Women’s History the U.S. Army has witnessed a included work in public health, lot during her life. labor and delivery, and home Month made When Mary E. Walton, R.N., health care. looks back, she considers her Walton’s first experience with extra special for life as one lived with purpose. “I the Department of Veterans a woman who believe being a nurse is exactly Affairs was in the late ‘50s when what God intended for my life,” she came seeking a job; but made history she said. “I love serving and blacks weren’t allowed at that hope when people mention my time. She returned to VA in name, they recall my service and 1978 as a caregiver when she dedication.” accompanied her husband (now Walton expressed an interest deceased), also a World War in health care from early child- II Veteran. She became a VA hood and recalls administering patient herself a little more than first aid to family and friends 30 years ago. and helping doctors to deliver When she was more recently babies in black people’s homes. admitted to the Dallas VA Medical “I didn’t know what a midwife Center, she made quite an was back then,” she said with a impression with her personable giggle, “but I guess that’s what I demeanor and openly sharing her was doing.” journey from a young neighbor- The Dallas native worked hood nurse to a highly skilled, as a candy striper at the city’s educated professional. Baylor Hospital, and it was there Pete Dancy, associate that she met a white nurse who director of VA North Texas she recalls “took her under her Health Care System, asked wing.” The nurse helped Walton retired Air Force Brig. Gen. Tom to enroll at Brewster Methodist L. Daniels if he would honor Hospital-School of Nursing in Walton with a visit. Daniels, a Jacksonville, Fla., which at the Vietnam Veteran, was recently time, was affiliated with Florida appointed as a member of the A & M University (FAMU) and Secretary’s Advisory Committee was also one of the few schools in for Minority Veterans. the country On March 19, he made a available to black nurses. surprise visit to Dallas VA After graduating from Medical Center to see Walton Retired Air Force Brig. Gen. Tom L. Daniels Brewster and FAMU, Walton and declared her to be “General visits WWII Veteran Mary E. Walton at the continued her studies at Howard for a Day.” Dallas VA Medical Center in March. The So how does an award- highly decorated Vietnam Veteran and University in Washington, D.C., current member of the Secretary’s Ad- and in 1944, she joined the winning nurse, who practiced visory Committee for Minority Veterans, for more than 70 years, rate VA declared Walton to be a “General for a Army as a first lieutenant. Day” during his surprise visit. Following her return from health care? World War II, Walton took on “It’s as perfect as perfect By Erika Neroes her first assignment with the can be,” Walton said. “The only A 93-year-old World War II city of Dallas at Parkland Hospi- problem I have is I sometimes Veteran and possibly the first tal – becoming its second black get cold, but I understand they black nurse from Dallas to join nurse. Her career eventually can’t heat up the whole building just for me.”

VA_Vanguard FINAL (MAY 10).indd 2 5/10/2013 1:58:26 PM Inside VA nguARD Features 2 Women’s History Month Made Special VA’s Employee Magazine 4 Veterans Gets Help From VA To Rebuild His Future Spring 2013 6 Million Hearts Campaign To Fight Heart Disease Editor/Senior Writer: Gary Hicks 8 COVER: Veterans Compete At Nordic Skiing World Cup

StaffWriter: Jennifer Sardam 10 Former VA Deputy Administrator At Asheville VAMC 12 Joining Forces At Durham VA Photo Editor: Robert Turtil 14 Sen. Daniel K. Inouye Laid To Rest Published by the Office of 16 Veteran Rocks With Georgia Overdrive Public Affairs (80D) 18 Veteran HR Specialist Erick Walton U.S. Department 19 of Veterans Affairs Helping Hands: VA Tennessee Valley Health System 810 Vermont Ave., N.W. 27 Formerly Homeless Veterans Get Housing Assistance Washington, D.C. 20420 28 Music Therapy Helps Soothe PTSD Symptoms (202) 461-7427 30 Veterans With TBI Aided With Acupuncture E-mail: [email protected] www.va.gov/opa/publications/ 31 Fitzgerald And Puppies Behind Bars vanguard.asp 32 Blind VA Doctor Sees Patients Differently 33 DMA Marks Two Years Of Improvement 34 Revolutionizing Long-Term Patient Care 36 Celebrating 90 Years Of Service 38 VA Warriors To Workforce Program

Departments COVER PHOTO: Army Veteran Jeremy Wag- 20-23 Around HQ ner prepares for his race at the Interna- tional Paralympic Committee Nordic Skiing World Cup in Cable, Wis. Wagner was one 24-25 Medical Advances of eight Veterans on the 11-man U.S. team at the event in January. (Photo by James 26 Introducing Netz)

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VA_Vanguard FINAL (MAY 10).indd 3 5/10/2013 1:58:29 PM Army Veteran Shane Nuttle shares a light moment with VA Speech and Language Pathologist Natalie Hartgrave while receiv- ing speech therapy. Photo by Christopher Beshears

the injury,” he said. “From what I’ve been told by other people in my platoon, (the IEDs) were completely unexpected and there was nothing that could have been done to prevent it.” Diagnosed with a severe traumatic brain injury that affected his speech, vision, balance, coordination and cognitive thinking, he had problems with his attention span, learning and decision- making. His injuries were so extensive that doctors said he would have to undergo intensive rehabilitation just to live independently. In March, Nuttle was admitted to the VA Polytrauma veteran gets help from Rehabilitation Center at the Minneapolis VA Medical Center, one of five PRCs around the VA to REBUILD HIS FUTURE nation. He underwent compre- hensive inpatient treatment and had to re-learn how to do basic By Nathan Schaeffer Balad when a roadside bomb things such as eating, walking Shane Nuttle’s Army career detonated near his Humvee. and talking. got off to a great start after The Pawnee, Okla., native “Basically, I had to change he earned his “Jump Wings” in suffered a ruptured spleen, every aspect of the way I lived 2004 with a vision of a 20-year broken jaw and several broken my life before the IED,” said Army career ahead of him. bones in his face and was Nuttle. “I’ve done a lot of therapy The newly minted paratrooper unconscious as Army medics and done a lot of recovery. It was immediately assigned to treated his wounds on the pretty much affected everything 2nd Battalion, 506th Infantry battlefield. He was evacuated in one way or another.” Regiment at Fort Campbell, Ky., to a U.S. military hospital in Two months later, Nuttle and shortly thereafter, deployed Baghdad, then Landstuhl, was discharged from the to Forward Operating Base Germany, and finally to Walter Minneapolis VA Medical Center, Falcon, just outside Baghdad in Reed Army Medical Center and the Army allowed him to November 2005. in Washington, D.C. Nuttle return to Pawnee to live with Exactly two months after remained in a coma for two his parents for the remainder hitting the ground, Nuttle was weeks following the blast. of his enlistment. on patrol with his platoon in “I don’t remember the day of At home, he helped his

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VA_Vanguard FINAL (MAY 10).indd 4 5/10/2013 1:58:31 PM father raise cattle on the family possibility of going to college for Hartgrave got me back to ranch, but he had trouble the first time in his life. wanting to live a life somewhat accepting his inability to do “His goal was to spend close to what I used to live,” he the same amount of work he 20 years in the military,” said said. “The VA has done a lot.” had done prior to his injury. Hartgrave. “He never pictured Nuttle was accepted “Before, I was very hyperactive himself going to college and he into the Wounded Warrior and hardly ever slowed down,” hadn’t imagined what he’d do Project’s TRACK program in said Nuttle. “Now, I’m not on up until that point.” San Antonio and began living the go nearly as much and I’m The 29-year-old set a goal of on his own in January. not nearly as active as I was attending Texas A&M University before. A lot of that also has to do and earning a bachelor’s degree. with some depression issues.” It would not be easy, but he was “The biggest thing I’ve While at home, he received determined. seen in him is a change treatment through the Oklahoma “Brain injury recovery is City VA Medical Center and different for everyone, and in his self-esteem.” Jack C. Montgomery VA Medical the ones who make the most When he set a goal Center in Muskogee. improvement are the ones who that we helped him In 2008, he began receiving are willing to accept that ‘yes, treatment through the Muskogee something really bad happened, define, he’s just worked VA’s Polytrauma Support Clinic but it’s not going to keep me so hard at it. He’s Team (PSCT). from moving forward in life,’” been very goal-driven PSCTs are responsible for said Hartgrave. “Their attitude managing the care of Veterans plays such a big part in how they once we’ve helped who have suffered polytrauma recover and he’s definitely been him define goals.” or TBI and assists them with the role model for that.” integration back into their home Benge and Hartgrave or community. encouraged Nuttle to start small Dr. Jodi Yelverton, PSCT and enroll in classes locally at director, and Janet Potter, social Tulsa Community College. worker, met regularly with “For the first four weeks of Nuttle, while the entire PSCT the semester, I didn’t like being staff met weekly to discuss his in the classroom setting,” said needs and progress, as well as Nuttle. “I was uncomfortable. other Veterans under their care. I get distracted easily and it’s In 2010, neuropsychologist hard to focus on one thing or Dr. Jared Benge began working somebody speaking.” with Nuttle to help him start To help him with the thinking about the next stage of coursework, Hartgrave taught life beyond his rehabilitation. him study skills and organization In 2011, speech and language techniques such as setting pathologist Natalie Hartgrave reminders in his smartphone also worked with Nuttle helping and writing out checklists before him with his goals, as well as beginning a task. speech therapy. Nuttle not only completed During his meetings with both courses, but also received Benge and Hartgrave, Nuttle an “A” in each class. seriously considered the “Dr. Benge and Natalie

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VA_Vanguard FINAL (MAY 10).indd 5 5/10/2013 1:58:32 PM Million Hearts: Photo credit – VA file photo Million Hearts Campaign To Fight Heart Disease

Since 2011, VA and the prevention efforts here at VA.” we serve,” said Roxane Rusch, Department of Health and Maddox said the campaign deputy assistant deputy Under Human Services have been encourages a targeted focus Secretary for Health for Quality, working together to promote the on the “ABCS”— Aspirin for Safety and Value. “This means Million Hearts™ campaign — a people at risk, Blood pressure focusing on the individual’s national initiative with a goal control, Cholesterol manage- experience as well as how we of preventing 1 million heart ment, and Smoking cessation are improving population health attacks and strokes by 2017. — all of which address the major over time. “The Million Hearts™ risk factors for cardiovascular “Participating in a campaign campaign wants to empower disease and can prevent heart of this magnitude,” she added, Americans to receive appropriate attacks and strokes. “reinforces the new ‘value equa- care for cardiac risk factors and “As the largest integrated tion’ everyone is talking about make healthy choices such as health care system in the United in health care these days. A avoiding tobacco use,” said Dr. States,” Maddox said, “we are an dedicated focus on value Thomas M. Maddox, a cardiologist integral partner in realizing these transforms our culture and our with the VA Eastern Colorado goals. In fact, VA has already teams, to create highly reliable Health Care System and lead for made large strides in achieving and safe systems, patient-driven the Veterans Health Adminis- excellence in identifying and care, and world-class quality.” tration/Million Hearts Initia- controlling these risk factors.” “Many Veterans in our VHA tive partnership. “They are an “Our goal is to provide high primary care population have invaluable partner in our disease value care for all the Veterans chronic conditions, and have

