Second in Command the Last Doughboy Homeless Veterans: Lives Transformed Veteran-Directed Care Features

March/April 2011

Second in Command The Last Doughboy Homeless Veterans: Lives Transformed Veteran-Directed Care Features

Frank Woodruff Buckles: The Last Doughboy 6 Saying goodbye to the final American link to the Great War Meeting the Needs of Moms-to-Be 8 VA is stepping up efforts to support veterans who are expecting 6 Battlefield Deception 10 Al Albrecht served in a daring and secretive unit during World War II Are We Ready? 12 A three-year study evaluated the preparedness of VA medical facilities Celebrate National Library Week 14 VA’s medical libraries provide information and tools to improve care Lives Transformed 16 Some employees have experienced homelessness firsthand Second in Command 20 8 Getting to know Deputy Secretary W. Scott Gould More Choices, More Control 22 A new partnership is helping disabled veterans live independently Never Too Late 25 Navy veteran Prentice Willis enrolls for VA health care at age 100

Departments

3 Outlook 33 Have You Heard 10 4 News You Can Use 36 Honors 26 Around Headquarters 39 Heroes 30 Introducing 40 National Salute 31 Medical Advances VAnguard VA’s Employee Magazine March/April 2011 Vol. LVII, No. 2

Editor: Lisa Gaegler On the cover Assistant Editor/Senior Writer: Gary Hicks The Honorable W. Scott Gould is a Photo Editor: Robert Turtil 26-year Navy veteran who has served Staff Writer: Amanda Hester in senior leadership positions both in government and the private sector. He’s Published by the Office of Public Affairs (80D) been VA’s Deputy Secretary—chief operating officer of the federal government’s second- U.S. Department of Veterans Affairs largest department—for the past two years. 810 Vermont Ave., N.W. And he draws on his many professional and Washington, D.C. 20420 personal experiences to help lead the (202) 461-7427 21st-century VA. photo by Robert Turtil E-mail: [email protected] www.va.gov/opa/publications/vanguard.asp

2 VAnguard • March/April 2011 FEEDBACKOUTLOOK There’s More to NCA Than Meets the Eye Steve L. Muro Acting Under Secretary for Memorial Affairs

What comes to mind when delivery of more than 800,000 Formerly known as the That’s why, even on days you hear the words “national engraved Presidential Memori- State Cemetery Grants Service, when few burials are scheduled cemetery”? For most people, al Certificates, recognizing the this NCA division was recently at a given cemetery, you will the answer is a respectful me- service of deceased veterans. renamed to reflect broaden- still see lots of activity: crews morial service, perfect rows of We also administer a ing engagement with federally mowing the grounds, remov- headstones and a flag waving Nationwide Gravesite Loca- recognized tribal governments. ing faded floral displays, and in the distance. tor; this Web-based database This year and for the first time realigning headstones. Our Now: What pops into (gravelocator.cem.va.gov) assists ever, we anticipate awarding goal is for every visitor to de- your head when you read loved ones, friends, military grants for the establishment of part feeling that the grounds, “national cemetery administra- pals and researchers in pin- veterans cemeteries on tribal the gravesites and the environs tion”? For many, the mental pointing burial locations of government lands. We are ex- of the national cemetery make image is the same. That’s not veterans and their family cited about this opportunity to a tribute worthy of veterans’ wrong; it’s just that here in members in state, national, reach and serve even more of service and sacrifice. 2011, there’s more to NCA and even some private cem- our veterans. We use only native trees than meets the eye. eteries. The database can also NCA has been recognized and shrubs in our landscaping, Nearly 150 years after be accessed through kiosks in repeatedly for delivering out- so the cemeteries offer seasonal Congress authorized purchase cemeteries we manage. standing customer service. In beauty to humans and impor- of the first national cemetery So, while nearly 140,000 January, the Federal Consult- tant habitats for wildlife too, grounds, our core mission— burials are conducted in NCA- ing Group presented us with a including some threatened and like that of the caretakers who preceded us—is providing dig- nified burials for our country’s We continue to expand the quantity and range of veterans. But the scope of our benefits available to veterans, while ensuring our national work today extends far beyond cemeteries convey the magnitude of their service and the walls of our traditional properties, as we honor and sacrifice. memorialize veterans in ever- expanding ways. and state-operated cemeter- special award for attaining the endangered species. For example, fully ies each year, an even larger highest scores ever recorded on We are also caretakers of two-thirds of the more than number of veterans and their the American Customer Satis- the nation’s history. Dozens 350,000 headstones and families make use of other faction Index, four consecutive of the cemeteries, soldiers’ lots markers we provide each year benefits and services we offer, times over the past 10 years. and monuments we manage grace veterans’ graves in state like the locator, medallions In part, the scores reflect are listed on the National Reg- and private cemeteries. These and certificates. survey responses from loved ister of Historic Places. include a growing number And speaking of state ones of veterans buried in For these reasons and of niche covers to mark cemeteries, NCA provides as- national cemeteries during others, national cemeteries are columbaria used for cremated sistance through the Veterans the preceding 12 months. treasured by community mem- remains—an increasingly Cemetery Grants Program for However, our relationship bers, many of whom volunteer popular option. up to 100 percent of funds with a veteran’s family has at our facilities. In 2010, lo- We also now provide needed to establish, expand or only just begun at the time of cal volunteers donated nearly small bronze medallions that improve veterans cemeteries interment. Because the federal 350,000 hours of work. can be attached to a privately owned and operated by states. government’s promise to veter- Without a doubt, there is purchased headstone or mark- Since 1980, VA has awarded ans includes perpetual care of more to NCA than meets the er in private cemeteries to in- grants totaling more than gravesites, we are committed eye. We continue to expand dicate the gravesite belongs to $438 million to 79 cemeteries to maintaining national ceme- the quantity and range of ben- a veteran. Since the program’s in 38 states and two territories. teries as national shrines—and efits available to veterans, while inception in summer 2010, Another six state cemeteries to exceeding survivors’ expec- ensuring our national cemeter- more than 3,800 medallions are projected to open by spring tations every time they come ies convey the magnitude of have been delivered. 2012 in Arkansas, Louisiana, through the gates. their service and sacrifice. Last year, our Memorial Mississippi, Texas, Virginia Nationwide Gravesite Locator: gravelocator.cem.va.gov. Programs Service coordinated and West Virginia.

VAnguard • March/April 2011 3 NEWS YOU CAN USE

Atomic Veterans: Blasts from the Past Still Reverberate

Military personnel observe a VA Regional Office. nuclear test in Nevada in 1951. In addition to health care, VA maintains a health registry evaluation program to track the health of veterans exposed to ionizing radiation during military service. The Depart- ment offers the evaluation, known as the Ionizing Radia- tion Registry, free of charge to all eligible veterans. Veterans do not need to be enrolled in VA health care to be eligible. With the WWII veteran population shrinking by about 800 a day, board members feel an added sense of urgency to reach every remaining atomic veteran with information about dose reconstruction, the registry, the list of presumptive diseases and the improvements in the claims process. To that end, the board has encouraged and helped coordinate an aggressive cam- National Nuclear Security Administration paign to reach atomic veterans directly with letters and three World War II ended more radiation to which a veteran ed the Veterans’ Benefits Act, websites, as well as employing than 65 years ago follow- was exposed. which required DoD and VA social media tools such as Fa- ing the detonations of two The Department of to appoint an advisory board cebook, Twitter and YouTube. atomic bombs over Japan. The Defense, through its Defense to provide independent review Veterans concerned about “fallout” from those events Threat Reduction Agency and oversight of the dose re- honoring secrecy agreements continues to have long-term (DTRA), provides dose esti- construction and claims settle- they may have signed in con- impacts on numerous aspects mates for veterans who were ment programs for veterans. junction with their participa- of our lives and a special group involved in these radiation-risk Named the Veterans’ Ad- tion should know that they of veterans. activities. Under its Nuclear visory Board on Dose Recon- have been relieved of that ob- They are often referred Test Personnel Review pro- struction (VBDR), the panel ligation relative to identifying to as “atomic veterans.” Some gram, DTRA has maintained conducts periodic, random their involvement for health were on the ground as prison- a database of participants in audits of dose reconstructions purposes. ers of war near the detonation U.S. atmospheric nuclear test and decisions on claims for Twenty-one different sites in Hiroshima and Na- activities since 1978. radiogenic diseases; helps com- cancers are now on the list of gasaki. Others participated in Because of concerns about municate to veterans, their “presumptive” illnesses eligible the above-ground nuclear tests the increased risk of cancer relatives and other interested for compensation. If you are conducted from 1945 to 1962 and other illnesses in veterans parties information about the an “atomic veteran,” or know in the Pacific Ocean and the who may have been exposed dose reconstruction program; someone who is, check out American Southwest. to radiation from nuclear and performs other oversight the information at the VBDR, Their exposure to ra- weapons, Congress has passed activities as needed. DTRA and VA websites: diation may be the cause several laws relating to the re- The board has had a www.vbdr.org; www.dtra.mil; of a number of cancers and construction of radiation doses positive impact by helping and www.publichealth.va.gov/ other adverse health effects received by veterans and the expedite the claims process for exposures/radiation. developed over the years. The compensation they would re- prostate and skin cancers and Check the board’s website key to getting treatment and ceive for negative health effects by recommending the cen- for updates from their public compensation from VA lies associated with such exposure. tralization of radiation-related meeting March 11 in Arling- in establishing the amount of In 2003, Congress enact- claims at the Jackson (Miss.) ton, Va.

4 VAnguard • March/April 2011 NEWS YOU OUTLOOKCAN USE

You’re a Keeper of VA’s History

Every VA employee is a guard- nation’s history and matters ian, or “keeper,” of VA’s his- to many people. Millions of tory! That message was spread military veterans—including last summer at the Office of our own employees’ ances- Public and Intergovernmental tors—have passed through Affairs’ national training con- our doors, either in person or ference held in Atlanta, where through correspondence, and a quiet campaign was launched they all form part of VA’s and to create awareness about sav- America’s story. ing VA’s history and heritage As the second-largest materials. Cabinet department in the Veterans Health Admin- U.S. government—which istration Historian Darlene is a leader in the modern Richardson and National world—we set an example for Cemetery Administration other countries, not just fellow Senior Historian Sara Leach Americans. offered sessions to public af- Other federal agencies, fairs officers on how to pre- state and local governments, serve VA’s history and handed the public, and even foreign out buttons that read: “I’m a countries, watch and follow KEEPER of VA’s History.” our lead, so we must follow all VA and its predecessor laws, not just the ones we like. agencies have provided benefits We are required by many of and assistance to American these laws to save and protect patriots since the Second Con- our historic buildings and re- tinental Congress—before we cords, but beyond the law, it is Every employee is a guardian of VA’s history. were legally a nation—so our simply the right thing to do. robert turtil history is a huge part of the How can others learn from us, and appreciate our or other types of records like hard work, if we destroy im- videos, brochures, organiza- portant resources? Never forget tional charts, and more. the significance and important VA preserves its history in mission of your own work and three major ways: that of our predecessors. n VA staff work with VA Many of our his- records officers and records toric buildings are national liaisons to ensure that the landmarks—one-of-a-kind Department’s vital and per- architectural treasures—that manent records are saved and are beautiful, inspiring rel- ultimately routed to National ics created by our ancestors. Archives for preservation. They help citizens and visitors n VA staff and former em- alike understand the Ameri- ployees route certain historic can ethos toward its military records, objects, memorabilia, veterans. When we allow these photographs and other materi- American treasures to crumble als to their administration’s through benign neglect, or historian. throw away historically valu- n VA staff work with VA’s Historic images able records, we send the Federal Preservation Office to like these, of the Milwaukee VA wrong message. ensure that our historic build- and of women VA employees and leaders ings, landscapes, monuments stuffing benefit have a responsibility to pre- and other objects are preserved checks, need to serve the agency’s history in all for future use and public en- be preserved. its forms, regardless of whether joyment. it’s a building, landscape, Do your part today and courtesy of darlene richardson document, report, blueprint, be a KEEPER of VA’s history!

VAnguard • March/April 2011 5 david dejonge Frank Woodruff Buckles The Last Doughboy Frank Woodruff Buckles, the last known known memorial to World War I veter- More than 4.7 million Americans American veteran of World War I, died ans from the District of Columbia into a served in the military during World War peacefully at his beloved farm in Charles national memorial. I. Here is the story of the last known Town, W.Va., on Feb. 27 at the age of Buckles was buried with full military Doughboy. 110. honors at Arlington National Cemetery “We have lost a living link to an im- on March 15, near the gravesite of “his” In 1917—more than 90 years portant era in our nation’s history,” said general, Gen. John “Black Jack” Persh- ago—the United States entered the VA Secretary Eric K. Shinseki. “But we ing. Before the burial, his body lay in Great War in Europe. Sixteen-year- have also lost a man of quiet dignity, who honor inside Arlington’s Memorial Am- old Frank Buckles decided he wanted dedicated his final years to ensuring the phitheater Chapel, while hundreds filed in, too. He figured he could fib about sacrifices of his fellow ‘Doughboys’ are past to pay their respects. After the public his age, say he was 18. appropriately commemorated.” viewing was over, President Obama and But the Army recruiter told him, In his later years, Buckles became Vice President Biden arrived to pay their “No good. You need to be 21.” So he an advocate for the expansion of a little- respects. kept shopping around until finally, he

6 VAnguard • March/April 2011 found a recruiter who believed him when he said his home state of Mis- souri didn’t keep birth records when he was born. It’s back home on the farm, he said, an entry in the family Bible. Soon, young Buckles was “Over There,” in England. His ultimate goal was France, where the action was. It took him a while but eventually he made it, thanks to some sage advice. “An old sergeant told me, ‘If you want to get to France in a hurry, then join the ambulance service. The French are big for ambulance service,’” Buckles recalled. “I had many different assignments,” Buckles said, “and I was doing things that I thought were important. No I didn’t, either; I didn’t think they were important. But I found out afterwards, when I read up on my history, that some of the things I did were quite important.” courtesy of u.s. army Opposite: Frank Buckles, the last known American veteran of World War I, at his farmhouse in West Being an ambulance driver, Virginia, surrounded by his beloved books; above: A caisson carries Buckles to his final resting Buckles didn’t see combat, but he saw place at Arlington National Cemetery; the gravesite is near that of World War I Gen. John “Black plenty of casualties. And after the ar- Jack” Pershing. mistice, he delivered German POWs prisoners were rescued in a daring life-long passion. But not just any- back to the Fatherland, a foreshadow- raid by paratroopers from the 11th thing—he was an unabashed student ing of his own fate 20 years later. Airborne Division. When Buckles of history. He had no time for fiction. After two years in the Army, emerged from Los Baños, he was 50 “Why should I read something Buckles set out to see the world, work- pounds lighter than when he entered. someone made up when real events ing for the White Star Line, of Ti- At war’s end, Buckles returned are so interesting?” Buckles said. tanic fame. For the next 20 years, he to the States. He fell in love with When asked his secret to a long lived the life of a merchant seaman. a California girl and she agreed to life, Buckles had a quick answer at By 1941, the shipping business settle down with him in the beautiful the ready: “Be prepared.” But the had taken Buckles to the Philippines. northeast corner of West Virginia, the longer answer may lie in the inde- On Dec. 8, he and millions of Fili- Buckles’ ancestral homeland. pendent way he always led his life. pinos experienced their own horrific Buckles and wife Audrey bought Frank Buckles neatly fit the profile version of Pearl Harbor when the and restored a charming 18th-century that gerontologists point to as ideal: Japanese invaded the islands. stone farmhouse. Audrey died in he had a life-long passion for reading Ironically, although Buckles 1999; their daughter Susannah Flana- and learning; an ongoing interest in served in only one world war, he suf- gan and her husband began spending foreign languages and culture; and was fered in two. For the next three and a much of their time helping to run the physically fit his entire life. half years, he was a prisoner of war. It farm and care for Buckles. He was still Years ago, Buckles made a senti- was a harsh, brutal experience. out riding a tractor well past his 100th mental journey to his father’s farm in Buckles ended up at Los Baños, birthday. Missouri, the place of his birth. There a former university campus that had In his last years, Buckles sur- he spotted the old bell that his father been converted into an internment rounded himself with family and rang the day he was born in 1901. He camp for more than 2,000 civilians. friends, books and mementos from a made the current farmer an offer and He kept himself and his fellow prison- life filled with journeys and adventure. bought it on the spot. On his farm ers mentally sharp by focusing on the His private study was home to dozens in West Virginia—110 years later— physical: every day, he led the group of books about World Wars I and II. that same bell rang loud and clear for in rigorous calisthenics. His larger library contained more than Frank Woodruff Buckles: a National Finally, in 1945, the Los Baños a thousand volumes. Reading was his Treasure.

