I have known and loved Abigail, a State Department Foreign Service officer who finished an Afghanistan tour this June working with provincial reconstruction teams, and her husband Eric Passaglia, for more than two decades and salute them both for their service. Abigail now serves as director for Afghanistan at the National Security Council.


• Lewis B. Puller Jr., friend and fellow Marine who touched me with his grace.


• Marine Maj. Cornelius Ram, the best company commander any Marine could ever have.


• Leon Daniel, Marine Korean War veteran and UPI bureau chief in Saigon on the last day of the Vietnam War. A friend, mentor and source of inspiration.

I don't know about the rest of you, but I either start or end my day by having some real fun scrolling through planned federal procurements on the Federal Business Opportunities website.

But, sometimes I miss a day. That included Oct. 22, when the Veterans Affairs Department put out an RFP to buy 600,000 PCs, a solicitation that was amended yesterday, and caught my attention.

This is twice the number of PCs VA ordered under its last big computer contract, a $248.4 million lease deal awarded to Dell in 2007 that expired in August. Based on that pricing, the new contract could be worth $500 million.

The VA said it needs more hardware today than three years ago due to the increase in the number of health clinics it operates and the overall requirement for more PCs to support its mission. The contract will run for eight years, with hardware orders in the first four years and support only in the last four.

The VA said in its performance work statement that it reserves the option to either purchase or lease the 600,000 PCs, but I bet that it will not be the same kind of single-source contract like the deal with Dell.

The VA inspector general said in a June 2008 report that an award "to a single vendor for leased PCs and related services was not necessary to achieve the stated objectives of the acquisition."

The fact that the VA has decided to go ahead with such a massive PC buy takes care of the question of whether or not it had a serious plan to move to thin client architecture. The agency has a planned test of 20,000 thin clients later this year.

It's hard to give up that heavy iron.

Ahh, an acknowledgement from inside the Military Health System that the AHLTA electronic health record system has so many problems it needs junking.

Lt. Col. Dan Davis, chief of EHR clinical requirements at MHS, not only called the military EHR antiquated and incomplete, but also said it lacks the reliability, usability and functionality to adequately to manage care of military personnel and their families, according to the slide set of a talk he gave in July that a reader sent my way.

MHS has all kinds of tiger teams working on a new EHR, and based on Davis's slides, it looks like a decision on a new system may happen by this December.

And oh yeah, of course it will play well with the VA EHR system -- but how often have we heard that?

I have picked up very strong signals that the Veterans Affairs Department has dropped plans to issue a second contract to develop a system to process claims for veterans suffering from diseases related to the Vietnam-era chemical Agent Orange.

IBM won the original claims processing system contract in July, and evidently did such a poor job that VA Secretary Eric Shinseki personally called IBM chairman Samuel Palmisano to express his dissatisfaction with the lack of progress.

The solicitation for the second contract, I'm told, was an added tool to get IBM's attention, vendors told me, more of a club than a real plan to go ahead with another deal. The VA quietly informed interested bidders it did not plan to issue a second contract over the past week.

So what's the status of the IBM system, which was supposed to go into operation earlier this month? I keep asking the VA that question, and so far have not received a reply.

If anyone out there in VA land has concrete info on the status of the IBM system please send me an e-mail.

Last week the Veterans Affairs Department announced it had granted a six-month extension on the IT contract for its Financial Services Center in Austin, Texas. The reason? The contract expired at the end of September, and without the extension, the VA could not pay the bills for its medical centers.

The VA said it had an "urgent and compelling need" to award $2.6 million to incumbent contractor RDI Systems/KGS Inc. of San Antonio for continued IT support at the Austin Center, as it had not finished the work on a new five-year contract for the center with the General Services Administration.

If this is so urgent and compelling, why wasn't someone compelled enough to get a new contract in place before the old one expired?

Veterans Affairs Secretary Eric Shinseki personally called the chairman and chief IBM, Samuel Palmisano, this summer to express his dissatisfaction with the company's progress on development of a computer system to process veterans' claims for ailments associated with Agent Orange, VA Chief Information Officer Roger Baker told the Senate VA Committee on Wednesday.