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VA_Vanguard FINAL (MAY 10).indd 6 5/10/2013 1:58:34 PM multiple diagnoses,” said Dr. these lifestyle changes will make smoking, alcohol use, stress Lisa Backus, national clinical a difference, and that’s why management, clinical preventive Million manager for VA’s Office of initiatives like the Million Hearts™ services, safety, and health care Population Health. “Of this campaign are so important in communication. population, 52 percent have helping us get the word out.” “We chose these topics,” Hearts hypertension, 36 percent have In its efforts to place more she added, “because of their obesity, 24 percent have emphasis on disease prevention, importance in reducing chronic diabetes, and 18 percent have VA has established a Health disease morbidity and mortality Campaign coronary heart disease. Promotion/Disease Prevention and improving quality of life. “By talking with our patients Program Committee at every VA Our Healthy Living messages To Fight about healthy lifestyle choices,” facility. Committee members will communicate to Veterans a she said, “and by encouraging represent a range of disciplines better way to live.” those who are motivated to take and content areas. Their job is to “The Million Hearts™ Heart small steps toward healthier oversee the prevention-related campaign is an important part- living, we can work with them activities of the facility and to ner in our disease prevention to improve their health, avoid or support VA’s “Healthy Living” efforts,” said Dr. Robert Jesse, Disease mitigate cardiovascular disease, campaign. VA’s Principal Deputy Under and reduce their chances of “We launched our Healthy Secretary for Health. “We’ll suffering a heart attack or stroke.” Living Campaign in 2011 to continue communicating our “While we’ve been successful encourage VA health care Million Hearts™ goals to our with tobacco and alcohol providers to continually front-line providers and patients. interventions here at the VA,” emphasize specific healthy We’ll continue promoting she continued, “I believe we living messages and suggestions effective management of the can help our patients achieve when talking with their patients,” ABCS goals through our Patient still greater success. That’s why explained Linda Kinsinger, VA’s Aligned Care Teams and our we’re putting increased focus Chief Consultant for Preven- Healthy Living campaign. And on helping our patients quit tive Medicine. “These messages we’ll continue to identify and smoking, lose weight, eat cover core prevention areas partner with community efforts healthier, and become more including nutrition, physical to promote and improve smoking physically active. We know activity, weight management, cessation and heart health.”

V A’s FIVE MAJOR GOALS 5) Identify and partner with (www.ucanquit2.org) website, 1) Communicate Million community efforts to promote through a VA partnership with the Hearts™ goals to front-line and improve smoking cessa- Department of Defense/TRICARE, providers and patients; tion and overall heart health. is targeted to meet the needs of 2) Demonstrate VA’s perfor- younger active military and mance of the ABCS goals Want to kick the habit? Veteran populations by providing and share best practices VA can help online tools to quit tobacco and achievement; VA’s Quit Tobacco website use, such as live chat services, 3) Promote effective manage- and the annual Great American personalized quit plans, and other ment of ABCS goals through Smokeout campaign are interactive support systems. To Patient Aligned Care Teams; coordinated by the Veterans date ,the rate of smoking among 4) Promote research in the Health Administration’s Tobacco Veterans in VA has decreased achievement of the ABCS goals, & Health: Policy & Programs noticeably, from 33 percent in opportunities for improvement, Clinical Public Health Office. 1999 to 19.7 percent in 2011. and implementation of The “QUIT TOBACCO – effective interventions; and make everyone proud”

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VA_Vanguard FINAL (MAY 10).indd 7 5/10/2013 1:58:34 PM Veterans compete

at Nordic Skiing World Cup ByIn Mike Molina ForceHe remembers a visit to a wing Veteran athletes tell me they picked It was an accident not unheard of hospitalized Veterans all of them biathlon because it was the most of for a young combat Veteran. amputees. challenging and most similar to In June 2008, Omar Bermejo “There was this guy who lost his their combat job – moving and had recently returned from his leg above the knee. He was telling shooting.” fourth deployment to Iraq. The me ‘Don’t give up. Don’t cash in. Army Veteran Jeremy Wagner then 27 year-old Marine Corps Give it your all.’” wasn’t sure if biathlon was for him sergeant was racing through life, Today, Bermejo is a competitive when he was first asked to try the searching for the familiar rush Nordic skier with hopes of making sport. of fear and adrenaline that had the 2014 Paralympics in biathlon, a In 2007, after a year in Iraq, he been fueled by bullets and IEDs combination of cross country skiing too returned home and suffered only months before. He bought a and marksmanship. He was one a motorcycle accident. The crash motorcycle with the money he’d of eight military Veterans on the injured his spinal cord and he lost received as a bonus for his service. 11-man U.S. biathlon team at the the use of his legs. The curve, the gravel, a sense International Paralympic Commit- “After my injury I was just taking of invincibility, all caused him to tee Nordic Skiing World Cup in it one day at a time,” Wagner said. “I lose control of the bike, he said. He Cable, Wis., Jan. 12-20. did some rehab on my own, but my slammed into a guardrail nearly The number of Veterans who cousin helped me go to the VA.” severing his arm between the bike competed in the event is an example The Hawaii native was treated and the metal. Many surgeries later, of the joint efforts by the VA and SU at the Palo Alto VA Medical Center’s doctors would amputate his arm at Paralympics, a division of the United Spinal Cord Injury Center in California. the shoulder. States Olympic Committee, to provide “That’s where my real road “The day to forget and the day physically disabled Veterans with to recovery began,” he said. “My my life changed,” Bermejo said. “It’s increased opportunities of activity therapist in Palo Alto gave me all true when they say that one of the and wellness. the necessary tools to get me going ways to appreciate life to the full- Through an active recruitment again.” She also introduced him to est, is to almost die.” effort, US Biathlon Paralympic the VA’s National Veterans Wheel- In the aftermath of his changed coach Rob Rosser said he makes chair Games. life he became depressed and visits to military and VA Medical In 2010, while competing in hopeless. “I was pretty down after Centers year round. the Games in Denver, Wagner was my accident,” he said. The once fit “Most Veterans joined the approached by a Paralympics Marine says he gained weight and military because they wanted a biathlon coach. felt out of shape. He decided to challenge, are highly competitive “I guess he saw me doing the use some of his benefits from the and enjoy physical exertion,” he slalom event, and he asked me if I’d Department of Veterans Affairs (VA) said. “Biathlon combines the most be interested in biathlon.” and visited a nearby VA Medical physiologically demanding sport Wagner took a chance and gave Center. of cross country skiing with a up the sandy beaches of Hawaii for “They were awesome, always more mentally challenging sport the snowcaps of the Colorado Rockies. letting me know I’m not by myself,” of marksmanship, under stress of He moved in with his cousin in he said. “I knew it’s not over. My high heart rate and the pressure of Colorado where he now trains time here is not over yet.” the clock running as they shoot. full-time in biathlon.

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VA_Vanguard FINAL (MAY 10).indd 8 5/10/2013 1:58:36 PM Committee and VA. The Fund being medically retired, he was Veterans compete provides grants ranging from $10,000 treated at the Charlie Norwood VA to $25,000 to organizations that Medical Center’s Augusta Blind support Paralympic sport and Rehabilitation Center in Georgia. physical activity programs for “The blind rehab program was disabled Veterans and disabled amazing,” Burton said. “I was really at Nordic Skiing World Cup members of the Armed Forces. worried about losing my remaining In its third year, the fund has vision, but after going through that, provided more than $4 million to I’m not that worried. I know I can 223 USOC partner and community still do pretty much anything.” programs, and has resulted in In March 2012, Burton attended thousands of Veterans with physical the VA’s National Disabled Veterans and visual impairments participating Winter Sports Clinic in Snowmass in sport programs. Village, Colo. It was the first time he’d “The partnership and support been on skis since losing his sight. from the VA has given hope to Like all biathlon athletes, numerous Veterans,” Rosser said. he skis and shoots targets, but “As the programs grow and expand, being visually impaired he has a the entire country gains awareness guide who skis in front of him and of the positive aspects sport offers shouts directions during the cross our Veterans, and the long-lasting country skiing. When it comes time affects it has on their quality of life to shoot the rifle he uses audio cues after the sacrifice they have made and the pitch of a tone to zone in on for our country.” the target. Wagner also receives a monthly “You wear headphones to tell training allowance from the VA. The you how close you are, and if you VA and US Paralympics’ collaborative are on target,” he said. “The normal provides a stipend to athletes who shooting advice doesn’t apply to meet established eligibility require- the visually impaired. It’s strictly His effort has paid off. In June ments, including training commit- distance from the center.” 2012, Wagner was named to the ment and qualifying Despite his newcomer status, 2012-13 US Paralympic Nordic competition standards. Burton went on to win a silver Skiing National Team. “The stipend really helps with medal in Cable and his finishing “You may think, ‘I’ll never be purchasing poles, gloves, all of the time was good enough to earn him at that level,’ but you never know other equipment that’s necessary,” the VA training stipend. until you try,” he said. “A lot of us, he said. “A lot of my success is because we want to be good at something When Kevin Burton arrived of the support I’ve been given from right away. When we don’t, we give at the event in Cable, he was still day one,” he said. “But I’ve still got up. But every champion wasn’t a learning the sport and had yet to to work hard and keep improving.” champion from the start.” qualify for the training stipend. Bermejo agreed. He also Wagner trains at the National In 2010, while on active duty qualified for the training allowance Sports Center for the Disabled in the Navy, he was diagnosed during the event. (NSCD) in Winter Park, Colo. with retinitis pigmentosa, a “Know if you put in the work In October 2012, NSCD was degenerative eye disease. The and have positive thoughts, good named one of 97 organizations to former Arabic linguist had served things will happen,” he said. “The receive a grant through the Olympic nine years with the Navy including opportunities are there, but in the Opportunity Fund, a partnership tours to Iraq and Kuwait when he end, if you want something you will between the United States Olympic began losing his eyesight. Before go get it.”

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VA_Vanguard FINAL (MAY 10).indd 9 5/10/2013 1:58:37 PM Former VA Deputy Administrator gets care at Asheville VAMC

By Dennis J. Mehring Heroes walk among us. about nine kilometers from the closer to the hospital so she If that expression is true city of Pisa, Italy, in July 1944. could see him every visiting anywhere, it certainly has to be Vaughn, a member of the hour. Vaughn received the Silver true in places like VA medical National Guard’s 178th Field Star and Purple Heart for his centers. Yet if you ask most Artillery, stepped on the mine service and sacrifice. Veterans, “Are you a hero?” they while trying to save a wounded When he returned home to are likely to say no. They will tell soldier. He made a tourniquet South Carolina, Vaughn began you that the real heroes are the with his belt to stop the bleeding, working for VA in Columbia, ones who didn’t make it home. and then laid there for hours with later moving on to Florida. They were just doing their job. his comrade, waiting for help. He held a number of positions Heroes walk or roll through A few years ago, Vaughn told during his 35-year VA career. “I the halls and clinics of the a reporter that he prayed to God was a GS-2 greeter in Florida— Charles George VA Medical Cen- to die while he was lying there, did you know there was a rating ter in Asheville, N.C., every day. but when he thought about his that low?” he joked. One of the men who just might wife, Virginia, and his 2-year- He eventually rose from a fall into that category is 91-year- old son, Odell Jr., he realized GS-2 greeter in Florida to Deputy old Odell Vaughn. that praying to die was wrong. Administrator of the Veterans Vaughn is a native of “I had a wife, and a child I had Administration. Vaughn worked Greenville, S.C., who was raised never seen. I quickly changed for Presidents Nixon, Ford and in Spartanburg, S.C. He enlisted my attitude,” Vaughn told the Carter. Vaughn said he liked in the National Guard at age reporter. working for President Ford best. 17—while still a student at He came home a double Vaughn explained that he and Spartanburg High School—to amputee. Vaughn lost his other Ford lived in the same neighbor- serve his country in World War II. leg nine days after the first hood in Washington, D.C., before He was sent to England and later because doctors were unable he became vice president and served in North Africa and Italy. to repair the damage. He eventually president when Vaughn lost one leg to a recuperated in a hospital for Richard Nixon resigned in the German landmine on a battlefield 13 months, and his wife moved wake of the Watergate scandal.