VAnguard • March/April 2011 7 Meeting the Needs of Moms-to-Be VA is stepping up efforts to support veterans who are expecting.

Left to right: Veteran Terri Maxine accepts a basket from maternity program volunteers Barb Shaw and Kathy Laurier at the Carl T. Hayden VA Medical Center in Phoenix. In 2010, volunteers there gave gift baskets to 60 new mothers. VA provides full maternity care to enrolled women veterans, and also covers the medical care of newborns for the first seven days.

laura segall

n 2008, two sisters––Kathy Lau- I wanted to give something back. I Health Strategic Healthcare Group, rier and Barbara Shaw––made decided I wanted to be involved with said VA sends expectant moms to lo- the decision to volunteer at the Women’s Clinic.” cal health care practitioners because, their local VA medical center “VA has come a long way as far as frankly, that’s where they can receive Iin Phoenix. They just wanted to help the care they provide to women vets,” the best care. In most cases, she said, out in some small way. But within a said Shaw, 73. “But not too many veterans can choose the obstetrician short time, their efforts touched the VA hospitals are set up to handle the they want to see. lives of hundreds of pregnant women needs of vets who are moms-to-be. So “Only a few of our larger medi- veterans. when a woman veteran becomes preg- cal centers are equipped to provide “I was in the Navy,” said Laurier, nant, the VA sends her to a private obstetrical care on-site,” Hayes ex- 64. “I’ve been receiving my health practitioner to get the care she needs.” plained. “So for the most part, VA care at the Carl T. Hayden VA Medi- Dr. Patricia Hayes, chief con- relies on private health care providers cal Center in Phoenix, and I felt like sultant for VA’s Women Veterans to perform this service. We pay for

8 VAnguard • March/April 2011 the care, we monitor the care, but we Top: A don’t actually provide the care.” mom-to-be loads her Hayes said it’s also VA’s policy to trunk with stay in contact with the woman dur- baby items ing her pregnancy, with the goal of at the Carl T. Hayden having her return to VA primary care VA Medical within six to eight weeks after her Center in delivery. Phoenix. The items “Our goal was to create a better, are donated closer, more personal relationship be- by various courtesy of kathy laurier and barb shaw tween these women veterans and their local and national VA medical center,” said Laurier. charities, “Making sure they have an adequate including supply of baby items—like diapers, the Daugh- ters of the baby clothes and blankets—is one way American of doing that. So we came up with the Revolution; idea of gift baskets. bottom: A new mom, “Our first baskets were very small, her daugh- with only a few items,” she added. ter and new- “Barb and I were buying most of the born are well stocked baby items ourselves.” with baby Shaw said she and her sister supplies, quickly realized that to keep their gift thanks to the Phoenix basket program going, they were going VA’s volun- to need some help. Specifically, they teer corps. courtesy of kathy laurier and barb shaw would need donations. “The Arizona State Daughters of the American Revolution was the first “Then we give her a basket that’s problems, and if her baby’s OK,” Shaw charity to chip in and help us,” Shaw just for her,” Shaw added. “It has explained. “We don’t give out medical explained. “Now, three years later, mom stuff, like lotions, a candle, slip- advice, we just listen. Then we pass we have a number of local and even pers, even a bathrobe.” on what we learn to Cara Garcia, the national charities helping out. In fact, Laurier recalled an experience she women veterans program manager at the Daughters of the American Revo- had with a 43-year-old veteran who the Phoenix VA.” lution recently adopted us––they’ve was single and pregnant with twins. “This monthly contact is critical taken us on as a national project.” “Originally she was pregnant with if we’re going to keep these women in “Our first year was kind of quiet,” quads,” said Laurier. “She lost one; the VA health care system,” Garcia Laurier noted. “We only had about then about two weeks later, she lost explained. “We don’t want to lose 25 moms. That’s because the program the second. track of them … we don’t want them was so new. But in 2009, we had “Barbara and I made her baskets drifting away from us once they de- about 48 moms, and in 2010, we had and she picked them up at the VA a liver, and now they won’t—thanks to 60. The word is starting to spread.” few days before Christmas. She called the efforts of Kathy, Barbara and other Laurier stays in touch with every me on Christmas night and was liter- volunteers like them.” veteran who becomes pregnant, call- ally sobbing. She told me––as do most A number of other VA facil- ing her once a month to make sure of the women––that she never expect- ities—including the St. Louis VA she’s doing OK physically, emotion- ed anything like this. What touched Medical Center, Central Texas Vet- ally and financially. me most were her last words to me erans Health Care System, and the “During their last two months, before she hung up. She said, ‘It’s the Overton Brooks VA Medical Center I call them every week,” Laurier ex- first time I’ve ever felt not forgotten.’ in Shreveport, La.—are enlisting vol- plained. “If she’s high risk, I’ll call her “That kind of thing makes all this unteers, as well as local community more often. About one month before work worthwhile,” Laurier said. organizations, including veterans ser- she delivers, Barb and I will bring her Once baby arrives, Shaw calls the vice organizations, to help provide for a gift basket––it’s more like a gift tub, new moms once a month for as long the needs of expectant mothers. actually––a big plastic tub full of use- as they’re breastfeeding. “That way ful baby items.” we know if she’s having any health By Tom Cramer

VAnguard • March/April 2011 9 Battlefield courtesy of rick beyer Deception Al Albrecht served with one of the most daring—and secretive—units of World War II.

e kept quiet for 50 years, sure the story was told again and again many interviews conducted about four because that’s what his to school and community groups. years ago. Skibba got permission from government told him to Albrecht kept talking until he was the filmmaker, Rick Beyer, to show a do. silenced once again—this time by rough-cut screening. HAl Albrecht was part of one of prostate cancer. About 50 friends, family members the most daring units in World War He was losing weight rapidly and fellow veterans from the Zablocki II—fighting with inflatable tanks and and given only months to live, so his VA filled the Matousek Auditorium sound effects to make the Germans daughter, Kathy Skibba, arranged to on the medical center campus Nov. think the U.S. Army had a stronger fulfill her dad’s dying wish: to tell the 27 for a special showing. Nurses line than it actually did. What they world about the World War II Ghost wheeled Albrecht into the auditorium didn’t have in actual weapons, they Army. in his bed. made up for with raw guts and trick- Albrecht, 86, a patient in pallia- “For the first time in months, he ery. tive care at the Clement J. Zablocki was smiling, and that smile didn’t And it worked. VA Medical Center in Milwaukee, leave his face the entire time,” Skibba When the work was finally de- participated in a not-yet-released said. classified in the mid-1990s, he made documentary on his Army unit, with The documentary tells the story

10 VAnguard • March/April 2011 courtesy of rick beyer of a group of soldiers who became a part of the 23rd Headquarters Special Troops. They nicknamed themselves the Ghost Army for their ability to Gary Porter/Milwaukee Journal-Sentinel stage 21 battlefield deceptions with Opposite: A World War II soldier stands inflatable tanks, jeeps, airplanes, next to one of the inflatable tanks used to trucks and sound effect recordings fool the enemy; top left: Soldiers pose next to the sound equipment used to fool the that made them sound like a full army Germans and make them think the Ameri- on the move. When one mission was cans had more soldiers and artillery on the over, they’d deflate the equipment battlefield than they actually had; top right: Al Albrecht greets well-wishers at the Nov. and head out again. 27 screening of the documentary on the In between those deceptions, Ghost Army; right: Al Albrecht in his mili- the soldiers would sew random unit tary uniform, surrounded by all the patches he wore while impersonating soldiers from patches on their shoulders and change other units to trick the enemy. markings on their vehicles, pretending to be part of different units. They’d go nothing but tracks because we were drinking in town to throw off the en- gone.” emy and make the Germans think the Skibba didn’t learn what her actual unit was on the move. father really did in the war until he “We had a very unusual unit,” got the all-clear to talk about those Albrecht told the filmmaker. “The missions. Gary Porter/Milwaukee Journal-Sentinel Ghost Army had very few weapons, “He has always been so strong, “The people who were involved and not very many defensive weapons. but since he got sick in November, in this Ghost Army really deserved We were mostly combat deception.” everything has happened so fast. more attention than they got, because His job was to drive the half-track That’s probably the hardest part for they saved many, many lives,” he told vehicle with speakers blasting out us. We know he doesn’t have a lot the crowd. “Thank you for being here military sounds. of time, and this has been his dying tonight.” “I told my children it was the big- wish, to tell as many people as pos- Skibba said she believes her dad gest boombox you ever saw,” he said. sible about what happened.” willed himself to stay alive to see the “It played sounds of tanks and other Photos of a young Albrecht in documentary. activities. Army uniform decorated the Ma- “He hasn’t been able to stay “The biggest thing we accom- tousek, along with patches from all awake for more than 15 minutes at plished was we saved a lot of Ameri- the different units he impersonated. a time, but he was awake for the full can lives, and also German lives,” he Covered in a blanket and frail event,” she said. “He was smiling the continued. “We had occasions where from his cancer treatment, Albrecht whole time. That was worth every- deferring actions saved many Ameri- still greeted family members and other thing.” can lives—imagine the face of the well-wishers. He gratefully acknowl- Albrecht died three weeks later. German commander preparing to at- edged the applause at the end of the tack and going over there and finding documentary. By Gary J. Kunich

VAnguard • March/April 2011 11 Are We Ready? A comprehensive three-year study evaluated the preparedness of VA medical facilities to respond to a variety of emergencies. ongress assigned VA re- the federal government has evolved incident management, occupant sponsibility for supporting an integrated, “all hazards” emergency safety, continuity/resiliency, medical the Department of Defense management system with states and surge, and support to external require- on health care for active local communities. Implementation of ments during the response and recov- duty members injured during an the “National Response Framework,” ery phases of emergencies. Coverseas conflict in 1982. This “VA- or NRF, is coordinated by the De- VHA hired Booz Allen Hamilton DoD Contingency Hospital System” partment of Homeland Security and to conduct independent, third-party identified larger VA medical centers involves all federal agencies and the assessments of all VAMCs and VISN as primary receiving centers and other American Red Cross. Since Hurricane offices from fiscal years 2007 to 2010. VAMCs in resource support roles. Andrew in 1992, VA has supported The BAH project manager, Arnie Staff at the PRCs worked with their several areas within the NRF, includ- Bierenbaum, had been the VHA di- community emergency response agen- ing public works and engineering rector of safety and technical services cies and the local airport to develop a (National Cemetery Administration), until his retirement in 2006. “Because plan to receive, stabilize if necessary, resource support (Veterans Benefits of my experience working to develop and transport military casualties to the Administration), and public health VHA’s safety programs,” said Bieren- PRC. and medical services (Veterans Health baum, “I was able to both identify ar- Several years later, another sys- Administration). eas critical to preparedness and assem- tem was developed to back up the The foundation for national ble a team of private sector and VHA VA-DoD system using a network readiness is the comprehensive emer- executives, engineers and clinicians to of non-federal hospitals agreeing to gency management programs at the conduct the on-site assessments.” provide beds and other resources for local VA medical centers and Veter- Each site visit team was headed the care of military or civilian casual- ans Integrated Service Network of- by a retired VA official (such as a ties. This “National Disaster Medical fices. Here, VA emergency managers network or facility director). Accord- System,” or NDMS, was designed to prepare each facility for a variety of ing to Jim Farsetta, a BAH assessment support both the need for additional hazards through development of plans team leader, “Directors are responsible resources in the event of a major and procedures; staff education and for ensuring a safe environment for military conflict, or a catastrophic training; and exercises involving the patients, visitors and staff. I think event overwhelming an area’s medical local community. what we were able to provide each di- system. In 2007, Joseph A. Williams Jr., rector was a comprehensive review of VA plays a central role in the assistant deputy under secretary for the activities that may be needed dur- NDMS, leading and staffing the feder- health for operations and manage- ing emergencies and clearly indicate al coordinating centers (which are set ment, asked a group of senior VHA the steps they could take to enhance up to receive patients in disasters and contingency planners, “Are We what they currently had.” route them to appropriate care) in 56 Ready?” This simple question led to BAH delivered its final report to of the 70 FCC locations in the U.S. the development of a three-year study VHA leadership in September 2010, today. designed to evaluate the day-to-day with more than 130 findings and Because of the many major natu- preparedness and mitigation activities, recommendations for improving the ral, technological and manmade emer- and to assess the capabilities of every comprehensive emergency manage- gencies and disasters since the 1980s, VAMC and VISN office to conduct ment programs at the national, VISN

12 VAnguard • March/April 2011 and VAMC levels. Of particular VHA and across the health care in- to emergency management is strong importance was the identification of dustry,” said Richard Callis, acting and involves a number of key offices 12 leading indicators of readiness. chief consultant, EMSHG. across VHA. VHA and VA Central Leading indicators are those capabili- Conclusions of the report in- Office officials provide “substantial ties that have the largest impact on cluded that VA medical centers “have policy and guidance” that supports overall preparedness as determined largely embraced the need for high- emergency management, and in fact, through data analysis of the “most quality, effective and efficient emer- VHA leadership and commitment at prepared” VAMCs and VISN offices. gency management systems,” as shown all levels is a significant factor in the The Emergency Management by their planning and response capa- successes of the VAMCs. Strategic Healthcare Group, or EM- bilities. There is “significant commit- According to the report, “While SHG (the program office for VHA’s ment” to comprehensive emergency VHA is prepared for the vast majority comprehensive emergency manage- management at the VISN level. At of the hazards it historically responds ment program), with the Office of the national level, the commitment to, there is still significant work to be done to prepare for hazards on a large scale, such as a major earthquake, category 4 or 5 hurricane, a major failure of a regional utility such as the power grid, or a substantial terrorist event.” Next steps in the process include providing support throughout the health system where needs for improvements in readiness were identified, and continuing to do exercises, training and preparedness for all the hazards VA may face. “Are we ready?” is a question that all levels of the organization and every individual must continually work to answer.