Baker alluded to a post I wrote in September on Shinseki's pique with IBM.

Contractors often run late on government information technology contracts, and IBM did not "understand it was not business as usual" when it came to the small-($9.1 million)-but-important-Agent-Orange project, Baker said in response to a question from the committee's ranking member, Sen. Richard Burr, R-N.C.

IBM got the message it needed to meet its 90-day delivery schedule for the system after Shinseki called Palmisano, he told Burr. "Its not every day a Cabinet secretary calls a CEO," Baker said.

He also said he expects IBM to meet the delivery schedule, but may need a backup if IBM misses it. VA issued a proposal for a second contractor in September, although the department has not issued an award.

VA expects to be hit with 240,000 claims from Vietnam veterans exposed to the Agent Orange defoliant and Burr said the VA definitely needs the Agent Orange system as it faces "an implosion of the claims process".

Now, if only IBM and VA would answer my multiple, more-than-month-old queries on what problems they have encountered with the Agent Orange claims system, what it's supposed to do, and when it will go into operation.

In July, the Veterans Affairs Department awarded IBM a $9.1 million contract to develop within three months a system to process claims for Vietnam veterans suffering from diseases stemming from exposure to the Agent Orange defoliant sprayed in that country by the Air Force. (The service's units had the motto: "Only you can prevent forests.")

VA presumes all 2.6 million veterans who served in Vietnam had exposure to Agent Orange. If veterans have one of 15 diseases -- including hairy cell leukemia, Parkinson's and ischemic heart disease, which were added
to the list on Aug. 31 -- they don't have to prove they were in an area where the defoliant was sprayed and their diseases resulted from military service.

The new approach to Agent Orange will add 240,000 claims to its case load, which is why it tapped IBM to build a separate system to process machine readable claims that veterans submit electronically.

VA Secretary Eric Shinseki hailed the approach as "a new way of doing business and a major step forward in how we process the presumptive claims we expect to receive over the next two years."

But after spending a month chasing rumors and tips, I'm told IBM quickly ran into problems trying to build, by the end of this year, a system that would process 30,000 claims.

I have confirmed with multiple sources that an angry Shinseki last month personally called top IBM management to express his dissatisfaction with the lack of progress on the system. I'm also told VA officials followed up Shinseki's call with a formal letter to IBM telling it to get its act together.

This probably explains why early this month VA issued a notice that it would like to find a second contractor to develop an Agent Orange claims processing system, with the ability to start within 15 days of award.

IBM officials did not respond to multiple calls placed during the past month about the status of the Agent Orange claims processing system. VA spokeswoman Katie Roberts declined to comment on whether or not a piqued Shinseki called IBM.

The Senate Appropriations Committee added $13.4 billion to the fiscal 2010 Supplemental Appropriations Bill this to foot the bill for the Agent Orange claims.

But Sen. Jim Webb, D-Va., a Marine Vietnam veteran, doubts everyone who served in Vietnam was exposed to Agent Orange, and he wants Shinseki to explain his case at a hearing of the Senate VA committee scheduled for 9:30 a.m. EDT on Thursday.

The Congressional Review Act gives Congress 60 days to review regulations before they go into effect, which means Congress could derail the new Agent Orange rules between now and the end of October.

(Full disclosure: I served in the Marine Corps in Vietnam in 1965 and 1966, and have been in the VA Agent Orange Registry since the mid-1970s.)

I have picked up strong signals that the Veterans Affairs Department has hit another speed bump with its 9/11 GI bill claims processing system.

Although VA rolled out the major portion of a new and improved claims processing system last month just in time to handle the fall semester, I hear another piece to handle automatic input of enrollment data from colleges may not be ready for prime time for another three months.

Keith Wilson, did not put a specific date on the delivery of this piece at a press briefing last month, but said it would go into operation this fall, which starts Sept. 22. I'd say VA will miss the deadline.

I have a query into VA, but have not heard back. That's OK. All will probably be revealed Sept. 16 when the House VA Committee holds a hearing to get an update on the status of the 9/11 GI bill.