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VA_Vanguard FINAL (MAY 10).indd 10 5/10/2013 1:58:38 PM Vaughn received more than he was impressed with Asheville. 50 awards and other recognition “My treatment has been excellent for his 35 years of service to —couldn’t be better,” he said. Veterans while working at VA. “The people who do the work He’s never let the loss of his are very personable, too. They legs slow him down, according take the time to explain what to those who know him. He’s has to be done.” golfed, skied and hiked, and Vaughn’s time in the military had a reputation as an amateur and political trenches has ended, carpenter and gardener. but he still keeps up with events. He retired from federal He’s had the chance to talk to service, and after a few years of Veterans who served in Iraq and inactivity, he said, “I took a job Afghanistan, many of whom selling life insurance because I are coming home from battle was bored.” Vaughn is not the missing limbs from improvised type of person who likes to sit explosive devices, known as IEDs. still for long. “I’ve been through He said he has an advantage about four sets of legs,” he said. talking to these Veterans because At 91, he has had to make of their common experience. some concessions to age. His Vaughn is a widower now. He back is no longer strong enough and his wife had two daughters to allow him to walk with arti- and one son. His son died in a ficial limbs, so he has been in a helicopter crash a few years ago, wheelchair for four years now. but in spite of all the physical and He stopped driving at around emotional pain he has endured, the same time, explaining that and the weight of 91 years, Odell he thought it was time he stuck Vaughn has a smile and a firm to being a passenger instead of handshake ready for any person the driver. who passes his way. His home in South Carolina Ask him if he is a hero, and is a one-and-a-half-hour drive he’ll probably tell you, “No. I from the Asheville VA, but he has was only doing my job.” been going there to get his medical care since 1999. He said he had shoulder replacement surgery that year. The bad shoulder was a lingering injury from the “I was only landmine explosion in 1944. So why did he choose the Asheville VA when he lives so doing my job.” far away? The answer requires some explanation. Vaughn said - O d e l l V a u g h n that during the time he worked for VA, he visited 72 different facilities across the country, and

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VA_Vanguard FINAL (MAY 10).indd 11 5/10/2013 1:58:38 PM Joining Forces at the Durham VA

Story By Pete Tillman Photo by Linnie Skidmore Joining Forces, an initiative to the issues facing Veterans, health care needs of Veterans, led by First Lady Michelle active duty military and families, having worked at the VA medical Obama and Dr. Jill Biden, the seminar aimed to educate center in Washington, D.C. asks Americans to do more in nurses on how to recognize the “That experience left an indelible support of military service symptoms and devastating impression on me as a young members and their families. effects of traumatic brain nurse,” she said. “We want to The movement features a three- injury and post-traumatic work in close partnership with pronged approach focused on stress disorder. those here, and it does not end employment, education and Dr. Charles Vacchiano, a today.” wellness. professor at the nursing school, After dispelling Hollywood’s The Duke University School opened the seminar. A 26-year portrayal of blast-related trauma, of Nursing recently put together Navy Veteran, he underscored Dr. Bruce Capehart, medical an informative seminar aimed at the importance of mobilization director of the Operation wellness entitled “Joining Forces to meet the critical issues facing Enduring Freedom/Operation at Duke University School of Veterans. More than 625 schools Iraqi Freedom/Operation New Nursing: A Call to Action,” and of nursing nationwide have Dawn Clinic at the Durham VA, the Durham (N.C.) VA Medical pledged support to enhance took care to explain the factors Center answered the call. the preparation of the nation’s that lead to diagnosis and When it came to finding nurses to care for Veterans, treatment of TBI. Capehart, an experts to lead portions of the service members and family Army Veteran called to active seminar, all the organizers members. “This seminar is the duty in 2003 for a deployment needed to do was look across first step to fulfill our pledge,” as the only military psychiatrist Erwin Road to their partners at Vacchiano said. in Afghanistan, recognized that the Durham VA. The Durham Dr. Catherine Gilliss, dean TBI in the civilian population VA’s mission to honor Veterans and vice chancellor for Nursing and military population present by providing health care that Affairs at Duke’s School of differently. improves their health and well Nursing, said she wholeheart- He is urging medical being made for a perfect fit and edly supports the Joining Forces educators to introduce Veterans’ offers two physicians that are campaign and believes it is scenarios into case studies at dually appointed at the Durham matched by the commitment medical schools and knows VA and the Duke University of the nursing profession to the compounding value of School of Medicine. care for those who have given teaching non-VA providers Joining Forces - Taking so much. “Today is more than about Veterans. “Joining Forces Action to Service America’s intellectual interest—we can is important because of the Military Families came to life better understand the nature of community care provided to at Duke’s School of Nursing for the sacrifice made by those who Veterans,” said Capehart. “The approximately 60 attendees, serve,” said Gilliss, the daughter Veterans who served overseas some of whom were Veterans of a Veteran. since 9/11 are using the VA for themselves. By calling attention Gilliss knows the unique health care at an unprecedented

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VA_Vanguard FINAL (MAY 10).indd 12 5/10/2013 1:58:39 PM Dr. Bruce Capehart, medical director of the OEF/OIF/OND Clinic at the Durham VAMC, and Dr. Eric Crawford, psychologist, point at a model brain to aid their discus- sion of Traumatic Brain Injury during a recent interdisciplinary team meeting for returning Veterans.

rate, but we still only see around you can find, and work with symptoms before launching into half of them. Those percentages them,” he said, after noting that the treatment options. are lower for other Veteran a condition this complex can Christy Knight is the cohorts. be matched by the strengths of caregiver support coordinator “It is important for non-VA diverse fields of study. at the Durham VA. She closed clinicians to understand the Dr. Michael Hertzberg, di- the seminar by presenting the unique health care needs of rector of the Durham VA role of the caregiver and the our nation’s Veterans so these Specialized Outpatient PTSD importance of recognizing the men and women can receive Clinic, provided a briefing on needs of those who care for the care they earned,” Capehart PTSD, and in a short amount Veteran patients. continued. His plea to clinicians of time covered the foundation For more information about looking to most effectively treat for the diagnosis and treatment PTSD, visit www.ptsd.va.gov, patients with TBI was in its own of the disorder. He defined the and for more information about right a call to action: “Seek out disorder and proceeded to TBI, visit www.polytrauma. the best interdisciplinary team talk about the diagnosis and va.gov/understanding-tbi.

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VA_Vanguard FINAL (MAY 10).indd 13 5/10/2013 1:58:39 PM Senator Daniel Inouye interred at Punchbowl

Top and Left: Family and distinguished guests, includ- ing President Obama and First Lady Michelle Obama, attended the memorial services of Sen. Daniel K Inouye National Memorial Cemetery of the Pacific in Honolulu Dec. 30, 2012. Inouye was a U.S. Army World War II com- bat veteran with the 442nd Regimental Combat Team, who earned the nation’s highest award for military valor, the Medal of Honor. Bottom Right: Former Senator and WWI Veteran Bob Dole (left) and Sen Inouye (right) during Gen. Eric Shinseki’s confirmation hearing for Secretary of Veterans Affairs on Jan. 14, 2009 . Photos by Defense Media Activity

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VA_Vanguard FINAL (MAY 10).indd 14 5/10/2013 1:58:42 PM By Nadine L. Siak Senator Daniel K. Inouye, a ‘What would they have achieved, American dignitaries that leading Veterans advocate for had they not died? I owe my included President Barack more than 50 years, was laid to success to them.’” Obama, Cabinet members, at rest at the National Memorial Inouye’s first wife of almost least a dozen members of Cemetery of the Pacific in 57 years, Maggie Awamura, was Congress, scores of general Honolulu Dec. 30, 2012. At the buried in Section D in 2006 and flag officers—and the few time of his death on Dec. 17 after a battle with cancer. remaining members of the 442nd. at age 88 from respiratory “But even before his wife Foreign dignitaries attending complications, Inouye was the passed away,” Castagnetti says, included a former prime minister most senior member—or president Inouye often stated his “desire of Japan, several ambassadors pro tempore—of the Senate, to be interred with his com- to the United States, and the making him third in line for rades-in-arms at this national governor of American Samoa. the presidency. shrine.” Altogether, close to 400 His eligibility to be interred at Inouye also joined 31 other dignitaries joined local residents a VA national cemetery, however, Medal of Honor recipients at the Punchbowl to say a final stemmed from his service in who have been interred at the farewell to Inouye. World War II as a member of Punchbowl. His grave marker, The memorial service the famous 442nd Regimental like theirs, is etched in gold and included an Army band playing Combat Team, considered to be includes the Medal of Honor patriotic music, a firing detail, the most decorated infantry Medallion. The inscription an F-22 Raptor flyover in the regiment in the history of the beneath his dates of military Missing Man formation, and a United States Army. service poignantly states: “Son joint service casket team led by a The 442nd was a fighting of Hawaii.” member of the Military District unit composed almost entirely Inouye had served the people of Washington’s Old Guard (the of American soldiers of Japanese of Hawaii since 1954, when he Army regiment famous as the descent who volunteered to fight began his career as an elected sentinels at the Tomb of the in World War II even though their official in the Hawaii Territorial Unknowns at Arlington National families were subject to intern- House of Representatives. He Cemetery). In addition, in a ment. More than 400 veterans went on to be their representa- break with tradition, a sitting of the 442nd are interred at the tive on Capitol Hill from the time member of Congress, Senator Punchbowl, as the cemetery is Hawaii became a state in 1959. John Tester of Montana, played colloquially known. To mark the His contributions to America taps instead of a military bugler. significance of this, the few were great; his contributions to The memorial service remaining members of the Hawaii were even greater. That commenced with a 19-gun 442nd’s 100th Battalion is why, after a memorial service cannon salute as the hearse donated a memorial stone to in Washington, D.C., and a period carrying the senator’s remains the cemetery in 2005 inscribed in which the senator’s body lay drove onto the main cemetery with their battle motto: “Go in state in the Capitol Rotunda, grounds. for Broke.” the people of Hawaii were given That was fitting, according Cemetery Director Gene a chance to say “Aloha” to their to Christine Kuia, the cemetery’s Castagnetti recalls that “on hero at a public memorial claims clerk. “He said, many more than one occasion, when service at the Punchbowl. times, that he always felt good Senator Inouye walked in Burial Some 800 members of the when he drove into the cemetery. Section D, the final resting place general public attended the He talked about a sense of of many members of the 442nd, memorial service, along with awe when he came into the he would ask, rhetorically: an unprecedented number of Punchbowl.”