Editor’s Note: Peter Brewster, Connie Raab, Ken Wheeler, RN, and Victor Ramos contributed to this story.

Cobb-Douglas (Ga.) Public Health

Above: A Haitian patient is quickly assessed by Atlanta NDMS Patient Reception Team members and Metro Ambulance of Atlanta paramedics in preparation for transport to a waiting NDMS Partner Hospital.

Right: Dr. Jose Lezama looks at the X-ray of a 3-year-old girl who came to Tampa with a broken neck. Lezama, chief of medicine at the James A. Haley Veterans’ Hospital, served as medical director of Operation Haiti Relief for the Tampa area. the Under Secretary for Health, Operations and Management and the Office of Quality Management, have incorporated these 12 indicators into a performance measure for all VAMC and VISN directors beginning in fiscal year 2011. “Through this study, we feel we have established some very important science for guiding future preparedness activities, both within susan ward

VAnguard • March/April 2011 13 Celebrate National Library Week VA’s medical libraries provide information and tools to improve the quality of care provided to patients. “I believe the care our dietitians pro- Comments like these demonstrate subscriptions. VA libraries distribute vide to veterans is top-notch due in the value provided by VA library nearly 100,000 patient education large part to being informed through professionals every day. The VA pro- pamphlets each year, and most pro- current research. This information is fessional staff in 153 medical librar- vide electronic databases that make readily available to us thanks to our ies provide tools and information to thousands of additional journal ar- highly skilled, conscientious and ef- clinicians, administrators, researchers, ticles and electronic books accessible ficient library staff.” residents, students and allied health to users. VA librarians and library staff Carla Van Langen personnel to directly improve the support health care nationally by par- Nutrition and Food Service quality of care provided to the more ticipating in national networks with Des Moines (Iowa) VAMC than 5 million veteran patients en- private, academic and other govern- rolled in the VA health care system. mental libraries to share resources and “As a physician, I cannot tell you how VA library staff also provide valuable achieve cost efficiency. much respect I have for librarians and information to inpatients, outpatients, Last year, VA libraries, through how much they have helped me over and their families and caregivers. their interlibrary loan services, shared the years …” more than 159,000 articles. Requests Deborah Younger, M.D. What Do VA Librarians Do? for such materials are usually filled Emergency Medicine Physician VA employs more than 140 pro- within 24 hours. Charleston (S.C.) VAMC fessional librarians who are experts in all aspects of information retrieval, Enhancing Health Care Yesterday “The library is a vital part of our or- assessment, procurement and admin- and Today ganization and critical for our mission istration. Librarians evaluate and Historically, VA librarians helped to provide high-quality health care, purchase books, license and manage develop and promote the profession education and research. On a daily electronic resources, search clinical of medical librarianship in the United basis we use electronic resources … medicine databases, organize products States. Formal education for medical for patient care.” for easier access, and train medical librarians was developed, in part, as a Sharad C. Mathur, M.D. center staff and patients in the use result of the need for specialized train- Chief, Pathology and Laboratory of library resources. They analyze in- ing for librarians serving in medical Medicine Service formation needs and determine the libraries at VA hospitals. Kansas City (Mo.) VAMC best resources to meet each need, and VA librarians also led the discov- ensure that VA medical centers get ery, in the early 1920s, that reading “Until I read the information you the maximum possible return on their (bibliotherapy) could be used to treat gave me, I thought I was having a information investment. some mental disorders. They have heart attack every time I had angina. Located in VA medical centers worked with the National Library of Now I understand that angina and a and VA Central Office, libraries also Medicine to develop many tools used heart attack are different.” support the Veterans Benefits Admin- by librarians in all types of medical Patient istration and the National Cemetery libraries, including the development Indianapolis VAMC Administration. of MEDLARS (Medical Literature Analysis and Retrieval System), the “ … I graduated in 2008 with my What is VALNET? predecessor to PubMed, which is now master’s in nursing, and you all had The VA Library Network (VAL- used to search medical literature. a big part in helping me achieve this NET), comprised of VA’s libraries, is Reliable health information is the degree.” one of the largest medical library net- foundation of clinical patient care, Jenny Maxwell works in the world. Its combined book research, education of new health Nurse collection exceeds 545,000 volumes professionals, and the development Dallas VA Medical Center and more than 95,000 print journal of the informed consumer/patient.

14 VAnguard • March/April 2011 Studies show that when health care VA librarian is out of the office. ACP No two libraries in VALNET are professionals use libraries to locate Pier Plus, an evidence-based resource exactly alike; each reflects the unique evidence-based information, the cost produced by the American College needs of its own facility. Libraries of patient care is lowered and health of Physicians that provides access to have been instrumental in assisting care quality is improved. VA librar- more than 400 summaries of the best facilities to achieve Magnet status by ians provide cutting-edge information research on a subject, was added in implementing evidence-based prac- tools and materials at the front line of 2008. In 2009, Lexi-Comp for Den- tices, meeting Baldrige and Carey health care—the point of care. tistry and Psychiatry Online were award standards, and supporting VA An informed and empowered made available. staff research. A VA library is a place patient plays a key role on the health In 2010, the LNO won the for people to gather, study and receive care team and is critical to optimal Veterans Health Administration IT training. health care outcomes. Low medical Innovations award with the sugges- “literacy” is linked to under-utilization tion to develop a core collection of Training Tomorrow’s Health Care of health care services, medication knowledge-based resources. With the Providers errors, increased hospitalizations, funding from that award, access was VA has the largest medical edu- poor health outcomes and higher provided to more than 700 online cation and health professions training health care program in costs. Library the United staff promote States. Each patient literacy year, about by providing 90,000 health timely access professionals to relevant are trained in health informa- VA medical tion so patients centers. More may better than half of understand and the physicians make decisions, practicing in which in turn the United improves qual- States received ity of care and some of their lowers associ- professional ated costs. education in the VA health Maximizing care system. Access to VA librarians Information train tomor- Across VA and robert turtil row’s health Beyond VA Central Office librarians Vivian Stahl, left, and Caryl Kazen developed a Veterans Day book care providers Recogniz- display and reading list and are doing the same for other observances. and clinical re- ing that access searchers; they to knowledge-based resources varied books. Today access is provided for all support the lifelong learning efforts of from site to site, the VA Library VA staff to: health professionals. Network Office (LNO) initiated a n more than 1,000 online books; Libraries and library staff play an core collection of electronic resources n more than 600 current journal important role in the health care pro- available throughout the VA network. titles; cess. They are sources for information The New England Journal of Medicine, n more than 1,000 journal title back you can trust. a premier medical journal, was made files; and April 10-16 is National Library available online to all VA employees n additional databases (Rehabilita- Week and April 12 is National Li- in 2005. tion Reference Center, VisualDX and brary Workers Day. Check out your In 2006, the LNO created a Access Suite). medical center’s library and thank Virtual Reference Service to provide the librarians and their staff for help- e-mail access to professional literature One Network, Many Libraries, ing VA provide health care beyond and reference services when another Countless Benefits compare.

VAnguard • March/April 2011 15 Lives Transformed Among the hundreds of employees volunteering at the 15th annual Winterhaven Homeless Veterans Stand Down in Washington, D.C., were two who know what it’s like to live on the streets.

sponsored its heads together.” left the Navy in 1987, and that put annual Winter- Veterans who attended the 15th him on a downward spiral. He was un- haven Homeless Winterhaven event received medical employable for 20 years, and for most Veterans Stand screenings, health care and housing of that time he was homeless. Down on Jan. 22, attracting more information. Men’s and women’s sta- “I made bad choices in life, and thanVA 500 veterans in frigid tempera- tions were set up to provide clothing I wound up walking away from my tures to participate in the event at giveaways. Men received free haircuts marriage, employment, and I basically the Washington, D.C., VA Medical at the barbershop, and women re- walked right into 17 years of home- Center. ceived free facials, makeovers, mani- lessness out in San Diego. The good Representatives and community cures and pedicures. thing about it was that I took it 3,000 partners from nearly 100 federal, state “We hope to serve hundreds of miles away from my family. I was out and local agencies, veterans service veterans who are homeless who come there by myself.” organizations, businesses and nonprofit through the doors today in many Berry ended up incarcerated from organizations came out to support the different ways,” said Jeff Gering, act- time to time while he lived on the homeless event. ing director of the D.C. VA Medical streets. He had lost everything. “This coming together of so many Center. “One day, a judge got hold of me agencies on one day at the federal, Hundreds of D.C. VAMC em- and helped me to see life in a different state and local level to provide ser- ployees volunteered their time to way,” Berry said. “I was court-ordered vices and benefits to homeless vet- participate in the homeless stand to a recovery program, Veterans Vil- erans is a tremendous outpouring of down, including Robert Berry. He lage of San Diego.” care and it is good to see,” said VA knows firsthand what it’s like to be That was when he became affili- Secretary Eric K. Shinseki, who vol- homeless—he was homeless himself ated with the San Diego VA Medical unteered with his wife, Patty, handing for 17 years. His life has come full Center. He went through a nine- out warm clothing and coats. “I think circle since he sobered up five years month recovery program. today is a wonderful example of what ago, with VA’s help. “I started getting counseling and agencies can do when they put their Berry started using drugs after he medical treatment there in San Diego

16 VAnguard • March/April 2011 and it helped me to For 17 years he had no relationship clear my mind and I with his ex-wife, but now they are got sober,” he said. back together, providing a two-parent “When I graduated home for their daughter. from the Veterans “I was able to get my wife and Village recovery daughter back into my life,” he said. program, I came “I have been clean and sober now for back to D.C.” five years, and I have not been incar- Before leav- cerated for going on five years. I was ing California, he able to be there when my daughter voluntarily partici- graduated from Towson State Univer- pated in a homeless sity.” stand down event Berry now works as a supply tech- at San Diego Com- nician, and he said his life has been munity College. It completely transformed after years was during that time of living on the streets, unemployed, that he realized he homeless and away from his wife and liked the feeling of daughter. These days, the three of camaraderie he got them attend church together and sing from working with in the choir. veterans. Army veteran William Harrison james rosenfelder

Weathering Life’s Storms After 31 years of marriage, Army veteran April Goodwin got the Above: Robert Berry was shock of her life from her husband. homeless for “Two years ago, my husband 17 years before told me he wanted to be free. He he got sober five years ago; took all the money out of the bank, right: William left us destitute. We had to move Harrison never from the house we lived in.” imagined he’d end up living Goodwin and her daughters, in a cardboard Angelica, Stalina and Kendra, box in an alley moved to keep from being evicted. after leaving “That Thanksgiving, we were the military. moving our stuff in the snow. We were told that if we didn’t get our stuff out, it was going to get put out,” said Goodwin. James Rosenfelder A native of the D.C. area, Good- win reflected on being homeless “That meant something to me,” never thought he would end up home- while attending the Winterhaven Berry said. “I came back to D.C. with less in the nation’s capital after leav- Homeless Veterans Stand Down. a mind that I wanted to help people, ing the military. As a former supply “Being homeless is not a fun but I first had to finish helping my- sergeant who had served at Fort Knox thing,” she said. “Not having a self.” and run his own supply room, he did place to live, not having a regular He enrolled in therapy and coun- not think it would be difficult to find address.” seling courses at the D.C. VA Medi- employment. After all, he had risen In 2009, a rapid turn of events cal Center. Berry credits God’s grace to the rank of specialist and had been sent Goodwin’s life on a downward and the staff at the medical center for responsible for approximately $4.5 spiral. helping him repair broken relation- million worth of equipment from the ships with his ex-wife and daughter. mid- to late-1980s.

VAnguard • March/April 2011 17 “My health just failed; I got sick,” At the time of the fire, Goodwin’s I said, ‘I am really feeling depressed, a she said. two oldest daughters, Angelica, 25, and little suicidal,’” Goodwin said. “I was Doctors diagnosed Goodwin with Stalina, 22, lived in the apartment. Some- just at the end of my rope. It felt like the rhabdomyolysis, a rapid deterioration of one told Goodwin to contact VA about whole world started crashing in on me.” skeletal muscle caused by damage to housing assistance. Goodwin described feeling like a muscle tissue. According to Goodwin, The Department of Housing and weight had been lifted off of her as a it popped up out of nowhere. She went Urban Development and the Department team of people came to her rescue and from being able to walk to being wheel- of Veterans Affairs Supported Housing provided mental health counseling. chair-bound. She spent nearly a year at (HUD-VASH) Program provides long- “It seemed like all of a sudden the the D.C. VA Medical Center. term case management and supportive walls moved, the ceiling lifted up, and “That is why I know everybody services with permanent housing sup- they were pushing me someplace and here,” she said. “I treat everybody with port through a cooperative partnership. I was sitting in front of this guy and he kindness because it’s important. I have When Goodwin found out she could was asking me all these questions. It all to set a good example for my kids and let get help through the HUD-VASH pro- happened so fast,” she said. them know that nothing is ever given to gram, it proved to be a bittersweet mo- Goodwin said without support from you. You make your own road and some- ment when she learned her two oldest VA, it would have been tough for her to times it’s rough.” daughters could not move in with her. go on. As Goodwin struggled with her “The blessing is that I got health, she and her daughters continued sick,” she said. “Someone told A rapid turn of to face homelessness. During that time, me about HUD-VASH, and I got events sent April Goodwin found out her husband had an an apartment the month before Goodwin’s life on a downward spiral affair for 20 of the 31 years they were the other apartment burned in 2009. married. down. I could not bring my older “I am dealing with my health issues, kids there, so they are bouncing I am dealing with being disrespected,” around, sleeping with me some- she said. “My kids are trying to pull to- times, so that I’m not breaking the gether, trying to work this madness out. I rules.” have these great kids and we have been Goodwin worried about where through so much.” her two older daughters would There was the day she got out of live after the old apartment was the hospital’s emergency room and then destroyed by fire, and it took a toll stood out in the cold for almost four on her. hours asking people for food. She got “It’s just been a very difficult sweet potatoes, white potatoes, onions, journey, and I probably would have james rosenfelder bread and blueberries. committed suicide by now if it was “We were so grateful because not for the VA,” she said. “She was in a difficult position, and we did not have any food left,” said Shelly McCrae, a social worker for what she needed from me was my ear Goodwin, who receives Social Security the HUD-VASH program, marveled at and my support and to be linked with the disability for her youngest daughter and Goodwin’s progress. appropriate services that could provide child support. She stretches the money “It has been a rewarding experi- her with the assistance she needed,” as far as she can, but it’s never enough. ence for me to assist a veteran to move said McCrae. “She did the work. She is When she found housing, her rent con- into her own place and watch her put awesome—very resilient—and I have tinued to increase. her life back together as she transitions learned a lot from her.” “Everybody wants to get paid,” she to self-sufficiency—which is the goal,” Despite the tumultuous journey said. McCrae said. Goodwin and her daughters have en- Then, out of nowhere, someone Goodwin credits McCrae with go- dured for the past several years, she is gave Goodwin and her daughters a ing out of her way to help her when she encouraged to go on with her life. place to live. needed it most. “We are still trying to find a happy “The place was a dump, but we “When I said, ‘I need food,’ she was balance with knowing that we are still were so happy we had someplace to on the phone trying to find places where here,” said Goodwin, who makes blous- go,” said Goodwin, who laughed to keep I could go pick up food.” es out of scarves, earrings out of soda from crying. “Last year, a day before my During one of her visits to the D.C. cans and purses out of potato chip bags. birthday, it caught on fire. We lost every- VAMC, a staff member casually asked “Whatever we have, be blessed to thing; it went up in flames.” her how she was feeling that day, “and have it and make it work.”