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VA_Vanguard FINAL (MAY 10).indd 15 5/10/2013 1:58:42 PM Veteran Rocks with Georgia Overdrive

By Rebecca Omick He’s opened for Trace Atkins, Jason Aldean, Tim McGraw, Montgomery Gentry and Sugarland, to name a few. He’s rocked the Tundra Tailgate stage at Lambeau Field, various summer festivals and even Summerfest. But whether it’s before big crowds and for big names, or local establishments, Army veteran and Milwaukee VA Medical Center employee, Dave Brees, is always all smiles as he takes the stage. That was the scene March 2 as he casually walked onstage with a huge smile on his face at Bootz Saloon and Grill and kicked off a night of fun for the crowded dance floor and cheering fans. From the moment they began to cover Thomas Rhett’s, “Something to Do With My Hands,” the crowd was dancing. By the time the band took them to some Eric Church, the packed house of fans were shouting out the chorus of “Smoke a Little Smoke,” louder than the singer. Being on stage in front of screaming fans who want to dance and have a good time is nothing new for Brees – on the weekends at least. “I’m a rock star on the weekend and then it’s back to reality on Monday,” he said. Brees is the bassist in the Milwaukee-based, country cover band, Georgia Overdrive, and the mailroom supervisor at the Milwaukee VA Medical Center. Above: Dave Brees plays to the crowd during a recent “Georgia Overdrive” gig. The Army veteran and mailroom His service to his country and service on supervisor at the Milwaukee VA Medical Center has opened stage have almost always gone hand in hand. Of for some of the biggest names in country music. his five years as an engineer in the Army, Brees Opposite Left and Right: Navy Veteran Steve Johnson, left, was stationed in Germany from 1982 to 1985, and Army Veteran Dave Brees, jam on stage. Johnson is with a roommate who already knew how to play. married to Dave’s daughter, and the two play in the band, “Georgia Overdrive.” A recreation center across the street from his barracks rented instruments, and a string of

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VA_Vanguard FINAL (MAY 10).indd 16 5/10/2013 1:58:43 PM Veteran Rocks with Georgia Overdrive

fortunate events tied it together. That was good news for Brees’ wife, Carla, Brees had no shortage of musical inspiration who is also the logistics division manager at the to motivate him either. Milwaukee VAMC. “I’ve always loved Elvis,” Brees said. “He’s the “I will never forget the day that a country king of rock and roll.” music band asked Dave to join,” Carla said. Looking at the pictures on the wall around his “I was so thrilled that he would be playing mailroom office, that wouldn’t be hard to guess, country music.” with a larger-than-life Elvis postage stamp picture For the next 10 years, Brees was the bassist as a nod to his career field and “The King.” for a local band, Great Guns. He became close “I actually got to meet Scotty Moore, Elvis’s friends with the guitarist, John Getner. original guitarist, D.J. Fontana, his original “We go way back,” Getner said, “and Dave is drummer, and Jim Molly, his engineer,” Brees just an all-around great guy.” said with excitement. When Great Guns disbanded, neither were His love of Elvis is apparent in his ready to stop playing. wardrobe, too. “We were playing at West Allis Western Days, “It used to be all I owned was Elvis shirts,” and my son-in-law sang and he was good, so we Brees said. “But I’ve scaled back now. I always formed a band,” Brees said. wear either a music shirt or Packer shirt.” Navy Veteran Steve Johnson is the lead rhythm There’s always something else to remind him. guitarist and male vocal force for Georgia Overdrive. Brees owns a Basset hound named Grace Lyn. Say He’s able to cover a wide range of country songs that five times fast and you hear Elvis’s famous impressively and keep the audience yelling out Graceland. No coincidence. some “Yee-haws!” Despite being in a country band, Brees calls He’s also married to one of Brees’ daughters. himself a “70s rocker man.” Some may say work and play don’t mix well, “I love Aerosmith, AC/DC, Ted Nugent, especially with family, but Johnson said he and Lynyrd Skynyrd and really any southern classic Brees have gotten along great since the day they rock,” he said. met. So where did the country come in? It was “Working with Dave is one of the coolest things already kind of there. I get to do,” Johnson said. “I’m very blessed to “I love old school country, but I like the new share the experience of building this band from stuff, too,” Brees said. “I wasn’t a big country guy, the ground up.” but I got asked to play a couple songs in a studio Despite the stories he has of celebrities Brees for some friends and ended up getting hired for remains humble. a country band,” Brees said. “I’ve been playing “I’m just in it,” he said, “to play my bass and country ever since.” play some music.”

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VA_Vanguard FINAL (MAY 10).indd 17 5/10/2013 1:58:47 PM Veteran HR specialist Erick Walton

By Kimberly Jackson Each morning, Erick Walton the chance to apply for an open employee development and arrives at his self-proclaimed position at VA. With nearly 10 training. He coordinates train- “dream job” at the Veterans years of DoD experience, Walton ing for all HR staff at his facility, Health Administration Service transitioned smoothly into VA in projects future training needs, Center in Cleveland as a VA 2007. and is an instructor for certain human resources specialist. A “A lot of the work is pretty courses. Veteran of Desert Storm and much the same as I’ve done Earlier in his VA career, Desert Shield, Walton feels before,” said Walton, “only I like Walton and other HR profes- closely tied to VA’s mission and it better because working at VA, I sionals struggled to find the kind has been driven to serve his fel- feel like I’m able to make more of of training they needed. Now, low Veterans since his days on a difference in Veterans’ lives.” VA’s HR Academy fills this gap, the battlefield. As one of VA’s nearly 4,000 delivering courses that are tai- “Serving Veterans is some- HR professionals, Walton plays lored to VA’s HR processes and thing I’ve always wanted to do,” a key role in building a 21st- requirements. As an employee he said. “And now, I’m able to century VA workforce. From pay development specialist, Walton do that every day.” and benefits to recruitment and has come to rely on HR Acad- Walton gained experience hiring, VA relies on its HR team emy’s offerings. in HR in both the private and to make sure the right employ- “HR Academy is really on public sectors prior to joining ees are in the right positions to track with its classes,” he said. VA. While he enjoyed the work, most effectively serve the na- “I can tell that a lot of research he continued to look for ways tion’s Veterans. As the Veteran has gone into determining what to link his career in HR with his employment coordinator at his training is needed for VA’s HR commitment to helping Veterans. facility, Walton takes it a step professionals and how it can He got his first opportunity further by helping Veterans find be continuously enhanced and when he worked as a contrac- a job at VA. improved. I’ve had great success tor helping disabled Veterans “I’ve seen first-hand how working with HR Academy, both find government jobs. Walton valuable it is for VA employees in my own professional develop- thrived in this role, drawing on to have personal experience as a ment and in helping other HR his personal experience to better Veteran. From our perspective, staff with their training.” relate to and build trust with the hiring Veterans is a win-win “As both a customer and an Veterans he helped. When his situation.” employee, I think VA is a perfect contract ended, he jumped at Today, Walton focuses on fit for me.”

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VA_Vanguard FINAL (MAY 10).indd 18 5/10/2013 1:58:47 PM By Christopher Conklin Most people could use a “We are extremely happy helping hand from time-to- to have these volunteers,” said time, and that is certainly true Jordan. “These volunteers will of Veterans in the Community be a great asset to the team Living Centers at the VA helping to improve quality of Tennessee Valley Healthcare life for the Veterans we serve. System in Murfreesboro. That’s They will be able to spend the why the health care system is extra time the Veterans want at implementing a new volunteer meal time and give them some program to give Veterans a little extra attention,” she said. extra help and attention during Kim Pham, a student at volunteers were part of the meal times. Middle Tennessee State initial pilot training held in The program is fittingly University, volunteered to assist November providing basic named “Helping Hands,” and Veterans after learning about skills to assist with Veteran its core is volunteers who it through the VA Tennessee meals. provide assistance to Veterans Valley Voluntary Service Office. “This training and the needing help to eat. The “I just want to make a opportunity to volunteer gives program’s purpose is to ensure difference in people’s lives,” me a lot of hands-on experience VA Tennessee Valley Veterans said Pham. “This is a great in a medical setting,” said Pham, have the extra attention they opportunity to give back to who is expected to earn her deserve and the nurses are happy Veterans. I just hope degree in health care adminis- to have the help for Veterans. volunteering for this helps tration this May. “I am grateful Rita Jordan, nurse educator those I help feel special. I also for that, but I am also happy to for VA Tennessee Valley’s Geriatric hope I am able to encourage have the chance to just spend and Extended Care Service, is others to volunteer.” time with Veterans and listen to training volunteers. Pham and two other their stories,” she said.

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VA_Vanguard FINAL (MAY 10).indd 19 5/10/2013 1:58:48 PM Around HQ

NCA /Ancestry.com Partnership Provides buried where they fell in battle or in temporary cemeteries, and Burial Records Dating To The Civil War sometimes that information, along with religious affiliation, can be found in the ledgers. VA cemeteries by the numbers: The collection was posted 131 national cemeteries in 39 states and Puerto Rico on the Ancestry.com website 33 soldiers’ lots and monument sites on Veterans Day 2012. The information can be accessed free 72 cemeteries dating back to the Civil War of charge by VA personnel as 3,700,000-plus buried, from every war and conflict well as by employees of the other federal agencies that maintain 20,000-plus acres of VA cemeteries national cemeteries, the Depart- ments of Interior and Defense. VA partnered with the high-resolution scanning process. Ledger data will also be Internet-based genealogy research The effort resulted in high- available for free at all NARA firm Ancestry.com to bring burial quality digital files that reproduced facilities, and at public libraries records from historic national approximately 9,344 pages and that subscribe to Ancestry.com. cemetery ledgers into the digital 113,097 individual records. NCA NCA cemetery staff will use the age. The effort will make the then transferred the original led- database to answer requests collection—predominantly of gers to the National Archives and from the public. The general Civil War interments—accessible Records Administration, where public will have access to the to researchers and Ancestry.com they will be preserved. NARA was database on their personal subscribers undertaking historical already the steward of at least 156 devices through Ancestry.com’s and genealogical research. military cemetery ledgers trans- regular subscription service. “We are excited to be able ferred from the Army years ago. This partnership between to share this wealth of primary In 2011, NCA initiated a Ancestry.com and NCA supports documentation,” said VA Under partnership with Ancestry.com to NCA’s ongoing Civil War 150th Secretary for Memorial Affairs index its cemetery ledgers, anniversary commemoration Steve L. Muro. “With the help of allowing the data to be searched (2011-2015). For more information Ancestry.com, we have opened or browsed in a variety of ways. on this project, contact Sara Amy the doors to thousands of service Ancestry.com spent more than Leach ([email protected]), NCA members’ histories through the 600 hours indexing NCA’s records senior historian. information contained in these at no charge to the government. VA operates 131 national burial ledgers.” Ancestry.com has assembled cemeteries in 39 states and Puerto From the 1860s until the mid- the digitized and indexed NCA Rico and 33 soldiers’ lots and 20th century, Army personnel burial ledgers with those at NARA monument sites. Seventy-two of tracked national cemetery burials into a new collection, “U.S. Burial VA’s national cemeteries date from in handwritten burial ledgers, or Registers, Military Posts and the Civil War. More than 3.7 “registers.” Concern for the fragile National Cemeteries, 1862-1960.” million Americans, including documents and a desire to expand The burial records contain Veterans of every war and conflict public access to the ledger con- information such as name, rank, —from the Revolutionary War tents led the National Cemetery company/regiment, date of death, to the operations in Iraq and Administration to duplicate about age at death, date of burial and Afghanistan—are buried in VA’s 60 handwritten ledgers repre- grave number. A large number of national cemeteries on approxi- senting 36 cemeteries using a Civil War soldiers were mately 20,000 acres of land.