18 VAnguard • March/April 2011 Harrison enrolled in VA’s Com- pensated Work Therapy program in 1999. “I treated that like it was a $20-an-hour job, even though I was only making $5.15 an hour, and I kept moving in that direction, to make my life better and make me better as a person.” In 2002, Harrison was hired to work in the call center at VA as an entry-level employee. Today, the formerly homeless veteran is an addiction therapist at the D.C. VAMC. He married seven years ago. “I don’t know where I would be right now if it was not for VA and the people in VA,” he said. michele hammonds

Above: Homeless Army veteran Michelle Thomas, 51, talks with another homeless woman veteran as they shop for free clothes at the Washington, D.C., VA Medical Center’s Winterhaven Homeless Veterans Stand Down on Jan. 22; right: Homeless Marine Corps veteran Curtis Buren, 47, receives a free haircut at Winterhaven. “When I came home, it was ex- tremely hard to find a job,” he said. Harrison did not prepare for un- employment. He thought his military experience would help him land a job. Eventually, he depleted his savings. “I was not able to pay the rent or the bills, so I was out on the street,” he said. He ended up living in abandoned buildings. Harrison believes the pit- falls of homelessness and drug addic- michele hammonds tion swallowed him up in the early 1990s. I did not get out of the cardboard box, Harrison looks forward to the “I got involved in alcohol and I was going to die in that cardboard annual Winterhaven Stand Down as drugs and other things that kept me box,” he said. “That very day I walked an opportunity to not only give back, on a downward spiral for the next across town to Central Union Mis- but also to send a message to homeless seven years,” he said. “After that, I sion. The next day I was upstairs on veterans who are now in situations was homeless on the street, living in the third floor at the VA hospital in similar to the one he was once in. an alley in Northeast Washington.” the SART (Substance Abuse Reha- “Go to the VA and you will get The last three years of being bilitation Treatment) program. “They the help you need,” he tells them. homeless, Harrison lived in a card- got me in touch with the homeless board box in an alley. team. They dealt with my acquired By Michele Hammonds “It got to the point where I was bad habits, my addictions to alcohol accustomed to being homeless and and cocaine, and set me off on a path Editor’s Note: VA held approximate- hustling all day to get a meal,” he said. to get me where I am today.” ly 210 homeless stand down events, In 1999, Harrison had an awak- Since joining VA’s SART pro- which lasted one to three days, at ening. gram, Harrison has been free of alco- different medical centers around the “I heard a voice telling me that if hol and drugs for 12 years. country last year.

VAnguard • March/April 2011 19 Second in Command Deputy Secretary W. Scott Gould carries out his duties with his fellow veterans, families and employees foremost in his mind.

hile you may know the Honorable W. Scott turned the city around in 10 months. I’d have to say also Gould as VA’s Deputy Secretary, you should that the person I admire most and am learning a huge also know that he is a Navy veteran who amount from is our own Secretary Shinseki. He is an ex- has held senior leadership positions at the traordinary leader, and a great individual, and he has taken Departments of Commerce and Treasury, served as a vice the time to coach and to mentor me. And I appreciate it president,W chief operating officer and chief executive officer very much. of several private sector businesses, been a White House Fellow, and co-authored a critically acclaimed book about Q: Can you tell us about your personal motivation to public institutions investing in their people. take the job as Deputy Secretary at VA? VAnguard sat down with the Deputy Secretary in A: Thank you for asking. I spent about 26 years in the Central Office to talk about how he views his role in the Navy, so a lot of folks I served with at sea are presumably Department, how the transformation is going, his personal using the services we provide here now. But most impor- motivation for serving at VA, and more. tantly, my own father was a veteran of World War II and Korea, and he actually spent the last 11 years of his life Q: As Deputy Secretary, you serve as VA’s chief oper- in a VA hospital, where he was cared for wonderfully. So ating officer. How do you define that role? I just remember the families arriving at the front door of A: We’re a big organization, and we have very far-flung our institutions across the country right now who need our operations, so the most important thing a COO can do is help, just like my family needed it. I’m here for them, and I synchronize the operation of the organization. And I re- want to build an institution that can do as well as VA did gard my second-most important function as making other in the ’90s for my dad. people successful. We’ve got a lot of great folks, and getting the resources they need to get the job done is critical Q: Could you talk a bit about employees as a resource to executing my duties. for institutions to deliver their services? How important are they, and why? Q: How would you describe your leadership style? A: We’ve got a lot of money, a lot of buildings, a lot of A: It’s very mission-oriented. I believe very much in the high-tech equipment, and none of them will deliver a thing that we are doing together as an enterprise, serving single service to our veterans. It’s the people. I believe our veterans from every generation. I would also describe people are the bedrock of an institution, and you need to my style as collaborative and listening. My grandfather build trust, provide inspiring leadership, but most impor- used to say you can always learn something from someone, tantly train and develop those leaders. Whether it’s the but you can’t be talking when you do it. individual that just joined VA this week or the one that’s been serving 30 or 35 years, everyone needs training and Q: You mentioned your grandfather. Are there others attention. And that investment in our people is what who had an impact on you as a leader? builds a strong institution. We hope that across VA, senior A: I would cite two individuals. One was a fellow named leaders and supervisors are taking a moment to make sure Jim Carlin. The governor of Massachusetts fired the mayor their people are getting what they need to do their jobs and the board of aldermen of the city of Chelsea, and ap- well, and investing in them. pointed three people to run it. I was one of the folks lucky enough to do that. And Jim Carlin was the lead guy. He Q: The Secretary has clearly laid out the transformation was this very passionate, action-oriented individual who he’s putting VA through to make it a veteran-centric, thrived in the business world, and could also work ef- results-oriented, and forward-looking 21st-century orga- fectively in government. I learned a lot from Jim, and we nization. How is it going?

20 VAnguard • March/April 2011 A: We’ve got a little over $2 billion worth of major initia- President hasn’t said, “I’m going to make this a priority,” tives going on in VA right now, those 16 major initiatives which he has, then it doesn’t happen. So the 2010 budget, that comprise the Secretary’s portfolio of priorities. And which was the largest increase in 30 years in the VA bud- they’re going very well. I’ve just finished the third in a get, the ’11 increase, and now ’12 adds another over 10.5 series of operational and management reviews designed to percent to that major increase—we’re growing. We have make sure that not only are we applying the people, mon- the resources to do what we need, and I’m very proud of ey, and things to make them go, but that we are getting playing a part in capturing those resources for our agency. the results out of them that we want. Examples of that success would include homelessness. Two years ago, we were Q: Any challenges you want to share? at 131,000 homeless veterans every night on the streets A: I think one of the big challenges we have is making of the U.S. We’re down to 76,000 now. In the area of our sure the hand-off between DoD and VA is done in a way virtual benefit management system, VBMS, we’ve just now that respects the service of all of the service members, soon completed the first-ever end-to-end electronic processing to become veterans, who go through it, that we do it with of a claim in VBA. And it took 47 days to do it. So we’re an assiduous focus on making sure the transition is the best seeing examples of new technology, and new leadership, it can be. [DoD Deputy Secretary] Bill Lynn and I, who are focused on our key priorities. I think the ship is turning. partners in this effort, have sat down together and rolled up our sleeves, and are trying to make good things happen. Q: You mentioned the homeless target and the tremen- A great example is electronic health records. As you know, dous goal the Secretary set to end veteran homeless- VA has the largest direct health care system in America. ness within five years. You recently participated in a DoD is kind of right behind us with their own direct care, one-night census here in D.C. Can you talk about that and also care that they purchase from the private sector. experience? But one would think they would have the same electronic A: It was cold, but it was a lot of fun. I got to see our team health record, and just last week the Secretary of Defense in action, and we were working together for the first time and the Secretary of VA slapped the table and agreed; we with HUD and about 70 dif- will have a joint electronic ferent agencies here in the health record going forward. D.C. area. I think the thing I think it’s going to improve that really hits you is the quality, and husband our re- need, the sense of vulner- sources more efficiently. ability of walking up to a veteran on the street, sleep- Q: Is there anything you’d ing in a sleeping bag that was like to say to VA employ- donated to them. These are ees? individuals who need help. A: The first is just to com- They need our support. So municate that I respect our goal is to get them off the what everyone is doing. street, provide housing, and The folks on our team do get them through our process robert turtil something that, in my view, so they can get the help they is unambiguously good. need. They’ve got to go home every night and be able to tell Q: What would you say has their families that they’re been your proudest moment proud of what they do, that so far as VA Deputy Sec- what they do matters, that retary? it is making a difference in A: This may sound terribly the lives of our veterans, mundane, but one of the and that the Secretary and roles I play is to compete for I are very grateful for their resources. And the Secretary The Deputy Secretary service, day in and day and I really take that seri- participated in a home- out. And we’re fighting for ously. You can have great, less census in Washing- them, as is the President, to alex horton ton, D.C., on Jan. 26. creative people ready to go, continue this service and to Top: An interview with Deputy Secretary W. Scott Gould from VA but if they don’t have the News. For closed captioning, please view the interview in VA News fulfill our commitment to resources they need and the located at http://www.va.gov/opa/feature/vanews/vanews-455.asx. veterans.

VAnguard • March/April 2011 21 A new partnership is helping veterans with disabilities live independently at home.

The Veteran Directed Home and Community Based Services Program allows Korean War veteran Frank Zampella to live comfortably at home with his wife of 57 years, Ida, while getting the care he needs. scott snell More Choices, More Control da Zampella, of North Plainfield, N.J., remembers only too well the ter- rible days that her husband Frank, a veteran of Korea, spent in a nursing home following open heart surgery and a stroke. She cried every night af- terI visiting hours were over. “It broke my heart to leave him there,” she said. 22 VAnguard • March/April 2011 Finally, Ida could no longer bear people, it doesn’t work for those who injured veterans. VA anticipates ex- to watch her husband’s decline. She want more control over their lives. panding the program to at least 14 brought Frank home, but soon the Under the traditional service system, more states in 2011. burden of caring for her husband be- for example, people who need assis- The Zampellas were among those gan to take a toll on her own health. tance getting up in the morning have who spoke at a Dec. 14 event held at She didn’t know how she was going to to adjust to their home care workers’ the Lyons Campus of the VA New manage. schedules—even if they prefer getting Jersey Health Care System to cel- Then Ida learned of a new ini- up at another time. They don’t have ebrate the success of programs in New tiative at VA called the Veteran much choice over what services they Jersey that began enrolling veterans Directed Home and Community get, from whom, when or how. in the VD-HCBS Program in 2009. Based Services (VD-HCBS) Program The program is active in three New that works with Area Agencies on Putting Power and Control in the Jersey counties: Somerset, Morris and Aging. It turned out to be a godsend. Hands of Veterans Bergen, which currently have enrolled The program enabled Ida and Frank Participant direction turns that 28, 17 and three veterans, respec- to hire a personal care aide for Frank around. “You set the rules for how tively. 32 hours a week, install a wheelchair you’ll live your life,” said Kevin Ma- Evelyn Marrinan’s husband John lift outside their home and make oth- honey, director of the National Re- lived most of his life with diabetes. As er purchases to meet Frank’s needs. source Center for Participant-Directed he got older, though, he became more Now Frank lives comfortably at Services, a nonprofit organization disabled. One of his legs was ampu- home while getting the care he needs. based at Boston College that works to tated. Later he was diagnosed with The Zampellas have been married 57 support participant direction. Parkinson’s disease. years, and Ida says she will always be “You decide what services you “He really couldn’t do anything,” grateful to VA for keeping them to- want and who will provide them. And said Evelyn, who lives in Bernards gether. “The VA really came through if you’re dissatisfied with the service Township, N.J. Yet she did not want for us.” you’re getting, you can hire someone to put him in a nursing home. When A partnership between VA, the else.” she heard about the VD-HCBS Pro- U.S. Administration on Aging (AoA) A pioneering participant direc- gram, it seemed too good to be true. and the National Resource Center tion program called Cash & Counsel- With John’s new monthly budget, for Participant-Directed Services, the ing showed that growing old or living Evelyn was able to hire additional VD-HCBS Program keeps veterans of with a disability does not have to personal care aides. The difference

“You set the rules for how you’ll live your life. You decide what services you want and who will provide them. And if you’re dissatisfied with the service you’re getting, you can hire someone else.” all ages and disabilities in their com- mean living in a nursing home or oth- was huge, she said. “The fact that we munities and out of nursing homes. er institution. With more choice and could hire and fire people was empow- Veterans in the program manage their control over services, most people can ering,” she added. The VA program own flexible spending budgets for get the services they need and prefer also paid a bookkeeping agency to their personal care services—deciding and remain at home. help the Marrinans manage their for themselves what mix of goods and The VD-HCBS Program is mod- monthly budget. services will best meet their needs, eled after Cash & Counseling. The John Marrinan died in April hiring and supervising their own National Resource Center for Partici- 2010. The VA program, Evelyn said, workers, including family and friends, pant-Directed Services directed Cash was “just invaluable.” and purchasing items or services that & Counseling, and now provides will help them live more indepen- technical assistance to the VA/AoA Making Care More Veteran- dently. program. Centered This approach, known as “partici- Nationally, as of December 2010, Heain Choi, community care pant direction,” was developed as an 23 VA medical centers in 14 states program director for VA New Jersey, alternative to traditional home care had a fully operational VD-HCBS said the VD-HCBS Program is help- services. Although the traditional Program with more than 540 veterans ing veterans live happier, more inde- service system works well for some enrolled, including young and severely pendent lives in their homes, while