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VA_Vanguard FINAL (MAY 10).indd 20 5/10/2013 1:58:50 PM ing began in the late 1990s when GIS : A New Way to Solve Problems datasets from databases such as the Financial Management System and Consults and Com- puterized Patient Record System were pooled into Veterans Inte- grated Service Network (VISN) data ‘warehouses’ and “people began to see the utility of hav- ing access to data from multiple sources in one location,” said Rob Woody, Director of the Region 1, Regional Data Ware- house. “In late 2009 regional IOCMAP Viewer showing VA sites and active weather data warehouses began to feed warnings in the Southeast US into a unified Corporate Data Warehouse under the Busi- ness Intelligence Service Line”. Most of us know from our will allow a community of like Users were able to access CDW earliest days in high school minded individuals to share a data with analytic tools such as geometry that the shortest united analytic and GIS capabil- Microsoft Excel and ProClarity. distance between two points is ity across the department.” “This unified data is now a straight line. But taking that In the past, researchers, being extended to include GIS straight line is almost never such as Sandra Winkler, a layers, images and tools. We possible. Geographical infor- research health scientist at the want GIS to be mainstream for mation Systems (GIS) can help Miami, Fla., VAMC have used business intelligence and analyt- navigate these complex deci- data from multiple sources to ics” said Jack Bates. sions by placing data on maps to answer questions that help VA The GeoBISL will allow reveal location or spatially based determine how good a job it is users to connect geographical relationships. VA is currently doing providing equal levels of information to the entire spec- creating a common data system care and access to the veterans. trum of VA data. that will include GIS technology “It’s really about equity in “While access to patient pro- in an array of tools that will help the provision of devices,” Win- tected information (PII) will be decision makers, researchers kler said. “You shouldn’t have restricted, researchers and deci- and veterans. to go to one facility vs. another sion makers that need such data To leverage its own data ca- to get the most appropriate will be able to access it.” said pabilities, VA is creating a com- device. In the VA, every veteran Michael Villeneuve, GIS Man- mon pool of data and common deserves an equal level of treat- ager in the VA’s Office of Secu- tools to be housed in the Corpo- ment.” rity and Preparedness. “When rate Data Warehouse (CDW). Winkler utilizes CDW data we pull together our four data “We are creating an enter- in her research, which she says pillars that include data about prise GIS infrastructure with is “good to have, particularly people, real property, personal a community of data for use since requesting permission to assets, and services to veterans, throughout VA,” said Jack Bates, access the data is also central- we are able to see relationships Director of the Business Intelli- ized.” in the data that we couldn’t even gence Service Line (BISL),.“This VA’s use of data warehous- imagine before.”

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VA_Vanguard FINAL (MAY 10).indd 21 5/10/2013 1:58:51 PM Around HQ

C ustomer Feedback Leads to Improved IT Service The annual IT Customer • Region 1, VISN 21, Manila • Region 1, VISN 20, Roseburg Satisfaction Survey was Outpatient Clinic-92 HCS-22 conducted in October 2012 • Region 3, VISN 7, Dublin • Region 2, VISN 12, Iron and detailed reports are now VAMC-90 Mountain VAMC-19 available on the IT Performance Dashboard. This year’s survey • Western Area, Anchorage • Region 1, VISN 20, Spokane achieved the highest response Regional Office-90 VAMC-19 level to date with nearly 44,000 • Central Area, Chicago • Eastern Area, Wilmington respondents. Congratulations Regional Office-90 Regional Office-19 to all who improved their score! • Eastern Area, Baltimore OIT has implemented Below are some of top performing Regional Office-90 a Continuous Feedback facilities according to this year’s • Southern Area, San Juan Driving Service Improvement results: Regional Office-90 Initiative and continues to gather customer comments Highest American Customer from the field with structured Most Improved Scores: Satisfaction Index ACSI Scores: quarterly interviews at select • Eastern Area, Togus Regional • Region 2, VISN 17, VA Texas facilities. Office-96 Valley Coastal Bend HCS-26 For complete results visit the • Central Area, Muskogee • Eastern Area, Newark IT Performance Dashboard at Regional Office-96 Regional Office-20 www.oit.va.gov/dashboard.asp.

Health care Analytics CertificateP rogram Develops Skills VA employees were recently of the program’s four courses, training opportunity associated certified in health care analytics each of which lasts 10 weeks and with VA’s Health Informatics for the first time through a VA typically requires six hours of Initiative, which helps to build program aimed at creating a cul- class time and homework per a sustainable, collaborative re- ture to identify patterns in data week. These courses focus on lationship between VA’s health and translate it into improve- health care data analysis, sys- care system and the Office of ments for Veteran health care. tems improvement, data mining Information and Technology, The 42 graduates are the and project analysis. “There are further transitioning VA to a first to have completed the many advanced analytic skills patient-centered model of care. Healthcare Analytics Certificate and techniques that I learned The program was developed Program. The program helps that I incorporate into my ev- in conjunction with the VA develop expert knowledge and eryday work and projects,” one Nebraska-Western Iowa Health skill in performing complex data graduate said. “Veterans benefit Care System and the Midwest analysis, translating information because I am able to help oth- Mountain Veterans Engineer- into knowledge, leading teams ers locate data more quickly and ing Resource Center, or VERC, in identifying relevant data, and really focus on the true question, through its affiliation with coaching and mentoring others ensuring that outcomes match the University of Nebraska in the use of data. what is intended for specific Lincoln Department of Nearly 500 other employ- projects at the outset.” Industrial and Management ees are enrolled in one or more The certificate program is a Systems Engineering.

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VA_Vanguard FINAL (MAY 10).indd 22 5/10/2013 1:58:52 PM Welcome Dr. Jennifer Lee “GI Bill” Finally a VA-owned Registered Trademark “GI Bill” is a registered Bill” as a trademark to protect undersecretary for benefits. trademark with the U.S. Patent individuals and ensure they are VA will issue terms of use and Trademark Office, and VA is directed to the right resources to for “GI Bill” within the next six the sole owner of the mark. make informed decisions. months. On April 26, 2012, President In addition, VA obtained “We want to ensure the right Obama signed Executive the rights to the GIBill.com balance with these new guide- Order 13607, directing VA, the website after the original owners lines so that our stakeholders Department of Defense, and the agreed to give up the site. VA is can still promote GI Bill and we Department of Education to taking a proactive approach in can prohibit others from using undertake a number of measures continuously taking action to it fraudulently,” said Curtis L. to “stop deceptive and misleading” eliminate fraudulent marketing Coy, deputy undersecretary for promotional efforts that target and recruiting practices. economic opportunity. the GI Bill educational benefits “Trademarking ‘GI Bill’ is a Since August 2009, VA of service members, Veterans, great step forward in continuing has paid more than $23.8 billion and eligible family members our mission to better serve this in Post-9/11 GI Bill benefits and survivors. One of the key nation’s service members, to more than 866,000 components of the order was Veterans, and their families,” Veterans, service members, for VA to register the term “GI said Allison A. Hickey, VA and dependents.

Welcome VHA’s Special Assistant for Community Engagement Dr. Jennifer Lee was support they have earned. to 2011. She appointed in October 2012 as the Lee joined VHA after serving received her Veterans Health Administration’s as a White House Fellow in VA’s bachelor’s Special Assistant for Community Office of the Secretary, where degree from Engagement. She works out of she was the VA liaison to Joining Yale Univer- the Office of the Principal Deputy Forces. sity and her Under Secretary for Health in VA Prior to the fellowship, Lee M.D. from Central Office. was an assistant professor of Washington “I’ll be helping VHA work Emergency Medicine at George University with community health care Washington University with School of providers and organizations in a joint appointment in the Medicine. She promoting the health and Department of Health Policy. completed wellness of Veterans and in She was also the director of the her residency understanding and supporting the George Washington University training in emergency medicine care we provide, building upon Emergency Medicine Health at Johns Hopkins University. the tremendous work undertaken Policy Fellowship Program. “Dr. Lee will certainly be a by the First Lady’s Joining Forces Lee previously served as tremendous asset to the Veterans Initiative,” Lee said. a health policy fellow on the Health Administration,” said Joining Forces is a compre- U.S. Senate Health, Education, Principal Deputy Under hensive national initiative to Labor, and Pensions Committee Secretary for Health Dr. Robert mobilize all sectors of society to and was appointed by Gov. Tim Jesse. “Most importantly, she’ll give service members and their Kaine to serve on the Virginia be a tremendous asset for the families the opportunities and Board of Medicine from 2008 Veterans we are honored to serve.”

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VA_Vanguard FINAL (MAY 10).indd 23 5/10/2013 1:58:53 PM Medical Advances

VA Research Currents issues like heart failure and “First, throughout VA pneumonia.” we’ve been working hard on VA Study Finds As the study progressed, improving the coordination an interesting pattern began that occurs between the hospital That Shorter to emerge: hospital stays at VA and our outpatient services,” Hospital Stays are decreased by almost 30 percent he explained. “Successfully over a period of about 14 years. transitioning out of the hospital Usually Better for “We initially thought this into outpatient care is so might translate into higher critical. The patient’s health Patients readmission rates and death and well-being depend on rates,” Kaboli said. “It turned this transition being done out to be just the opposite: correctly. A shorter stay in the hospital readmission rates went down “Second,” he continued, can actually be more beneficial by 16 percent. Death rates went “we’re working hard on constantly to you than a longer stay, improving the quality of the care according to a VA study that we provide. For example, care at appeared in the Dec. 18, 2012, “It’s all about listening VA is now delivered by Patient issue of Annals of Internal to the patient so we can Aligned Care Teams—a team of Medicine. specialists who coordinate closely “This study shows that a determine what their with one another regarding the large health care system like needs are, what their patient’s case. The patient is a VA can improve both quality big part of this team.” and efficiency to provide better, goals are. The patient The third big factor? more cost-effective care,” said Specialization. Dr. Peter Kaboli, a hospitalist at needs to be at the center “VA has adopted the use of the Iowa City (Iowa) VA Health- of the whole process.” hospitalists at over 80 percent care System and the study’s of our medical centers,” lead researcher. “Ultimately, the Kaboli said. “Hospitalists are focus should not be how long down by 3 percent.” physicians who specialize in the a patient is in the hospital, but The take away from all this? care of hospitalized patients. ensuring they get the care they “The individual needs to be in Care delivered by hospitalists need as efficiently as possible the hospital for as long as it has been shown to be more and get them out of the hospital takes to address their medical efficient and can result in as soon as they are ready.” issues, and no longer,” Kaboli higher quality health care.” Kaboli and his research observed. “Everyone is different Kaboli said quality health team came to this conclusion ... one patient might be able to care occurs when everyone— after examining the records of go home within 48 hours. An- the patient, the patient’s family more than 4 million Veterans other patient might not be able and hospital staff—are hospitalized at 129 VA medical to go home for five days.” communicating with one centers between 1997 and 2010. Kaboli said VA’s success in another. “People come to the hospital lowering readmission rates while “In the end,” he said, “it’s for all kinds of medical conditions, simultaneously reducing hospital all about listening to the patient so for our study we looked at stays points to an increased level so we can determine what their everybody,” the researcher said. of efficiency. He attributes this needs are, what their goals are. “But we also zeroed in on some increased efficiency to three big The patient needs to be at the of the more common health factors. center of the whole process.”