VAnguard • March/April 2011 23 microwave ovens to emergency alert medallions. Where is VD-HCBS? “These veterans need so much Currently, VA medical centers care, and the VD-HCBS Program has in 14 states have a fully opera- really changed their lives,” Choi said. tional VD-HCBS Program, and She also commended the vari- VA anticipates expanding to ous aging and VA agencies at both an additional 14 states in 2011. the state and county levels that have These states are: made the New Jersey program so successful. “Getting the program up and Alabama running was hard work for everyone,” Arkansas* she said, “but well worth it. We had Connecticut* one goal: to serve our veterans and to Florida* make it happen.” Georgia Poonam Alaigh, M.D., New Jer- Hawaii sey’s health and senior services com- Illinois* missioner, called VD-HCBS “an ex- Indiana ample of what we want to see happen Kentucky in health care.” By “putting power and Louisiana decision-making in the hands of vet- Maine* erans,” she added, the program gives Maryland “respect, honor, dignity and choice Massachusetts* back to our veterans.” New Jersey also Michigan* operates its own Cash & Counsel- Minnesota* ing program, Personal Preference, for robert turtil Montana frail elderly people and those with Dan Schoeps, VA’s national director of pur- New Hampshire disabilities, which has proved highly chased home and community-based service successful. programs, says participant direction is help- New Jersey* ing make VA care more veteran-centered. New York* Dan Schoeps, VA’s national Ohio director of purchased home and com- VD-HCBS Program could be a better Oregon munity-based service programs, said option for these veterans. South Carolina participant direction is helping make Mahoney noted that participant Texas* VA care more veteran-centered. “Vet- direction is not for everyone. “It’s for Washington* erans want more options,” Schoeps people who want more control over West Virginia said. “Both young veterans and older their lives,” he said. Wisconsin* veterans tell us that they want more People who don’t want that much Vermont control over their care.” control and who would rather have Virginia* Schoeps said he believes the others manage their home help for VD-HCBS Program will be of particu- them can simply keep their traditional *States marked with an asterisk lar value to younger veterans return- home care services, he said. But, he have an active VD-HCBS Program. ing from Afghanistan and Iraq. “We added, he believes it should be an op- think the program is ideal for this tion for everyone in need of personal population,” he said. care services. During the Gulf War, he noted, Schoeps agreed. There will always providing relief and support for their he received many phone calls from be a need for nursing home care, he spouses and other caregivers. Not only families anguished by the prospect said, and VA will continue to con- is home care available to veterans of sending loved ones who had been tract with nursing homes. through the VD-HCBS Program, but seriously injured in conflict to nursing Ultimately, though, he envisions also house cleaning, food delivery, homes. But he has not fielded a single that the VD-HCBS Program will be dog walking, adult day care and other nursing home call for younger veter- available to all veterans. “It is going to services that can help veterans live ans in recent years. take a number of years to get nation- at home. In addition, they can use “They’re either choosing tradi- wide coverage of this program,” he their budgets to make purchases rang- tional home care services or they’re said. “We will move as quickly as we ing from bathroom modifications to not going into nursing homes.” The can, as resources allow.”

24 VAnguard • March/April 2011 Never Too Late Navy veteran enrolls for VA health care at age 100. rentice Willis thinks long and “He is a charming, mod- hard before making a serious est man who does not seem to decision in life. Leaning forward want to be a bother to anyone,” inP a brown leather recliner, he pauses Eutsler says. “He seems very for a moment staring at a checker- pleased with his welcome to the board before moving a single checker VA and seems to appreciate the forward. At 101 years old, the former services that are available to Navy aviator keeps active by playing him.” checkers nearly every day with Cruzita The spry centenarian lives Gallegos, a home health care nurse with his other son, Robert, and assistant. Robert’s wife, Anna McCormick “He’s like the grandfather I never Willis, in their traditional Santa had,” she says. “He helps cut up the Fe home. Willis’ bedroom is bill armstrong paper for the fire, and we exercise just off the living room. Above Former Navy aviator Prentice Willis keeps active by playing with walks and stretching. We try to his small bed hangs a collection checkers almost every day. keep busy.” of framed and fading military lowing his retirement in the late Willis will be the first to tell you photos and certificates tracing his life 1960s, Willis lived for some time in he’s no Jack LaLanne, the late fitness experiences. Texas, and later in Taos, N.M., before guru who emphasized the importance Willis’ passion for flight began in moving in with Robert and Anna. of daily rigorous workouts. 1933 near his home in Beattie, Kan. Today the father of three, grand- “I stay active,” he says. “I exercise, “I looked up at the sky and saw an father of four and great-grandfather but I don’t do a lot of special exer- airplane flying,” he says. “I had never of four seems satisfied with the slower cises.” flown before, and I said that it must be pace of retirement. When asked the Like many senior citizens, health wonderful to fly like that.” secret of his longevity, Willis just has shifted to the top of Willis’ list of A girl standing nearby overheard shrugs his shoulders. priorities. Last summer, his son David him and just happened to know how “No special diet. I eat anything I contacted Beth Eutsler about getting Willis could achieve his dream. can get my hands on,” Willis says with his father enrolled for VA benefits, “This little girl (gesturing with his a laugh. including home health care. Eutsler is hand a height of about four feet) gave His daughter-in-law backs up his a social worker at VA’s community- me the whole story on how I could boast about food. Anna says when she based outpatient clinic in Santa Fe, become a pilot. I left immediately—I needs Willis to do something at home, N.M., part of the New Mexico VA didn’t waste any time!” she is able to bribe her father-in-law Health Care System. Willis traveled to Pensacola, Fla., with cookies and pineapple. “I usually answer these types of and joined the Navy’s Aviation Cadet “He’s a good eater,” she says, nod- calls,” Eutsler says. “I had him come in Program in 1933. After earning his ding. with as much military documentation “wings,” he served four more years of For a variety of reasons, many and information as he had, and we active duty before leaving the Navy to veterans delay their enrollment into pieced together the 10-10EZR (VA’s fly for American Airlines in 1940. the VA health care system. In Pren- personal information update form) His days as a civilian pilot were tice Willis’ case, he decided it was with the available documents.” numbered. When war broke out a year better late than never. After following a fascinating and later, he went back on active duty “It seemed like the best thing historic paper trail, Eutsler was able to with the Navy, flying a variety of mili- for me to do to take care of the situ- help Willis enroll in the system. She tary aircraft. ation,” he said as he moved another then assisted him in getting medical After the war, he remained in the checker forward. appointments and arranged for his Navy Reserve, but went back to his home health care services to begin. job flying for American Airlines. Fol- By Bill Armstrong

VAnguard • March/April 2011 25 AROUND HEADQUARTERS

VA Submits $132 Billion Budget Proposal for Fiscal Year 2012

VA submitted a $132 billion telehealth—will be harnessed budget proposal for 2012 on to meet the evolving needs of Feb. 14. Congress must ap- patients. prove the budget request for Among the Department’s the fiscal year that begins Oct. operational improvements is a 1 before it can take effect. provision that calls for VA to In announcing the re- implement Medicare’s stan- quest, Secretary Eric K. Shin- dard payment rates, a measure seki emphasized the need to that will free $315 million for “make every dollar count.” other health care needs. He said the Department has The proposed budget for “put into place management the new fiscal year includes systems and initiatives to max- more than $70 billion in imize efficiency and effective- “mandatory” benefits pro- ness, and to eliminate waste.” grams, mostly disability com- The budget request seeks pensation and pensions. nearly $51 billion for medical Shinseki reaffirmed his care. It would provide care commitment to “break the to more than 6.2 million back of the backlog” of claims robert turtil patients, including nearly from veterans for disability 540,000 veterans of military compensation and pensions. VA Secretary Eric K. Shinseki speaks at a briefing on the release of the 2012 bud- operations in Iraq and Af- VA’s goal is to provide vet- get proposal on Feb. 14 at VA Central Office. ghanistan. erans with decisions on their The budget request also claims within 125 days at a 98 VA will seek nearly $3.2 seismic corrections, improve- includes almost $1 billion percent accuracy rate by 2015. billion for the new fiscal year ments for patient safety, and for a contingency fund and The requested budget for to operate and maintain its enhancements for access and $1.2 billion for operational mandatory benefits programs information technology. patient privacy. improvements to manage the also includes nearly $11.5 bil- The Department has a Additionally, the spend- appropriated funds in a fiscally lion for VA education, train- major role in the developing proposal includes funds for responsible manner. ing, vocational rehabilitation ment of the “virtual lifetime a gravesite expansion project at Major health care provi- and employment programs, electronic record” as part of an the National Memorial Cem- sions include: including educational benefit inter-agency federal initiative etery of the Pacific in Hawaii. n $6.2 billion for mental programs VA administers for to provide complete and por- VA is seeking more than health programs, including the Department of Defense. table electronic health records $250 million next year for the $68 million directly for suicide Approximately 925,000 people for service members, veterans, operation and maintenance of prevention; will receive benefits under other family members and, its 131 national cemeteries. n $344 million to activate these programs. Nearly three- eventually, all Americans. The Department expects newly constructed medical quarters of the funds will go Nearly $590 million in to inter about 115,000 people facilities; to recipients of the Post-9/11 major construction is included next year at its national cem- n $208 million to implement GI Bill. within next year’s budget re- eteries. Nearly 90 percent of new benefits for veterans’ care- The budget proposal quest. the U.S. population is within givers; and continues development of an The funding proposal 75 miles of a VA-run national n nearly $509 million for automated Post-9/11 GI Bill provides for the continuation cemetery or a state-run veter- research. claims processing system that of seven ongoing construc- ans cemetery. Shinseki noted the will speed tuition and housing tion projects at health care The fiscal year 2012 bud- Department has created “a payments to eligible veterans. facilities—New Orleans; Den- get plan includes $46 million portfolio of initiatives” to The funding request ver; San Juan, Puerto Rico; St. to fund creation and improve- improve the quality of VA includes nearly $940 mil- Louis; Palo Alto, Calif.; Bay ment of state veterans cem- care while making it easier lion for specific programs to Pines, Fla.; and Seattle—plus eteries and tribal government for patients to access services. prevent and reduce homeless- new projects in Reno, Nev.; veterans cemeteries. Primary care providers will ness among veterans and their Los Angeles; and San Fran- More information about put more emphasis on disease families. This funding is a 17 cisco. VA’s budget proposal for fiscal prevention and healthy living. percent increase over the cur- Also in the budget request year 2012 is available on the New technology—securing rent budget of nearly $800 is $550 million for minor con- website at www.va.gov/budget/ e-mails, social networking and million. struction for such purposes as products.asp.

26 VAnguard • March/April 2011 AROUND HEADQUARTERSOUTLOOK

National Cemetery Administration Earns Highest Customer Rating

For the fourth time in 10 and sustained high levels of years, the National Cemetery service at the organization’s Administration has received annual customer service con- the highest rating in customer ference for federal government satisfaction of any federal ACSI participants, held Jan. agency or corporation sur- 25 at the National Press Club veyed, according to a presti- in Washington, D.C. gious, independent survey of In presenting the award, customer satisfaction. Ronald Oberbillig, chief op- “This survey is testament erating officer of the Federal to the outstanding service Consulting Group, said, “No employees at VA’s 131 na- other federal or private orga- tional cemeteries provide our nization has scored as high nation’s veterans and their as the National Cemetery families,” said Secretary Eric Administration. The amazing K. Shinseki. “It is VA’s privi- part is that NCA has sustained chris erbe lege to care for the nation’s those high scores for more Acting Under Secretary for Memorial Affairs Steve Muro, right, accepts an award heroes in perpetuity, and it is than a decade, outpacing such from Ronald Oberbillig, chief operating officer of the Federal Consulting Group, our goal to meet the highest corporations as Amazon.com recognizing NCA for sustained high levels of service at the organization’s annual robert turtil standards for professionalism and Heinz.” customer service conference for federal government ACSI participants. and compassion.” NCA participates in the The American Customer ACSI every three years, pre- The ACSI survey polled ity Research Center of the Satisfaction Index (ACSI) is viously in 2001, 2004 and next-of-kin or others who had University of Michigan Busi- the only uniform, national, 2007. This is the fourth time arranged for the interment of ness School, NCA received cross-industry measure of NCA has participated and a loved one in a VA national ratings in the categories of satisfaction with the quality the fourth consecutive time it cemetery within the past six “customer service” and “user of goods and services avail- has received the top rating in months to one year. More trust” of 96 out of a possible able in the United States. In the nation. For 2010, NCA than 1,900 people received the 100 points, indicating that 1999, the federal government achieved a customer satisfac- survey, and 444 responded, a respondents are exceptionally selected ACSI to be a standard tion index of 94, nearly 29 high response rate for a mail- pleased with their experience metric for measuring citizen points above the average for in survey. at national cemeteries and are satisfaction. More than 100 federal agencies, which was Using methodologies de- willing to recommend their federal agencies have used 65.4. veloped at the National Qual- services to others. ACSI to measure citizen satisfaction with more than 200 services and programs. The Revised Online Health Benefits Application Offers Chat Feature Index was founded at the University of Michigan’s Ross Veterans will find it easier and faster to apply for their health care benefits now that VA has en- School of Business and is pro- hanced and streamlined its online Form 10-10EZ, “Application for Health Benefits.” duced by ACSI, LLC. This revised online application now features a chat function, which allows veterans to receive “VA should be com- live assistance while they are filling out the form. Additional enhancements to the process include mended for continuing to simplification of questions relating to military service in Southeast Asia during the Gulf and Viet- provide such a high level of nam wars. Several additional minor enhancements make the application easier and faster for veter- service to America’s veterans ans to complete. and their families,” said Jon The 10-10EZ application is divided into six different sets of information, including personal Cioffi, senior consultant with information, insurance information, employment, military service, and a financial assessment. CFI Group USA, one of the Since November 2000, nearly 400,000 veterans have already used the online 10-10EZ to start re- survey’s sponsors. “NCA ceiving health care benefits from VA. serves as an excellent example Future enhancements to the online application will include a 10-10EZR Health Benefits of how government should Renewal Form for veterans to update their personal information, and a special 10-10EZ designed provide services to its citi- specifically for demobilizing military service members. zens.” Veterans may complete or download the 10-10EZ form at the VA health eligibility website The government’s Federal at www.1010ez.med.va.gov/sec/vha/1010ez. They can also contact VA at 1-877-222-8387 (VETS), Consulting Group presented visit the VA health eligibility Web site at www.va.gov/healtheligibility, or apply for health care ben- NCA an award for continued efits at any VA medical center with the help of a VA health care eligibility specialist.