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VA_Vanguard FINAL (MAY 10).indd 24 5/10/2013 1:58:54 PM V A Maryland Health Care System First in State to Offer 3D Mammograms

The VA Maryland Health Care System has become the first health care system in the state to offer three-dimensional mammograms and the first VA in the country to offer this new technology to women Veterans. “This new technology, known as breast tomosynthesis, allows doctors to examine breast tissue one layer at a time, rendering deeper and more accurate readings,” explained Dr. Eliot Siegel, chief of Imaging Service at the VA Maryland Health Care System and a professor at the University of Maryland School of Medicine. “Because the new machine takes multiple images of the was a definite improvement over when there is a potential cancer— breast in just seconds and the standard mammogram. I and when there isn’t,” the produces a 3D image of the was pleasantly surprised … radiologist explained. “It also breast tissue in one-millimeter “The real plus,” she added, reduces the need for unnecessary layers, it allows for more “is that the technician was able follow-up appointments and accurate readings and the ability to review the images right away, undue worry by our Veteran to detect cancers earlier when without even having to leave the patients.” they are most treatable.” room, to see if she’d gotten a During the 3D mammography Siegel said the more accurate good image. It made the whole procedure, the X-ray arm readings will mean substantially process a lot smoother. The sweeps over the breast, taking fewer call-backs, which in turn will whole appointment went a lot multiple images in just seconds. result in fewer biopsies as well as quicker.” 3D mammography uses high- higher cancer detection rates. Dr. Rakhi Goel, director of powered computing to convert “It was a very positive breast imaging at the VA Maryland the images into a 3D image, experience,” said Cate Conroy, Health Care System in Baltimore, which can then be examined by a 49-year-old Army Veteran said 3D mammography allows a doctor one “slice” at a time. who recently had her first 3D doctors to more clearly evaluate Fine details are more clearly mammogram at the VA. “There’s breast tissue. “This improves visible and no longer hidden by still a bit of discomfort … but it our ability to understand sooner the tissue above and below.

Spring 2013 | VANGUARD | Page 25

VA_Vanguard FINAL (MAY 10).indd 25 5/10/2013 1:58:56 PM Introducing

T uscaloosa Welcomes New Director retired in January after working Wilkes-Barre, Pa., Philadelphia, in the VA system for 40 years. Pa., Chicago, Ill., and El Paso, “Alan’s legacy is that he Texas. Before coming to expanded services here at Tuscaloosa, she served as Tuscaloosa in recent years,” associate director of the VA Andrews said. “I hope to Southern Nevada Healthcare continue that growth. I’m System in Las Vegas, where excited about the process she oversaw close to 2,000 of taking this already well- employees and a $400 functioning organization to million budget. the next highest level.” Andrews is a graduate of A native of Pennsylvania, the Senior Executive Service Andrews is the first female Candidate Development Program The Tuscaloosa VA Medical director of the Tuscaloosa VA. and Leadership VA.. She holds a Center has a new director, Maria She has spent 34 years working Masters Degree from Marywood R. Andrews, who began her new in the VA system, starting as University in Scranton, Pa., and job in March. The Tuscaloosa VA a dietitian intern in Chicago, a Bachelor of Science Degree from serves nearly 20,000 Veterans. then moving up the ranks. Rutgers University in New Jersey. Andrews replaces former Over the years she has worked She possesses a post-graduate Director Alan Tyler, who for the VA in Albuquerque, N.M., certificate in Gerontology.

Chaplain Benjamin Vegors

By Linda Wondra On Sept. 25, 2012, Chaplain in the Army Air Corps during Benjamin Vegors quietly World War II. He flew 30 celebrated his 90th birthday; missions without incident. On 40 of those years have been three occasions, however, he devoted to serving Veterans at missed getting on the planes, the Jonathan M. Wainwright and on all three occasions, those Memorial VA Medical Center in planes crashed with no survivors. Walla Walla, Wash. Following his discharge from He stills maintains a daunting the military, Vegors went back 40-hour work week counseling to school and then seminary, Veterans, conducting weekly where he met his future wife, the chaplain at the VA hospi- chapel services, and responding Betty. He said it was love at first tal. Dennis invited Vegors to tirelessly to numerous other sight, and two years later, they accompany him on his night requests—all because of his were married. calls to Veterans. That led to an dedication to serving others. His pastoral career began in intermittent chaplaincy appoint- When asked what called Astoria, Ore., followed by a 10- ment with VA and eventually to him to the ministry, Vegors is year post in Junction City, Ore., a part-time chaplaincy position. quick to mention a pact he said and then on to Walla Walla, Then in 1972, he was appointed he made with God while serving where he met Jim Dennis, as a full-time chaplain.

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VA_Vanguard FINAL (MAY 10).indd 26 5/10/2013 1:58:59 PM Formerly Homeless Veterans To Receive Housing Assistance

Army Veteran Daniel Parker Since 2009, the HUD-VASH California and Southern Nevada. is one of many formerly homeless program has provided thousands The Team AMVETS: Veterans to receive housing of homeless Veterans with Section Welcome Home program will assistance through the Depart- 8 housing vouchers, including begin in the San Diego and ment of Housing and Urban about 1,000 per year to California Long Beach areas—where the Development-Veterans Affairs Veterans. The program follows homeless Veteran population is Supportive Housing (HUD-VASH) a “housing first” model, which relatively high—and is expected program. But it was another VA allows homeless Veterans to rent to expand to other parts of partnership that helped to make privately owned housing and, at Southern California soon. his new apartment a home. the same time, access clinical and “Team AMVETS is pleased On Dec. 12, 2012, Parker supportive services through VA’s to provide furniture and other became one of the first few health care system. household items to Veterans who recipients of donated beds, But those Veterans often have been homeless but are now couches, tables and other move into empty apartments and in the process of rebuilding their household goods through Team cannot furnish their homes until lives,” Team AMVETS President AMVETS: Welcome Home, a long after moving in. The VA and Jim Pidgeon said. “We hope the partnership between VA and Team AMVETS’ partnership goal items we provide to a HUD-VASH AMVETS Department of is to eventually offer furnishings recipient will transform an California Service Foundation. and household items to HUD- otherwise empty housing unit into “This was truly a blessing— VASH recipients throughout a true home for that Veteran.” the VA is here to help us,” Parker the state. Both programs are in To help a homeless Veteran or said. “This is one of the best support of VA’s goal to end Veteran at risk of homelessness, programs I have ever seen Veteran homelessness by 2015. give him or her the number to the that VA put together. All the “Rebuilding a life is not easy, National Call Center for Homeless representatives of AMVETS but now Veterans can get started Veterans, 1-877-4AID-VET. The came together to deliver the with this crucial support. hotline connects homeless Veter- furniture to my home. They were Transforming a house to a home ans, Veterans at risk of becoming so caring. I’m very thankful for will transform a life,” said homeless and their families with this program and everyone has Sharon Elefant, VA Homeless the VA services and benefits they been so respectful and kind.” Coordinator for Southern have earned.

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VA_Vanguard FINAL (MAY 10).indd 27 5/10/2013 1:59:00 PM M usic Therapy Helps Soothe PTSD Symptoms

VA TVHS Public Affairs Office With the sound of a Foster. “It is such stress relief, will help develop insights into strumming guitar ringing in the and it really keeps you motivated. their struggles as well as problem- background and the scratching of It keeps you thinking, and not solving skills and social interaction. pen to pad, Veteran Todd Foster of bad stuff; it really gives you a “It’s important to put meaning of Smyrna, Tenn., writes the brighter perspective on how to and connect to what we have soundtrack to his rehabilitation deal with life.” seen,” says Haynes. “While from the traumas of war. Most Veterans in the group therapy is a good idea for Foster and other Veterans, have little-to-no experience Veterans, music therapy adds with help from Tina Haynes, with music. Haynes says that an extra dimension that is not music therapist at the VA should not stop Veterans from accessed through standard ‘talk’ Tennessee Valley Healthcare participating, because the staff therapy.” System in Murfreesboro, and provides all equipment and Haynes says this extra Bob Regan, a Nashville musician instruction. dimension provides a safe and Grammy Award-winning According to Haynes, the structure for Veterans to access songwriter, are using the craft group offers safety, support and traumatic memories and look of songwriting as therapy for stimulation for Veterans to tell at them objectively. Veterans to overcome post- their stories and express their Foster agrees, but says the traumatic stress disorder. thoughts and feelings though group offers other elements Foster began the songwriting songwriting. She says the goal to his therapy as well. He says therapy group in November 2012 of the program is to provide an the program is not only fun and quickly noticed its benefits. environment for emotional, to be part of, but there is a “This is one of the best spiritual and psychosocial camaraderie that is built with therapies in the VA,” says support. This, Haynes says, other Veterans in the group.

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VA_Vanguard FINAL (MAY 10).indd 28 5/10/2013 1:59:02 PM Top Left: Bob Regan listens to a song that was written and recorded during a session of the music therapy song writing group at the Alvin C. York VA Campus of the VA Tennessee Valley Healthcare System. Right: Veterans Todd Foster and Regan work on writing a song during a session of the music therapy. Bottom: VA Tennessee Valley Healthcare System Music Therapist Tina Haynes (left) along with Regan help Foster.

The idea of creating something “Military Intelligence,” pokes fun group, contact Haynes at with other Veterans keeps him at the term in a high-spirited way. [email protected]. coming back. The program is Foster and Haynes agree that To learn more about how so valuable to him, Foster says, while the group is light-hearted VA Tennessee Valley is serving that he takes vacation time from and many of the songs they write Veterans, visit work just to attend the weekly reflect the playful atmosphere, www.tennesseevalley.va.gov. meeting. the group has a more somber “We come away with a song side as well. That, says Haynes, almost every week,” says Foster. helps them deal with the issues “We start talking and then we of PTSD and the memories of war. One song written brainstorm and start jotting One such song written by ideas down. Bob starts picking the group, “Still Coming Home,” his guitar and then we just start clearly outlines the purpose of by the group, piecing it all together. The staff the songwriting group. The song helps us put it into a song format. highlights how many Veterans “Still Coming Home,” Then the next thing you know, still struggle with their time in a we have a song.” combat zone—even years after clearly outlines Inspiration for songs varies returning from war. The song’s from week to week. Foster says lyrics include the line “the battles its purpose. the group has rewritten the lyrics may be over, but they rage on in to Christmas carols to identify our hearts.” the stresses of the holiday season. For more information on Another song they wrote, the music therapy songwriting

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VA_Vanguard FINAL (MAY 10).indd 29 5/10/2013 1:59:06 PM Veterans With Traumatic Brain Injury Report Relief With Acupuncture

By Lynne Morgan, R.N, L. Ac. The movie ‘The Hurt Locker’, Symptoms can be mild to Veterans Health Administration which received best picture of the severe. Mild symptoms include (VHA) in Salt Lake City, we are year in 2008, helps to portray headaches, dizziness, and fatigue, using acupuncture to provide what our veterans are being lack of concentration, irritability, some relief to these patients. exposed to during war time. It is sleep problems, balance issues, Acupuncture has become one easy to see through the lens of a and ringing in the ears. More component of the Integrative camera, why we see Traumatic severe symptoms include being Medicine program being offered, Brain Injury occurring at such easily confused, forgetful, and under the umbrella of Holistic high rates. Traumatic Brain troubled with constant and Medicine. Patients are seen on Injury is defined as a non-degen- intense headaches. Difficulty an outpatient basis, where they erative, non-congenital insult with speech and difficulty with are being treated for a variety of to the brain from an external decision making are also health issues including, chronic mechanical force, leading to common symptoms that require pain, Post traumatic stress possible concussion, skull ongoing rehabilitation. Many of disorder and traumatic brain fractures, internal hemorrhage, these symptoms are debilitating. injury. or other internal injuries. This Too often; these returning With the use of even a few basic may result in permanent or Veterans are unemployable, points, patients are reporting a temporary impairment of and unable to attend school decrease in the intensity of their cognitive, physical, and for re-training. This presents a headaches, better sleep, and an psychosocial functions, with tough challenge for a young ability to cope on a daily basis. an associated diminished or Veteran who has his or her whole One of my patients “Jim’’ came altered state of consciousness. life ahead of them upon returning. to the Acupuncture clinic for Veterans are at high-risk for Medical treatment often treatment of his severe head- Traumatic brain injury and blast- consists of rehabilitation, mental aches, and his sleeplessness. Jim, related concussions because of the health counseling, vocational a 27-year old male, and Iraq war frequent exposure to improvised rehabilitation, and group therapy. vet, got caught in a ‘cross-fire’ explosive devices, suicide bombers, Patients are often on a long in 2003. A bullet entered his land mines, mortar rounds, and list of medications to treat the helmet, but did not penetrate rocket-propelled grenades. These various symptoms. Common his skull. The blast resulted in a types of injuries account for medications are antidepressants, blood clot located in the parietal upwards of sixty-five percent of sleep aides, migraine medications, area of his brain. For the first combat injuries, and of these, sixty anti-seizure medications, and year, his words were slurred and percent of theses vets have symp- narcotics. his concentration and short term toms of traumatic brain injury. At the George E. Whalen memory adversely affected.

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VA_Vanguard FINAL (MAY 10).indd 30 5/10/2013 1:59:09 PM Russell is the first service Puppies Behind Bars dog to work at VBA. He performs 80 commands, including “salute” On work release to help Veterans and “watch my back.” He also opens doors, turns on lights and By Samantha O’Neil retrieves specific items. Russell is There is a new employee service dogs to Veterans return- also trained to identify stress and working in the Veterans Benefits ing home from combat in Iraq anxiety in his Veteran and respond Administration at VA Central and Afghanistan, including with comfort and support. When Office, and he can’t help standing those who have suffered a commanded to “watch my back,” out from the crowd. Russell is physical injury, traumatic brain he stands next to Fitzgerald facing a service dog whose partner, injury, or exhibit post-traumatic backwards, and alerts him if some- Marine Corps Veteran Brendan stress disorder. For the first year one approaches from behind. Fitzgerald, works for VBA’s of their lives, the dogs are trained Both Russell and Fitzgerald Education Service. by inmates at several prisons in had to pass a detailed “Public Fitzgerald started with VA New York, New Jersey and Access Test” given by their train- in 2008 at the Muskogee (Okla.) Connecticut. The inmates who ers during their two-week pairing VA Regional Office, processing trained Russell kept a training and training course, following education claims. Since 2010, diary of his time living and work- standards set by Puppies Behind he has continued his work with ing at a prison in New York; they Bars, and must re-test each year Education Service at VACO in cared for Russell while working something not all service dog Washington, D.C. on their own rehabilitation. organizations require. Fitzgerald was selected by the nonprofit Puppies Behind Bars organization to match up with a Veterans service dog after a rigorous screening process conducted by the organization. He said he got a lot of support throughout the process from numerous colleagues in VBA. Carolyn McCollam, executive assistant to the VBA chief of staff, and Chris Holly, VBA deputy chief of staff, introduced Fitzgerald to Under Secretary for Benefits Allison Hickey, who wrote Puppies Behind Bars a letter on Fitzgerald’s behalf recommending him for a service dog. Education Service Director Rob Worley and his deputy, Leigh Ann Skeens, supported Russell’s integration into the office environment by explaining the purpose of service dogs to Education Service employees. Puppies Behind Bars provides

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VA_Vanguard FINAL (MAY 10).indd 31 5/10/2013 1:59:10 PM Dr. Tim Cordes, a psychiatrist at the Madison VA who’s been blind since childhood, has a knack for getting his patients to relax and open up. His dog Bella already knows how to relax. Photo by Jeffrey Root, Senior Medical Photographer, Madison VA

traumatized, it changes you. You don’t always get ‘past’ it. But you can get through it. “It’s one of my jobs to help veterans work through Blind VA Doctor Sees their trauma and come out the other side of it.” It’s a job Cordes seems to Patients Differently be exceptionally good at. “There’s a lot of pressure By Tom Cramer on people with addictions,” Dr. Tim Cordes, a psychiatrist more of the nation’s most quali- said Dean Krahn.“They’re often at the William S. Middleton fied applicants to begin the elite told they just need to change, VA Hospital in Madison, Wis., program, which he completed in that they need to overcome has a unique way of seeing 2007. He finished his residency that hurdle in their lives. And patients: he doesn’t see them in psychiatry there in 2011. their response? They’ll say, at all. He’s been legally blind When did he first realize he ‘Doc, you don’t know what it’s since early childhood. wanted to be a doctor? When he like. It’s not a hurdle I can just “He’s very calm,” said Dr. was in high school? Kindergarten? overcome. It’s just too hard.’ Dean Krahn, chief of psychiatry “In college, I read the book, “But you know what? at the Madison VA. “Given that ‘White Coat, White Cane,’ by They tend to say that a lot less he can’t see, I think that he’s David Hartman,” Cordes to Tim, because they can see more attentive to everything explained. “It’s about a blind he’s a blind doctor, that he’s you say. He picks up on a lot; he doctor. I found that to be had to overcome enormous listens closely for the sound of inspirational. I liked science, but challenges to get where he is. your breathing, the tone of your I wanted to do more than just He’s actually an inspiration voice ... he senses a lot about research. I wanted to do to his addiction patients. It’s the patient, and has a unique something more personal, like his patients are thinking way of picking up on things more human. So I decided to themselves: ‘This guy’s been other doctors might miss.” to go into medicine.” blind since he was a little kid, and The fact that he’s super Not just medicine, but now he’s a doctor. If he can do smart doesn’t hurt either. psychiatry—with a special that, then I can stay sober today.’ In 1998 Cordes graduated focus on addiction. “Tim’s perseverance is valedictorian from the University “In order to be the best admirable, and he is a model of of Notre Dame, where he earned psychiatrist I could be, I figured determination and resilience,” a bachelor’s degree in biochem- I needed to learn as much said Dr. Jeff Schiffman, another istry. He was then accepted as I could about addiction,” addiction specialist at the into the MD/PhD program at Cordes explained. “Addiction Madison VA.“Tim puts your the University of Wisconsin’s is a problem with many of mind at ease pretty quickly,” School of Medicine and Public our veteran patients ... it can he said. “He’s a guy who Health. At that time he was one accompany post traumatic has figured out how to get of eight people out of 200 or stress disorder. When you’re through a lot of barriers.”

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VA_Vanguard FINAL (MAY 10).indd 32 5/10/2013 1:59:12 PM DMA marks two years of improving C&P

Dr.Barbara Gales, Vermont VAMC the Veteran is an actor.

March 2013 marked the two- to perform C&P exams nationally VBA to accept telemental health year anniversary of the creation and overseas as needed. examinations for disability benefit of VHA’s Office of Disability and DMA also conducted two claims processing purposes, Medical Assessment (DMA). major workshops that provided and greatly enhanced its analytic In March 2011, the DMA clinicians with the most current and reporting capability to office was established to provide training available and revised gather and effectively capture executive leadership to VHA’s all of its training certification disability evaluation data, and Compensation and Pension modules. Two national live developed a single web-based (C&P) programs and soon satellite broadcasts were made dashboard that contains data became the single point of contact available to assist VHA clinicians that is consistent between VBA for all VHA and Department of with better understanding the and VHA. Defense (DoD) disability evalua- complexity of Military Sexual DMA provided significant tion-related matters. Trauma and the Veterans funding to support the Integrated Since its establishment, Benefits Management System. Disability Evaluation System a renewed focus has been Other notable successes (IDES) and has participated in placed on ensuring veterans include: Establishing a new the development of a Separation and servicemembers receive Quality Assurance program to Health Assessment, a disability thorough, accurate, and timely review disability evaluations, examination for separating/ disability evaluations. And it monitor timeliness performance retiring Servicemembers that is working. Metrics used to and the development of an satisfies examination criteria for measure the effectiveness of appeal process to ensure quality both DoD and VA. DMA is also program operations reflect reviews are conducted fairly and the authoritative source for all significant improvement in the accurately. Timeliness across the issues related to national policy overall national quality and time- enterprise greatly improved to and guidance for the disability liness of all disability evaluations. 26 days from 44 days and quality evaluation process. Over the past two years, has remained consistently high In the areas of policy and DMA has improved collabora- at more than 91 percent. communication, DMA has tion with the Veterans Benefits DMA helped to improve issued fact sheets on topics Administration (VBA), DoD, the Disability Benefit Questionnaires including: Examinations for Office of Policy and Planning (DBQ) and successfully coordinat- incarcerated Veterans, providers (OPP), C&P staffs, and other ed and executed a national DBQ/ for examinations for traumatic stakeholders to establish a wide CAPRI training that allowed for brain injury, and examination range of innovative solutions the successful rollout of DBQs, scheduling procedures. that are transforming the dis- modernizing evaluations for DMA developed a team of ability examination process. disability benefit claims. subject matter experts to address These efforts include: For Other achievements include: the complex issues and provide the first time allowing clinicians Coordinating VHA disability medical opinions, reducing the to conduct C&P examinations examiners use of VBA’s Veterans backlog of these claims for on Veterans residing overseas; Benefits Management System disabilities claimed as a result establishing a Disability Exami- (VBMS) to facilitate electronic of potential exposure to nation Management Contract claims processing in the future; contaminated drinking water that provides a surge capability instituting an agreement with at Camp Lejeune.

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VA_Vanguard FINAL (MAY 10).indd 33 5/10/2013 1:59:12 PM Long-Term Ptia ent care

Milwaukee VA Public Affairs | Steve Martinex A skeletal home of bare wooden beams and panels of drywall is visible on the east end of the Milwaukee VA campus. By the late summer or fall of 2013, that skeleton will transform into a cutting-edge, long-term care facility known as a Green House, according to Fred Kier, the co-division manager of the Rehabilitation and Extended Community Care department. “It’s very exciting,” said Kier, a geriatric psychologist, as he peered out a window overlooking the construction. “Last week they didn’t have any walls up.” This Green House, with plans for three more, marks house model of long-term care a significant and substantial step forward in the realm of with a particular emphasis on nursing home care, Kier said. These Green Houses will elder vitality, respect, autonomy look nothing like traditional nursing homes – and that’s and dignity. This model of care exactly the point. redefines structural and cultural When they open, Milwaukee will be one of only three norms found in virtually all VA sites with this concept of nursing home care. traditional nursing homes, “This takes the institutional setting out of nursing Kier said. home care, which is something we have been moving Green Houses are small, toward since 2006,” said Mary Pfeiffer, who also serves self-contained homes that as co-divisional manager in RECC, but has a nursing accommodate 12 or fewer background. residents. They feature private “Our current Community Living Center and the rooms and full bathrooms, along Green Houses will operate at the same time, and both with family-style communal serve a specific need. Because the Green Houses are spaces like a hearth, a dining cozier with private rooms, front porches and sun rooms, area and a central kitchen. it will be much easier for people to adapt to that environ- However, the homes can ment. They’ll offer more quiet and individualized care, vary in size, amenities and which is ideal for those patients who have dementia or structure, and may be built on those who fare better in a quieter environment.” a long-term care campus or in a Dr. Bill Thomas, a Harvard Medical School graduate, residential neighborhood. first proposed the idea of the deinstitutionalization of The houses will also provide nursing homes when he founded the Eden Alternative patient-accessible patios, in 2003. porches, walkways and gardens, Thomas is a self-proclaimed “nursing home Aboli- or “green areas,” and will include tionist,” and he and his wife, Judith Rebig, turned the many large windows to allow assisted living model of care on its head when they a great amount of natural light created the Green House Project later that same year. into each home. The movement focuses on a revolutionary small- These homes also make an

Page 34 | VANGUARD | Spring 2013 Revolutionizing VA_Vanguard FINAL (MAY 10).indd 34 5/10/2013 1:59:13 PM “Our veterans deserve the best care we can provide them,”