VAnguard • March/April 2011 27 AROUND HEADQUARTERS

Board of Veterans’ Appeals Publishes Third Edition of Law Review

What do Harvard Law School anty, vocational rehabilitation, benefits. By creating the Veter- Veterans Law Review is being and VA’s Board of Veterans’ dependency and indemnity ans Law Review, Terry hoped released this spring. It contains Appeals have in common? compensation, and health care to “stimulate ideas for improv- several notes and articles on They both publish a law re- eligibility. ing the benefit system for our current “hot topics,” includ- view. A law review is a scholar- The Veterans Law Review nation’s veterans and their ing an analysis of the Veterans ly journal devoted to exploring owes its inception to the many families.” Claims Assistance Act of 2000, legal trends and issues. dedicated employees of the Another driving force 10 years later, and book re- In January 2009, the Board, including the current behind the journal was Editor- views pertaining to the war in Board published the first chairman, James P. Terry, who in-Chief John Crowley, a vet- Iraq. volume of the Veterans Law was a driving force behind the erans law judge with the Board Annual publications of Review, a journal focused on creation of the VLR. since 2005. Crowley dedicated the Veterans Law Review serve veterans benefits law. The sec- Terry was first appointed many hours to making the as a practical resource for legal ond volume was published in to head the Board in 2005. publication a reality. professionals, policy mak- March 2010. As a Marine Corps veteran With the publication ers, and the general public. The Board is a compo- himself, he saw that the field of the seminal edition of the The journal also serves as an nent of VA that adjudicates of veterans benefits law was Veterans Law Review, Crowley important vehicle of change and makes final decisions on growing rapidly. wrote: “We dedicate this work for those who want to start a behalf of the Secretary on He recognized how dif- to improving government conversation about the future appeals from decisions from ficult it could be for practitio- service to veterans and their of veterans benefits law. Each local VA offices. The Board ners and individual claimants families. issue includes articles focus- is comprised of attorneys and to navigate extensive regula- “We have started some- ing on current or developing veterans law judges who review tions, statutes, claims process- thing that we hope, over time, trends in the law, in addition all appeals for entitlement to ing procedures, and a body will create a forum that will to notes, comments and book veterans benefits, including of developing case law of the help improve a $30 billion reviews. claims for service connection, U.S. Court of Appeals for Vet- benefits system designed to For more information increased disability ratings, erans Claims and the Federal help those who have been pro- about the Veterans Law Re- pension, insurance, education- Circuit Court of Appeals when tecting us for generations.” view, visit www.bva.va.gov/ al benefits, home loan guar- processing their claim for VA The third volume of the VLR.asp.

Sports and Recreation Programs for Disabled Veterans Expanding

VA is awarding two grants to- nizations, Paralympic sports Huebner, chief of U.S. Para- Delaware, and parts of West taling $7.5 million to the U.S. clubs, and veteran and military lympics. “We know that sports Virginia, New Jersey and New Olympic Committee to en- organizations nationwide to and physical activity can have York. A 17-year VA employee, hance recreation and sporting implement community-based a transformative effect on he directed a $92 million activities for disabled veterans physical activity programs for those with a physical disability. budget and all prosthetics and disabled members of the disabled veterans and disabled “These funds will help operations for 10 VA medical armed forces. members of the armed forces. our community partners centers. “Many of our veterans Disabled veterans can locate expand and provide greater Nowak joined the Marine have experienced traumatic adaptive sporting events in access to sports programs for Corps in 1983. His military injuries while at the peak of their communities by visiting injured veterans, disabled career ended in 1987, when their physical conditioning,” the U.S. Paralympics website members of the armed forces, the then-infantry squad leader said Secretary Eric K. Shinseki. at www.usparalympics.org. and all living in their local lost his right leg to friendly “Our partnership with the Public Law 110-389 au- area with a physical disability,” fire during a routine training U.S. Olympic Committee will thorized VA to award grants Huebner added. exercise. aid in their recovery by allow- to the U.S. Olympic Com- Additionally, Christopher Nowak has long been a ing them to engage in thera- mittee to plan, manage and J. Nowak has been selected to champion of sports rehabilita- peutic sporting events and implement an adaptive sports be the director of the VA Para- tion for wounded soldiers and competition right in their own program. lympics Program Office. veterans. He developed and communities.” “This support from the Since 1999, Nowak co-chaired “First Swing” and Under the terms of the Department of Veterans Af- served as a prosthetics manager “Next Step” golf clinics for grant agreements, funding will fairs will have far-reaching for VA Healthcare Veterans amputee veterans and he is be provided to the Olympic impact in communities around Integrated Service Network 4, also a former member of the Committee’s member orga- the country,” said Charlie which includes Pennsylvania, USA Amputee Hockey Team.

28 VAnguard • March/April 2011 AROUND HEADQUARTERSOUTLOOK

HR Academy: Advancing VA’s Human Resources Workforce

Transformation begins with all of VA for the betterment of support all of VA’s employees basic and advanced staffing, your people. the nation’s veterans. throughout the country. To communicating effectively, pay To transform our or- The Deputy Secretary de- date, VA has trained more setting, position management, ganization and deliver the scribed the current challenges than 200,000 VA employees. and more. best health care, benefits and VA faces: a growing veteran Since June 2010, the HR Soon, the HR Academy services to veterans and their population; rapidly changing Academy has trained more will offer a range of certifica- families, it is critical that we technology; and the looming than 1,200 employees through tion tracks and a career map- hire the best talent available, retirement of significant por- a series of instructor-led cours- ping program so that HR and in an effective and timely tions of VA’s workforce, cou- es and webinars. Additional employees can further advance manner. This means we must pled with a new generation of courses are being offered both their careers. invest in the skills, educa- workers with different working in person in select cities across To learn more about tion and development of the styles and expectations. In the U.S. and virtually through the HR Academy, visit people who are doing that describing the important role webinars, with courses avail- www.vahracademy.com. To hiring—our human resources that its HR workforce plays able for all levels of HR profes- learn more about ADVANCE, workforce. in meeting these challenges, sionals. Course topics include visit vaww.va.gov/ADVANCE. These were the central Gould stated that it is criti- themes of the official launch of cal that HR professionals be the new HR Academy last fall equipped with the tools and New Office to Serve as Advocate at VA Central Office. A part resources to help VA effec- of the ADVANCE initiative— tively address these challenges, for Tribal Veterans the long-term, Department- and concluded that VA must wide investment in all VA em- “dramatically increase” its in- A new Office of Tribal Government Relations will help ensure ployees nationwide—the HR vestment in its HR workforce. the more than 200,000 veterans who are American Indians, Academy provides educational, Following Gould’s re- Alaska Natives, Hawaiian Natives or are part of the Alaska Na- professional development and marks, Deputy Assistant Secre- tive Corporations re- skills training opportunities to tary Deanes further noted how ceive the VA benefits VA’s HR workforce. the HR Academy is designed they have earned. The event drew more to empower HR professionals About 200,000 than 150 attendees who came to learn across organizational, veterans are repre- to hear VA leaders discuss technical and geographic sented by the 800 the HR Academy’s mission, boundaries, and how it is tribal governments resources and learning oppor- expected to create learning officially recognized tunities. Moderated by Pro- communities that will improve by the United States. gram Analysis Officer Carolyn support and collaboration. Although VA has Hunt, it featured inspirational Though he could not be long provided benefits remarks from Deputy Sec- in attendance for the launch, to veterans in tribal retary W. Scott Gould and the program highlighted the lands, the new office Deputy Assistant Secretary for vital role played by Assistant will further strengthen Human Resources Manage- Secretary for Human Re- and expand that rela- ment Tonya M. Deanes. sources and Administration tionship. In his keynote address, John U. Sepúlveda in launch- Stephanie Elaine Deputy Secretary Gould re- ing the HR Academy. It was Birdwell, an enrolled flected on the commitment of his “leadership [that] shaped member of the Chero- Secretary Eric K. Shinseki to the HR Academy strategy and kee Nation from robert turtil VA’s employees and his vision helped make the launch pos- Oklahoma, has been Stephanie Birdwell for transformation across the sible,” said Program Analysis selected as the office’s Department. Gould empha- Officer Hunt. first director. A former social worker, she spent nearly 15 years sized the importance of invest- Assistant Secretary Sep- working on tribal issues with the Bureau of Indian Affairs and, ing in their skills and profes- úlveda is responsible for the most recently, the Bureau of Indian Education. sional development, and the ADVANCE initiative that She will oversee a six-person office responsible for “establish- vital role of the HR Academy, gave rise to the HR Academy. ing, maintaining and coordinating a nation-to-nation, federal- in VA’s Strategic Plan. He In addition to the HR Acad- tribal relationship,” according to a VA briefing. described the HR Academy as emy, ADVANCE offers a The office has a charter that officially extends to veterans a “transformational learning variety of programs and train- who are American Indians, Alaska Natives, Native Hawaiians opportunity” that strengthens ing opportunities designed to and Alaska Native Corporations.

VAnguard • March/April 2011 29 INTRODUCING

Oliver L. Avery III INTRODUCING For 30 long, agonizing years, “The VA helped me push Air Force veteran Oliver L. the restart button,” said Avery. Avery III abused alcohol to “While in the voc rehab pro- “survive life’s challenges.” In gram, I began work as a house- 2003, he found himself twice keeping aid, and then became divorced, homeless, desperate, a medical supply technician. and ready for a change. The job was what I needed to “I embraced recovery and get back on my feet and into haven’t looked back,” said the workforce, plus I enjoyed Avery. “I give all the credit for working with fellow veterans. where I am today to the Mi- It was a safe environment for chael E. DeBakey VA Medical me to heal.” Center. The staff there saved VA’s Compensated Work my life.” Therapy programs were estab- In March 2003, Avery lished in the 1950s. Veterans entered the Vocational Reha- receive a certificate document- bilitation Transitional Work ing their proficiency in hospi- Experience Program and the tal linen processing or general Substance Dependence Treat- housekeeping. ment Program at the DeBakey Veterans with the desire VA in Houston. to develop more advanced These programs help vet- skills receive classroom and erans recover from drug and on-the-job training in: hospital alcohol dependence through safety; patient room cleaning; comprehensive treatment, equipment operation; proper which may include: detoxi- handling of biohazard trash; fication; case management; customer service standards; addiction education; relapse infection control; special pro- prevention skill training; sup- cedures for transporting wheel- port groups; urine, drug and chair and stretcher patients; jordan denner alcohol screens; social work techniques to clean critical Air Force veteran Oliver L. Avery III with Environmental Management Service services; health screening; care areas such as surgical Housekeeping Aid Elizabeth Johnson. referrals for medical care or suites, spinal cord units, and an improved quality of life, Institute, a program designed vocational rehabilitation; and nursing home areas; shipping Avery gradually progressed in to enhance leadership skills of psychiatric assessment and and receiving; medical supply; his career. In 2004, he became individuals with recognized care. Levels of care include grounds-keeping; food service; a full-time medical supply potential for higher-level lead- partial hospitalization, day and or wheelchair repair. technician and attained three ership positions. Today, he is the assistant chief of Environ- “I embraced recovery and haven’t looked back. The VA helped me push mental Management Service at the restart button.” the 120-bed Loch Raven VA Community Living & Reha- nighttime schedules for low “The goals of the program certifications. After three years, bilitation Center in Baltimore. intensity and aftercare, and are very progressive,” said he was promoted to program “My job is to honor a alumni groups. The goal is for Clarence Mitchell, vocational support clerk to enhance his person’s dignity and self- veterans to reach their highest rehabilitation specialist at the customer skills, and then to esteem, but at the same time, level of vocational productiv- DeBakey VA. “They include assistant hospital housekeep- help someone with psychoso- ity. structured vocational evalua- ing intern. In 2007, at age cial challenges walk the line Veterans are provided tions, learning to follow work 51, Avery graduated from the between independence and vocational counseling, work schedules, working with oth- VISN 5 Emerging VA Leader- recovery,” said Mitchell. “Mr. therapy, job readiness train- ers, and accepting supervision. ship Program and completed Avery is a true success story ing, and employment search Going back to work reduces his bachelor’s degree in health and should give other veterans assistance. Supported Employ- psychiatric and physical symp- administration. hope that they, too, can over- ment Services are available to toms, improves relapse preven- Recently, Avery was se- come their struggles.” veterans with severe mental tion skills and self-esteem.” lected to attend VA’s yearlong illnesses. With restored hope and Leadership Development By Bobbi Gruner

30 VAnguard • March/April 2011 MEDICAL ADVANCESOUTLOOK

New Approach to Smoking Cessation Boosts Quit Rates for Veterans with PTSD Smoking cessation treatment that is made part of mental health care for veterans with post-traumatic stress disorder improves quit rates, according to a VA study published in the Dec. 8 Journal of the American Medical Association. On measures of smoking abstinence for shorter periods of time, researchers found that quit rates were as high as 18 percent for the integrated care group, versus 11 percent for those receiving usual care. When compared to usual care—referral to a Veterans in the study who quit smoking showed no worsening standard smoking cessation of their PTSD symptoms. clinic—the new, integrated robert turtil approach nearly doubled the do to improve the quality and Prolonged abstinence from diction is no match for what rate at which study volunteers length of their patients’ lives is tobacco, as reported by par- is a chronic, relapsing disorder stayed smoke-free for a year to help them stop smoking by ticipants, was confirmed using for many of our veterans.” or longer, from 4.5 percent to using proven, evidence-based breath and urine tests to detect Based on the findings and almost 9 percent. practices.” evidence of smoking. Using evidence from prior research, Importantly, veterans in McFall is director of such “bio-verification” mea- VA has begun piloting the the study who quit smoking PTSD Programs and Saxon sures in combination with self- integrated smoking cessation showed no worsening is director of the Addictions reports is considered the “gold approach as a standard of prac- of symptoms of PTSD or Treatment Center at the VA standard” in smoking cessation tice at six VA medical centers. depression. In fact, study par- Puget Sound Health Care research, says McFall. The researchers say they hope ticipants averaged a 10 percent System. Both are professors in Of some 400,000 veterans to see the new approach fur- reduction in PTSD symptoms, the department of psychiatry being treated for PTSD in the ther expanded over time. regardless of which treatment and behavioral sciences at the VA health care system, roughly McFall notes that while they received or whether they University of Washington. 30 to 50 percent are smokers, most of the participants in quit smoking or not. The find- VA smoking cessation compared to a smoking rate of the study were Vietnam-era ings help dispel concerns that care generally involves a mix of about 20 percent among VA veterans, integrated smoking combining care for PTSD and group and individual counsel- enrollees and U.S. adults in cessation care may be espe- smoking cessation detracts ing, typically in combination general. Research shows, also, cially beneficial for younger from PTSD treatment or with nicotine replacement that those with PTSD smoke veterans with PTSD, such as makes it less effective. therapy or other medication more heavily than smokers many of those returning from Study leaders Miles prescribed by a VA health without PTSD and have an Iraq or Afghanistan, who stand McFall, Ph.D., and Andrew care provider. In VA’s study, especially hard time quitting. to benefit greatly from quitting Saxon, M.D., say the results veterans in the integrated-care “We’ve come a long smoking relatively early in life. validate a promising new VA group worked with the same way in understanding that Says McFall, “Ideally, we model of care that can make therapist on PTSD and smok- nicotine dependence for can help veterans quit smoking safe, effective smoking cessa- ing issues. Medication for many veterans with PTSD is before it becomes a chronic tion treatment accessible to smoking cessation, if used, was a chronic, relapsing condition or intractable condition and far more veterans with PTSD. prescribed on an individual that responds best to inten- causes irreversible health prob- The new approach may also be basis by the same medical pro- sive treatment extended over lems such as cardiovascular or effective for smokers receiving vider managing pharmaco- time,” McFall says. “These lung disease.” mental health care for other logic treatment of the veteran’s study findings will help us The study was conducted psychiatric illnesses, they add. PTSD symptoms. empower more veterans with by VA’s Cooperative Studies Says McFall, “One of The study followed 943 the resources they need to quit Program. For more informa- the most important things veterans at 10 VA medical smoking. Single-shot, brief tion on CSP, visit www. mental health providers can centers nationwide. episodic care for nicotine ad- research.va.gov/programs/csp.

VAnguard • March/April 2011 31 MEDICAL ADVANCES

Houston First VA to Fit cant difference in function in Patient With Cutting- this device over the other 200- Edge Prosthetic Device plus feet we have used here at The Michael E. DeBakey VA the DeBakey VA,” said Mark Medical Center in Houston Benveniste, certified prosthe- recently became the first VA tist. “It is the most improve- medical center to fit a patient ment over conventional pros- with the iWalk PowerFoot thetics in the last 20 years.” BiOM™, just weeks after In addition to metabolic Brooke Army Medical Center cost reduction, the ankle range in San Antonio and Walter of motion is increased by near- Reed in Washington, D.C. ly 50 percent, thus actually re- This technologically advanced placing energy and generating prosthesis is the world’s first propulsion. The PowerFoot bionic lower leg system to BiOM uses sensors and a mo- replace the action of the tor to propel the foot through foot, Achilles tendon and calf each step, keeping simple muscle, and offer a near-nor- walking from being a drain on malized gait for amputees. people who have lost a leg. bobbi gruner This prosthetic device, “I feel like I have my leg funded by VA and the Depart- back and I can do the things I “I feel like I have my leg back and I can do the things I used to do,” said Randall Tipton, a 20-year Army Special Forces veteran who ment of Defense and devel- used to do,” said Randall Tip- served in Iraq and Afghanistan, with Mark Benveniste, certified pros- oped by Hugh Herr, Ph.D., of ton, a 20-year Army Special thetist at the DeBakey VA. the Massachusetts Institute of Forces veteran who served in Technology Biomechatronics Iraq and Afghanistan. “It just increase mobility and improve The goal is not only to teach Group, is clinically shown to helps out a lot. It takes the quality of life for a greater amputees to walk or use an replace lost muscle function, strain off my back, my hips. I range of amputees than ever artificial arm and hand, but allowing amputees to walk don’t feel as tired at the end of before.” to integrate body, mind and with normal metabolic rate the day.” No less important than machine. Continuing care and speed. “It is important for us new prosthetic technology is and long-term support from Currently in early market to offer our veterans a wide the overall care an amputee VA multi-disciplinary teams release, preliminary results for variety of advanced products,” receives during rehabilitation. have shown that patients often the device are groundbreaking said Angela Bishop, Prosthetic The model for that care has can improve their functioning in the field of prosthetics. Treatment Center chief at the changed over the years to im- months or years after their in- “We have seen a signifi- DeBakey VA. “Our goal is to prove services to VA patients. juries or amputation.

VA Office Developing are honored to serve. We need since 2001. future of high-quality health Innovative Patient- to be data-driven, providing “VA’s vision and com- care to our veterans.” Centered Model of Care treatments and therapies with mitment to cultural trans- The VA Office of Patient- for Veterans the best clinical evidence, formation comes at a pivotal Centered Care and Cultural VA has created a new office and we need to be patient- moment for health care in this Transformation will have four to develop personal, patient- centered, never losing sight country, and I am deeply hon- regional implementation teams centered models of care for that we have been given the ored to be joining VA in this at select VA medical centers veterans who receive health noble mission to care for our important work,” said Gaudet. across the country: Birming- care services at the Depart- nation’s veterans, families and “The Office of Patient- ham, Ala; East Orange, N.J.; ment’s more than 1,000 points survivors.” Centered Care and Cultural Dallas; and Los Angeles. of care across the nation. The new VA Office of Transformation will be a liv- Each VA medical center “VA has become one of Patient-Centered Care and ing, learning organization in was selected for excellence al- the nation’s leaders in quality Cultural Transformation be- which we will discover and ready demonstrated in produc- health care and is increasingly gan operations on Jan. 17 and demonstrate new models of ing cultures of patient-centered cited as the standard to emu- is based in Arlington, Va. care, analyze the results, and care based on established late,” said Under Secretary for The office’s director, Dr. then create strategies that allow criteria. These regional teams, Health Dr. Robert A. Petzel. Tracy Williams Gaudet, came for their translation and imple- comprised of patient-centered “However, we must always to VA from Duke University mentation across VA. VA care consultants, will be re- continue to find ways to de- Medical Center, where she will continue to be a national sponsible for facilitating the liver more with our systems served as the executive director leader in innovation, and, in culture change for patient-cen- to the incredible patients we of Duke Integrative Medicine this way, we will provide the tered care at all VA facilities.

32 VAnguard • March/April 2011 HAVE YOUOUTLOOK HEARD

Japanese American Veteran Receives San Francisco VA Nation’s Highest Medical Center Civilian Honor Reaches Out to Robert Masami Iso received Student Veterans the Bronze Star and two The San Francisco VA Purple Hearts for his service Medical Center has in the Army during World developed a unique War II. On Feb. 3, he re- partnership with City ceived the nation’s highest College of San Francisco civilian commendation, the to provide mental health Congressional Gold Medal, services on campus and honoring his service in the outreach to veterans. storied Japanese American CCSF opened a newly 442nd Regimental Combat curt campbell modernized Veterans Team, the most decorated Robert Iso with wife Rose at the ceremony. Resource Center with unit of its size in WWII. the mission to serve More than 100 family members, friends and VA Palo Alto Health Care System employ- students who are vet- ees were on hand for the presentation at the Menlo Park division’s Community Living erans and to enhance Center. their successful transi- Iso was the second soldier from his unit to receive the award; the others will receive tion from military life their medals in August in Washington, D.C. Iso’s VA doctor, Eric Strong, M.D., was to civilian careers. San concerned about the 92-year-old veteran’s failing health, so he arranged to have the award Francisco VAMC men- presented as soon as possible. Although the medal itself was not yet available to present, tal health and outreach the Japanese American Veterans Association was able to get one of the original documents staff are on site five days signed by Congress and the President declaring that members of the 442nd would receive a week to provide enroll- the medal. James Iso, Robert’s younger brother, told the story of his bravery on the battle- ment and mental health field during the ceremony. Robert Iso died on Feb. 6. counseling services. The VA office is in a suite with GI Bill ‘Helmet Heroes’ Auction Supports New Graduate Certificate Program counselors and next door Sarah Froese, director of homeless veteran programs at the Harry S. Truman Memo- to the veterans lounge, rial Veterans’ Hospital in Columbia, Mo., is a graduate of the University of Missouri a place where veterans School of Social Work and an artist. Recently, her artistic can relax, and also pro- helmet—“Universal Soldier”—was the most popular entry vide and obtain support in a fundraising reception and auction for scholarships as- from each other. CCSF sociated with a new graduate certificate program aimed at estimates there are nearly helping veterans and their families. Froese’s entry was one 900 veteran students of 16 helmets designed and decorated by local and regional currently enrolled. “We artists that were auctioned Nov. 11 at a Columbia art gal- believe it’s important lery. to take our services to The new certificate program, which will begin offering where the veterans are, courses this fall, recognizes the need to help social workers and a college campus provide good clinical practice for veterans. As VA caregiv- is an excellent place ers know, many of these individuals need help coping with to start,” said Keith post-deployment problems such as PTSD, TBI, depres- Armstrong, director of sion, substance abuse, homelessness, divorce and domestic Sarah Froese titled her popular family programs at the violence. With the increasing need for social workers at entry “Universal Soldier.” San Francisco VAMC. hospitals, military bases and other agencies and organiza- “We’re looking forward tions, there has been much support and interest in the Graduate Certificate in Military to partnering with other Social Work. The fundraiser netted $23,000, just $2,000 shy of the minimum to endow colleges and universities a scholarship. Efforts have continued by the university to raise the necessary money for in the future.” the scholarship.

VAnguard • March/April 2011 33 HAVE YOU HEARD

Rural Health Team Reaches All Counties in Catchment Area The Salisbury (N.C.) VA Medical Center’s Rural Health team achieved a fantastic feat in 2010: they traveled more than 12,000 miles in the last eight months of the year, completing more than 60 outreach events, with at least one event in each of the 24 counties in their catchment area, and multiple events in 15 of those counties. The team educated more than 2,000 rural veterans and families on health care issues, while simulta- neously delivering in excess of 1,400 applications for enrollment into the VA health care system. The team, whose members include admin- istrative staff, pharmacists, nurses and a social worker, conducted 21 educational sessions, training more than 580 veterans and family members on topics such as diabetes, COPD, hypertension and depression. They sought out a variety of dwight holmes venues, including health fairs, churches, town Melissa Yost, a Rural Health team nurse, explains health care benefits to a veteran halls, parades, festivals, county fairs, job fairs and during an outreach event at a mall in Concord, N.C. sporting events in an attempt to reach as many veterans as possible. They often worked weekends, traveling to events in 40 cities and towns. “We are VA, we’re Rural Health, and we’re here for the veterans and the communities they live in,” said Edwina Gray-Wright, program manager.

‘Love is Blind’ Takes on a Whole New Meaning for One Texas Couple William Shakespeare’s observation that “love is blind” took on a whole new meaning for Michael Goree and Frances Colsom. The two legally blind veterans met in the blind rehabilitation unit at the Central Texas Veterans Health Care System in Waco in the summer of 2009. They were just there to get some help coping with their sight challenges, but what they found was each other. “I came out of the computer room and saw this figure,” Goree recalled. “I couldn’t make out her features, but something came over me. I turned around and she was gone. But later I heard this laugh and knew it was her. From then on, I made it a purpose to be around her. And she kept laughing.” Colsom let him know she liked his attentions by leaving treats on his chair. The couple married Dec. 3 in the chapel on the grounds of the facility where they first met. Chaplain Thomas Rardin performed the ceremony, blind rehab instructor Stephen Foreman central texas veterans health care system was the best man, and Colsom’s daughter, Yohantis Moore, was Michael Goree and Frances Colsom met and married at the Central the maid of honor. The blind rehab staff hosted the reception, Texas Veterans Health Care System in Waco. with a wedding cake made by nurse Ethel Dowuona.

Marking a Long-Ago Tragedy in California’s San Fernando Valley Feb. 9 marked the 40th anniversary of one of VA’s greatest tragedies. In 1971, at approximately 6 a.m., an earthquake along the San Andreas Fault destroyed the San Fernando VA Hospital in the town of Sylmar in Southern California. Forty-six people lost their lives, including 36 patients and 10 VA staff. Since that time, VA has become a leader in the federal government in addressing seismic safety. Several new hospitals have been constructed and dozens of buildings have been strengthened to protect occupants from the risk of an earthquake; hundreds of millions of dollars have been dedicated to this effort. Seismic safety continues to be one of the top priorities in VA’s construction program. Many projects are underway today and others will be funded in the next several years to continue to improve the safety characteristics of VA facilities.

34 VAnguard • March/April 2011 HAVE YOUOUTLOOK HEARD

Patient Donates Her Artwork to Indianapolis VAMC The Richard L. Roudebush VA Medical Center in Indianapolis is displaying four paintings created and donated by a patient. Cherie Zacharkiw’s paintings depict soldiers from World War II, Korea, Vietnam, and Iraq/Afghanistan. Zacharkiw, a civilian pilot, flight instructor and artist, enlisted in the Marine Corps after 9/11 to serve her country, as her father had in Vietnam. But midway through boot camp, she sustained a permanent, debilitating back injury and was medically retired. Her three back surgeries at VA medical centers in Alabama, Flor- ida and Ohio gave her a deep appreciation for the dedication and commitment of VA staff. Zacharkiw is married to Paul, an Israeli Army veteran she met when he called her after seeing her paintings of Israeli soldiers on courtesy of indianapolis vamc the Internet. They are the parents of 14-month-old Neta. Zacha- A debilitating back injury left Cherie Zacharkiw unable to sit rkiw says painting soldiers is her way of paying tribute to the men up for lengthy periods, so she does her artwork lying down. and women of the armed forces, and giving some of her works to the medical center allows her to honor both veterans and staff. Her service-related back injury left her unable to sit up for lengthy periods of time; she does her artwork lying down while her child naps. A typical painting takes about 10 hours to complete, spread over several weeks.

Welcome to My VA Maryland Health Care System The VA Maryland Health Care System introduced its “Welcome to My VA Maryland Health Care System” organizational pride campaign last fall to highlight the distinctive contributions employees, volunteers and patients make to the health care system’s success. The campaign banners rotate throughout the system in hallways, on the Web page, electronic bulletin boards, and on banners outside the Baltimore and Perry Point VA medical centers and the Loch Raven VA Community Living & Rehabilitation Center. Commut- ers are also noticing the campaign bumper stickers on vehicles throughout the state. The campaign has received numerous accolades, and several other VA medical centers across the country have expressed interest in duplicating it at their facilities. The success of the campaign became the inspiration for the cover of the new VA Maryland patient resource guide. This publication will be used at outreach events throughout the state, so the campaign theme was changed to “Welcome to Your VA Maryland Health Care System” to remind potential patients that they too are part of the VA Maryland family.

National Caregiver Support Line Now Operational A new toll-free telephone line to provide support to the caregivers of veterans of all eras is now fully operational. The National Caregiver Support Line—1-855-260-3274—serves as the primary resource and referral center to assist caregivers, veterans and others seeking caregiver information. The line unofficially started Feb. 1, and in its first week logged nearly 600 calls, including 134 referrals to local VA caregiver support coordinators and 233 calls from caregivers themselves. The support line provides information on new caregiver benefits, referrals to local caregiver support coordinators, and emotional support to those concerned about their ability to provide care to loved ones who are veterans. It is open Monday Volunteer and veteran Walter through Friday, 8 a.m. to 11 p.m., Eastern time; and Saturday, 10:30 a.m. to 6 p.m., White Jr. is featured in VA Eastern time. Licensed VA social workers and health technicians staff the support line. Maryland’s organizational pride campaign.