Fred Kier, Co-Division Manager Rehabilitation and Extended Community Care Department

effort to avoid the inclusion of nization’s website. ducted within the last five years nurses’ stations, medication The non-traditional nature has detailed the benefits of that carts and public address systems of these homes even extends to home-like environment. – all of which are common in the staff. Green house residents were the traditional hospital setting. Historically, Certified Nurs- less depressed and better able All of these factors combine ing Assistants are at the bottom to perform daily, living activities to make the Green House as of the care hierarchy, but, in a longer than comparable residents home-like as possible, and that Green House, they are the ones of nursing homes, according to is very important to Kier. responsible for meeting the resi- a Minnesota School of Public “In a hospital, you treat dents’ needs on a daily basis. Health study published in 2007. people and then get them back CNAs function as a sort of In 2009, researchers at the home, but in long-term care (the universal worker, managing University of Minnesota found hospital) is their home,” he said. food preparation, laundry, per- that individuals with family “Green Houses are homes that sonal care and patient growth members in a Green House were people live in where they can get and opportunity. They are more satisfied with and engaged care.” always on-site with the residents in their resident’s care. Moreover, the Green House while physicians, nurses, thera- And two years later, the same movement is not solely con- pists and other professionals group of researchers reported cerned with reconstructing comprise a visiting clinical sup- that resident-CNA interactions in nursing homes. It is based on port team. a Green House promoted a more a number of guiding principles Full-time caregivers undergo caring environment, interdepen- that, together, represent a culture 200 hours of training in culinary dency and stronger ties com- change in long-term patient care. arts, dementia care and habilita- pared to the traditional nursing These principles include tion, and will oversee the day-to- home setting. supporting the privacy and day care of veterans while also In light of all this evidence, security of the residents, offer- building personal relationships. Kier, along with Surgeon Gen- ing meaningful activities and The Green House project has eral Regina Benjamin, believes promoting maximum functional welcomed elders since 2003, that the Green House model is abilities, according to the orga- and scientific research con- the future of long-term care.

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VA_Vanguard FINAL (MAY 10).indd 35 5/10/2013 1:59:15 PM Celebrating Central Alabama Veterans great leadership from directors famed Tuskegee Airmen in that Health Care System (CAVHCS) throughout the years, we’ve seen both were created because of celebrated 90 years of service at this campus really show the way segregation and yet each proved the Tuskegee Campus on Feb. 12 – the way in which care is ren- its worth through performance commemorating the establish- dered to those who have served and leadership while fulfilling ment of the Tuskegee Veterans this nation.” the nobelist of missions. Affairs Medical Center. From its origins as the “Had it not been for the The Tuskegee VA Hospital Treasury Department’s Hospital Tuskegee VA Medical Center, grew out of a need to overcome for Sick and Injured Colored black heroes would not have had the racial segregation and World War Veterans following anywhere to receive health care, discrimination experienced World War I to today, VA “said CAVHCS Director James throughout the South by black Medical Center Tuskegee has R. Talton. “But, we have to take World War I Veterans. As a been an active part of history, that one step beyond, because result, Congress authorized the while providing comfort, aid, a each succeeding director of the U.S. Treasury to build a hospital teaching platform and quality Tuskegee VA Medical Center solely for the care of more than care to countless Veterans. took it upon themselves not to 300,000 black Veterans in the “A number of U.S. have a black hospital, but to South. presidents came to Tuskegee open the doors to every Veteran “When you think of Tuske- or had a major impact in Tuske- who served this nation.” gee, you think of many, many gee,” said keynote speaker, Dr. While planning for the brave people who have forged Gilbert L. Rochon, president and future, it is often beneficial to the way through difficult times professor at Tuskegee University. honor and learn from the past. of discrimination and bias, to “Vice President Calvin Coolidge “I think that it’s not an overcome and in order to serve was here to cut the ribbon at the accident that it was Feb. 12, 1923 people who needed care in dedication of what is now the – on the observance of Abraham this region,” said William C. VA Medical Center. After he Lincoln’s birthday – that this Schoenhard, the Veterans became President, in his State of institution was dedicated,” said Health Administration’s Deputy the Union address he indicated Schoenhard. “It was Abraham Under Secretary for Health for how amazing it was – unprec- Lincoln in his second inaugural Operations and Management. edented in history – the prog- address who said, ‘To care for “It was a time, when this campus ress of the American Negro since him who shall have borne the was dedicated with 300 acres the Emancipation Proclama- battle and for his widow and his donated by the Tuskegee tion – Even so far as to provide orphan.’ That mission continues Institute for this purpose; that medical services and to manage today. And we thank all of you a very special mission began in the great Veterans hospital at for all of your collective efforts serving African American Tuskegee.” in which you have made a special Veterans who needed care. The Tuskegee VAMC in a contribution to this very, very And under the care of such way, share similarities with the special mission. Congratulations.”

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VA_Vanguard FINAL (MAY 10).indd 36 5/10/2013 1:59:15 PM 90 Y e a r s o f S e r v i c e

Far Left: Central Alabama Veterans Health Care System Kinesiotherapist Gloria Brown provides a stirring rendition of the National Anthem. (VA Photo by Robin Johnson)

Above and Left: “A number of U. S. Presi- dents came to Tuskegee or had a major impact in Tuskegee,” explained Keynote Speaker and President & University Profes- sor, Tuskegee University, Dr. Gilbert L. Rochon, reviewing the historical signifi- cance of Tuskegee. “Vice President Calvin Coolidge was here to cut was here to cut the ribbon at the dedication of what is now the VA Medical Center. After he be- came President, in his State of the Union address he indicated how amazing it was - unprecedented in history - the progress of the American Negro since the Emanci- pation Proclamation.”

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VA_Vanguard FINAL (MAY 10).indd 37 5/10/2013 1:59:19 PM By Laura Edwards in VA and across government, care for our nation’s Veterans. Though they come from Deputy Assistant Secretary Jan The cohort model provides a different backgrounds and R. Frye had an idea to create a built-in support system and circumstances, the Veterans in program specifically for returning network that mirrors the team the VA Acquisition Academy’s wounded Veterans to train them environment and camaraderie Warriors to Workforce (W2W) for careers as federal contract that Veterans experience in the Program share more similari- specialists. This program would military, easing the transition to ties than differences—a sense of address the growing shortage the civilian professional world. duty and love of country, an un- of this mission critical position During Secretary Shinseki’s paralleled loyalty to one another and transition Veterans from the keynote address at the W2W borne of their military service, battlefield to the VA acquisition ribbon cutting ceremony, he and all have experienced the workforce. said: “Their military training wounds of war. Many of them “It just made sense,” said stressed the importance of joined the military right out of Frye, a program architect. “We integrity, and they’ve learned to high school with plans to devote had the infrastructure and talent work together in diverse teams their life to the military. But, to stand up the program at the to achieve difficult operational for many of them, the injuries VA Acquisition Academy located objectives. Those are precisely they sustained on the battlefield in Frederick, Md., and it aligns the attributes we value in our

VA Warriors to Workforce Program Answers the Call to Serve

abruptly ended their military ca- with our mission of recapitalizing professional Acquisition Corps.” reers. Now, things had changed the VA acquisition workforce. The W2W Program begins and they had to answer the The program also supports the as a three-year developmental question, “What’s next?” Secretary’s commitment to journey to become eligible for While there has been Veteran employment, supports a career in and learn the field progress in reducing the Veteran agency succession planning, and of acquisition. During the first unemployment rate, in 2011, at supports our wounded warriors year, participants earn the 24 the W2W Program’s inception, by providing them a career path educational credits in business there were approximately one where they can make a difference.” required to become contract- million unemployed Veterans, The W2W Program be- ing professionals; take peak and the unemployment rate for came a reality in December performance training focused on post-9/11 Veterans, particularly 2011, when 23 Veterans walked managing mental, emotional, and 18-29 years old, was and is still, through the doors of the VA physiological responses; learn the significantly higher than the rest Acquisition Academy ready to fundamentals of contracting; and of the Veteran population, as embark upon a new journey to participate in mission service. well as the civilian population. become federal contract special- After completion of the first With a growing shortage ists responsible for buying the year, participants transfer into of contracting professionals goods and services needed to the two-year Acquisition Intern-

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VA_Vanguard FINAL (MAY 10).indd 38 5/10/2013 1:59:19 PM ship Program at the academy, taking since I had not been in “As I look back on the past which includes fundamental school for almost 19 years.” year it has not been easy,” said skills development for Federal “This was such a big paradigm Wesseling, “but I swell with pride Acquisition Certification in shift for them,” said W2W Pro- knowing that I am only nine Contracting, leadership and gram Manager David Sella. “The classes away from a bachelor’s personal skills, skill-building battlefield has little in common degree in business. I think, not workshops, mission service with the office or the classroom, bad for a high school dropout activities, and on-the-job training. but they hung in there and that had nothing more than a Through collaboration with persevered. These interns have mechanics background from the VA Veterans Employment Co- repeatedly demonstrated some U.S Army.” ordination Service, Vocational of the many qualities that make “I accomplished things I Rehabilitation and Employment Veterans good employees – never thought I’d do,” said Program, Veteran Service commitment, leadership, and Burgee. “This program started a Organizations, and Department teamwork.” new chapter in my life. I’m proud of Defense Wounded Warrior “At first, I did not know what to be a Veteran, and indirectly Transition Units, the program I was getting myself into,” said support my fellow Veterans received 180 applications, and W2W intern Bryan Burgee, “but through contracting.” 23 Veterans from across the then, after a few weeks, I real- The program has been so

Wesseling Burgee Campbell Sarabia

United States were chosen for ized this is how I am going to successful that the academy the inaugural W2W class. Many make a difference.” created and launched a W2W had to uproot families and move In December 2012, all 23 Program Management track across the country, and many Veterans in the program complet- cohort in January 2013 that is had fears about returning to the ed their first year and ascended funded and sponsored by VA’s classroom after so many years. into the two-year Acquisition Office of Information and “When I decided to take Intern Program. Not only did 100 Technology (OIT). Year one the challenge of moving 1,400 percent earn the business credits program content includes IT miles from home to embark on a required to advance, their and business college credits, new life, I was not sure where I cumulative GPA was 3.7, and mission service, foundational would end up,” said W2W intern 75 percent of the class achieved program management training, Billie Wesseling. “As the only dean’s list status. In February and peak performance training. woman in the class of 23, I saw 2013, the interns went out on In years two and three, this as an opportunity to pave their first job rotation in VA participants will attend the way for women service contracting offices where they VAAA’s Program Management members to follow in my foot- “learn by doing” under the Fellows program. steps. I was very concerned mentorship of a senior To learn more visit www. with the classes that I would be contracting officer. acquisitionacademy.va.gov.

Spring 2013 | VANGUARD | Page 39

VA_Vanguard FINAL (MAY 10).indd 39 5/10/2013 1:59:24 PM U.S. Department of Veterans A airs U.S. Department of Veterans A airs O ce of Information and Technology O ce of Information and Technology

U.S. Department of Veterans A airs U.S. Department of Veterans A airs O ce of Information and Technology O ce of Information and Technology

U.S. Department of Veterans A airs

O ce of Information and Technology

IT is at the heart of everything VA does to serve our Veterans. We support of over 300,000

VA employees who work in 152 hospitals, 791 communityU.S. Department based outpatient clinics, U.S. Department 57 benefits processing offices, 131 cemeteries and 33of soldier’s Veterans A airslots and monument sites who help of Veterans A airs over 10 million veterans a year. SupportingO ce You. of Information Serving Veterans. O ce of Information and Technology and Technology

COMMhttp://vaww.oit.va.govITMENT

VA_Vanguard FINAL (MAY 10).indd 40 5/10/2013 1:59:27 PM