VAnguard • March/April 2011 35 HONORS

VA’s Clinical Research Illinois Employee Pharmacy Coordinating Elected to Lead Blacks Center Presented Baldrige in Government Trophy David A. Groves, Equal Em- In December, Vice President ployment Opportunity man- Biden presented the VA Coop- ager at the VA Illiana Health erative Studies Program Clinical Care System in Danville, Ill., Research Pharmacy Coordinat- has been elected National ing Center with the Malcolm Board Chair of Blacks in Gov- Baldrige National Quality ernment. BIG currently has Award, making it the first VA more than 400 chapters bro- organization to receive this ken out in 11 regions through- prestigious award and only the out the United States, Guam, second federal program to be so Puerto Rico and the Virgin honored. Named after former courtesy of nist Islands. The National Board Commerce Secretary Malcolm Vice President Joe Biden and Commerce Secretary Gary Locke of Directors determines the Baldrige, the award recognizes flank Thelma Salazar and Dr. Mike Sather of the Albuquerque- policy of the organization and based center. organizational excellence in the has the authority to undertake business, education, health care, and nonprofit/government sectors. Accepting on behalf of the Co- all appropriate actions that re- ordinating Center was Dr. Mike R. Sather, director of the Albuquerque-based center, and Thelma quire national attention. Salazar, assistant center director. Part of the VA Research and Development Program, the Coordinating Center manages the pharmaceuticals and devices that are used in clinical research trials conducted within the VA health care system. The center has played a key role in landmark studies on the routine use of aspirin to prevent heart attacks, the use of deep brain stimulation to treat advanced Parkinson’s disease, and revolutionary treatments for heart failure. In the 23-year history of the Baldrige Award—the nation’s highest for quality and performance organizational excellence—only one other federal agency, the U.S. Army Armament Re- search, Development and Engineering Center, has been similarly recognized. Find out more about the VA Cooperative Studies Program Clinical Research Pharmacy Coordinating Center at www. research.va.gov/programs/csp/abq.cfm.

Florida’s Marchese Recognized for Homeless Center North Florida/South Georgia David A. Groves Veterans Health System employee Vianne Marchese re- BIG was established in ceived a Secretary’s Award for 1975 and incorporated in Excellence for her leadership 1976 by a small group of in establishing the HONOR African American employees Center (providing Hope, in the Department of Health Opportunities, Networking, and Human Services’ Public Outreach and Recovery) in Health Service. The organiza- Gainesville, Fla. The award tion was viewed as essential was presented by Secretary to the black civil service Eric K. Shinseki during VA’s robert turtil employee, based on a wide as- national forum on ending Vianne Marchese accepts her award from VA Secretary Eric K. Shin- sortment of racial issues faced homelessness among veterans. seki at the homeless forum. by employees. Initially, it was The HONOR Center is thought that the umbrella or- a state-of-the-art facility providing comprehensive homeless programs, including Permanent Sup- ganization would only address ported Housing, HUD-VASH, Grant and Per Diem Transitional Housing, Health Care for Re- problems at the federal level. Entry Veterans, and Veterans Justice Outreach. The facility also features The Residence, a 45-bed However, it was soon deter- domiciliary designed to meet the needs of homeless veterans who are disabled or in need of a place mined that state, county and to recuperate from health care crises or serious illness. The 24-hour, homelike facility offers private municipal black employees and semi-private rooms, with the ability to serve up to six female veterans. were faced with the same general employment problems.

36 VAnguard • March/April 2011 OUTLOOKHONORS

Two Honored for Clinical ‘Who’s Who’ Program Simulation Excellence Recognizes VBA’s Top- VA employees Dr. David Perfoming Employees M. Gaba and Timothy The Veterans Benefits Ad- W. Liezert were recently ministration’s “Who’s Who” named the first recipients Program recognizes outstanding rating veterans service of the Under Secretary for representatives and veterans Health’s Awards for Excel- service representatives nation- lence in Clinical Simula- wide. The program is part of tion Training, Education VA’s Claims Transformation and Research. Simulated Initiative, a series of process, learning enhances patient performance and technology- safety by ensuring clinicians curt campbell centered improvements de- receive experience on virtual signed to “break the back of “patients” to improve procedural performance. the claims backlog” and pro- Gaba, staff anesthesiologist at the VA Palo Alto Health cess veteran claims within 125 Care System, was recognized for his numerous contribu- days with 98 percent accuracy by 2015. tions to the field of clinical simulation over the past two Who’s Who recognition decades. He created the first modern mannequin-based is given to RVSRs and VSRs fully interactive simulator, which has since been com- who spend at least 80 percent mercialized and, along with his curricula, is in use in of their time processing veter- thousands of simulation training and education programs ans’ claims and meet or exceed around the world. established performance stan- Liezert, director of the Orlando VA Medical Center, dards with at least 95 percent was recognized for his role in championing clinical simula- accuracy. A maximum of 25 tion practice at the facility, and in support of VA efforts to top-performing RVSRs and establish its Simulation Learning Education and Research VSRs in the Veterans Service Network (SimLEARN) as a program of peerless excellence. Centers and five at the Pen- sion Management Centers are To learn more about the SimLEARN program, visit www. Dr. David Gaba, top, and Timo- recognized each quarter. simlearn.va.gov. thy Liezert were recognized for championing clinical simulation. Final selections are those shown to be the highest, most accurate producers. The third VA Maryland Health Care System Voted Best Place to Work and fourth quarter fiscal year In the February issue of Baltimore Magazine, the VA Maryland Health Care System was 2010 winners are currently named one of the Best Places to Work. Baltimore Magazine’s Best Places to Work issue featured at vbaw.vba.va.gov/ recognizes businesses based on pay, perks and benefits. transformation/who on the In the profile about the VA Maryland Intranet. Health Care System, the magazine notes, For fiscal year 2011, in “The pride in one’s mission is something addition to quarterly recogni- you hear time and again when you talk tion, VBA will also annually to staffers, many vets themselves, at Balti- select the RVSRs and VSRs more’s VA Hospital, which is next to the who are the top Who’s Who University of Maryland Medical Center. performers for the entire fiscal And aside from benefits, pay and perks, year in the Eastern, Southern, Central and Western Areas. that’s something that makes people want One RVSR and VSR from to roll out of bed for work in the morn- each area and one RVSR and ing.” VSR from the Pension Man- The VA Maryland Health Care Sys- agement Centers will be in- tem joins the ranks of companies such as vited to headquarters to receive Baltimore Magazine’s Best Places to Work issue rec- The Johns Hopkins Hospital & Health an award of $1,000 each and ognizes businesses based on pay, perks and benefits. Care System, Northrop Grumman Cor- special recognition from the poration and Under Armour in the magazine’s 2011 Best Places to Work honor roll. The Under Secretary for Benefits. health care system also has the distinction of being the only federal agency in Maryland to be named by Baltimore Magazine as one of the Best Places to Work for 2011.

VAnguard • March/April 2011 37 HONORS

VA Police Service is a Doctor Honored for Family Affair in Omaha End-of-Life Care Serving in law enforcement is Eric Widera, M.D., director of a proud tradition for the Ven- hospice and palliative care at ditte family of Omaha. Two the San Francisco VA Medi- veterans of the Omaha Police cal Center and an assistant Department proudly celebrat- professor of geriatrics at the ed the promotion of a third University of California San member of their family during Francisco, is one of five Ameri- a ceremony at the VA medical can physicians honored for center in Omaha in January. improving the care of patients Retired OPD veterans near the end of life. He is a Sgt. Charlie Venditte and Lt. recipient of the second annual Bernie Venditte celebrated the Hastings Center Cunniff- promotion of Ross Venditte to Dixon Physician Awards in the a lieutenant in the VA police ted wzorek early-career physician category. service. Sgt. Venditte retired Retired Sgt. Charlie Venditte pins the lieutenant badge on his son, Widera was honored for from the OPD in 2003; Lt. Lt. Ross Venditte. his humility, commitment to Venditte retired in 1993. Lt. patients and their families, and Ross Venditte is a two-year veteran of the VA Nebraska-Western Iowa Health Care System’s po- leadership in creating forums lice service, which provides law enforcement and security for health care facilities in Nebraska and of communication on geriatric western Iowa. Ross Venditte is a bicycle patrol, defensive tactics and firearms instructor. He previ- palliative care issues. ously served at the Federal Bureau of Prisons. VA police services provide protection of medical centers and other facilities operated by the Department.

Lovell Physician Selected as Top Doctor for Women Dr. Janice Laurie Gilden, Captain James A. Lovell Federal Health Care Center diabetologist/endo- crinologist, was recently recognized as one of the “top doctors for women” in the January issue of Chicago magazine. “I was pleasantly surprised, as I was not previously informed about this nomina- tion,” said Gilden. “A colleague informed me about the award, and I am truly proud to be cited with such an honor.” Gilden was among 250 area physicians honored with the recognition. According to the magazine article, a health care research and information company surveyed doctors and hospital medical leaders before screening doctors for the final selection that was published Eric Widera, M.D. in the Chicago article. Gilden has been cited twice in previous editions of the magazine, The awards were given and believes the award is largely attributable to by the Cunniff-Dixon Foun- jonathan friedman her colleagues and the institutions where she’s dation, whose mission is to Dr. Janice Gilden practiced her profession, including the Lovell enrich the doctor-patient FHCC, Rosalind Franklin University of Medicine and Science/Chicago Medical School, and relationship near the end of Saints Mary and Elizabeth Medical Center. life, in partnership with The Hastings Center, a bioethics research institute that has done 2011 Under Secretary’s Award in Health Services Research pioneering work on end-of- Paul G. Shekelle, M.D., Ph.D., received the Under Secretary’s Award for Outstanding Achieve- life decision-making. Awards ment in Health Services Research—the highest honor for a VA health services researcher—at the were made in three categories: 2011 Health Services Research and Development National Meeting. Shekelle is chief of general senior physician, for leadership internal medicine at the VA Greater Los Angeles Healthcare System, and a professor of medicine in end-of-life care; mid-career in residence at the David Geffen School of Medicine at UCLA. physician, for longstanding He has met the major criteria for this award by: improving understanding of factors that affect commitment and leadership in the health of veterans and improving their quality of care; contributing to the future of VA health palliative care; and early-career, services research by inspiring and training the next generation of investigators; and enhancing the for serious commitment to the visibility of VA research through national recognition within the research community. To learn field and contribution through more, visit the HSR&D website: go.usa.gov/gu8. research or clinical work.

38 VAnguard • March/April 2011 OUTLOOKHEROES

Two N.C. Employees Credited with Saving Lives Two Durham (N.C.) VA Medical Center employees were recently involved in separate lifesaving incidents. Dr. Hamid Afshari, Oral Medicine and Dental Anes- thesiology attending, dashed to the airport to catch a flight back after speaking at a VA dental conference in Arizona. His original flight had been cancelled and he barely made an earlier scheduled flight. During the flight, Afshari responded to the pilot’s request for someone with medical training to help a passenger in distress. After assessing the passenger, Afshari immediately suspected severe cardiac distress and realized the woman was in agony. He requested that the plane be diverted. As the woman’s condition worsened, Afshari monitored her, collected measurements, recruited help, and started an IV. Once the plane landed, he turned the critically ill passenger over to paramedics. Nurse Educator Kathy Burgess was attending an event with her family at the Tomb of the Unknowns at Arling- ton National Cemetery when she was alerted to a man pete tillman choking in a restroom. When she arrived, the man was Kathy Burgess and Dr. Hamid Afshari responded to calls to put their unconscious and needed to be pulled from underneath the medical training to use helping people in need. stall. To the amazement of her family, Burgess jumped in and started CPR. After 10 minutes, she had recruited help to continue for another 10 minutes until paramedics arrived for the hand-off. Both patients were later reported to be doing well.

Alabama Bus Driver Saves a Veteran’s Life Saving a Life on Super Bowl Sunday Bus driver Michael Stephens was transporting patients to On the morning of Super Bowl Sunday, Dr. Joel Haas, the Birmingham (Ala.) VA Medical Center when he heard a staff physician at the Rochester (N.Y.) VA Outpatient a woman on the bus yell Clinic, set out to go skiing with his two youngest children. that her husband needed As they turned out of their neighborhood, they ended up help. Stephens immediately behind a white truck that began swerving and then lunged evaluated the man, realized off the road into a snow bank. It was a nice day and the he was in cardiac arrest, and roads were dry, so Haas knew the driver’s loss of control instructed personnel to call was not due to bad weather. He pulled off the road in a code. Stephens adjusted front of the truck and ran back to make sure the driver the man and began CPR. and passenger were OK. He continued CPR until he A distraught woman got out of the truck on the pas- was relieved by medical per- senger side and told Haas her husband had a heart condi- sonnel. Those on the scene tion and she thought he’d had a heart attack. Haas found said Stephens was calm and her husband unconscious behind the wheel, in full cardiac professional throughout the arrest, without pulse and not breathing. He pulled the emergency. man out of the truck and onto the snow bank and imme- Less than a month be- diately began CPR. Haas’ son talked to the 911 dispatcher, fore, Stephens had a similar Michael Stephens and the emergency crew arrived within five minutes. situation on his bus and fol- They restored the man’s heart to normal rhythm and lowed the same procedure to render timely assistance to a took him to a local hospital. Haas called the hospital an veteran in distress. “Mike is a true professional who on a hour later to check on the man’s condition, and was told daily basis is complimented and appreciated by passengers he was awake and alert. The family contacted him at the that ride his bus,” said Michael A. White, transportation clinic three days later to let him know the man underwent program manager at the VAMC. “His performance over bypass surgery and was doing well. the past month has been truly exceptional when serving On March 9, Haas received an award from the North our veterans. He is an individual who cares for their wel- Greece (N.Y.) Fire Department recognizing his actions fare and comfort and shows it on a daily basis.” that day.

VAnguard • March/April 2011 39 Night of Nostalgia The Platters, one of the most popular and successful groups of the Doo-wop era, rolled back the years to create a night of nostalgia for a festive crowd on Feb. 11 at Georgia Tech’s Ferst Center for the Arts in Atlanta. The concert, during which the group performed hits like “Only You” and “Smoke Gets in Your Eyes,” was a highlight of the Atlanta VA Medical Center’s National Salute to Veteran Patients activities. Mizanuel Phillips, a resi- dent of the Atlanta VA’s Community Living Center, got a poster autographed by the Platters after the concert.

ann hamilton