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Sample records for affairs va health

  1. VA telemental health: suicide assessment.

    PubMed

    Godleski, Linda; Nieves, J Edwin; Darkins, Adam; Lehmann, Laurent

    2008-01-01

    The Department of Veterans Affairs (VA) encompasses one of the largest telemental health networks in the world, with over 45,000 videoconferencing and over 5,000 home telemental health encounters annually. Recently, the VA designated suicide prevention as a major priority, with telehealth modalities providing opportunities for remote interventions. Suicide risk assessments, using videoconferencing, are now documented in the literature, as are current studies that find telemental health to be equivalent to face-to-face treatment. Remote assessment of suicidality, however, involves complex legal issues: licensing requirements for remote delivery of care, legal procedures for involuntary detainment and commitment of potentially harmful patients, and liability questions related to the remote nature of the mental health service. VA best practices for remote suicide risk assessment include paradigms for establishing procedures in the context of legal challenges (licensing and involuntary detainment/commitment), for utilizing clinical assessment and triage decision protocols, and for contingency planning to optimize patient care and reduce liability.

  2. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    ERIC Educational Resources Information Center

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

  3. Improvements in VA health services for women veterans.

    PubMed

    Weiss, T W

    1995-01-01

    Since the early 1980s, health care for women veterans in the Department of Veterans Affairs (VA) has improved considerably, although problems still remain. The lack of privacy for women at many VA facilities and the provision of incomplete physical examinations for women continue to be problematic issues. A 1992 congressional appropriation of $7.5 million has substantially increased the awareness of women veterans health care in the VA. This appropriation, from Public Law 102-585, Veterans Health Care Act of 1992, Title I-Women Veterans Health Programs, has allowed VA to expand services for women veterans. Using these funds, VA has established eight comprehensive women veterans health centers, 23 full-time women veterans coordinators, and four regional stress disorder teams. This paper describes these and other important new initiatives and discusses how they will serve as the foundation on which VA expands care for women within the context of a changing health care system.

  4. The effect of pre-existing mental health comorbidities on the stage at diagnosis and timeliness of care of solid tumor malignances in a Veterans Affairs (VA) medical center.

    PubMed

    Wadia, Roxanne J; Yao, Xiaopan; Deng, Yanhong; Li, Jia; Maron, Steven; Connery, Donna; Gunduz-Bruce, Handan; Rose, Michal G

    2015-09-01

    There are limited data on the impact of mental health comorbidities (MHC) on stage at diagnosis and timeliness of cancer care. Axis I MHC affect approximately 30% of Veterans receiving care within the Veterans Affairs (VA) system. The purpose of this study was to compare stage at diagnosis and timeliness of care of solid tumor malignancies among Veterans with and without MHC. We performed a retrospective analysis of 408 charts of Veterans with colorectal, urothelial, and head/neck cancer diagnosed and treated at VA Connecticut Health Care System (VACHS) between 2008 and 2011. We collected demographic data, stage at diagnosis, medical and mental health co-morbidities, treatments received, key time intervals, and number of appointments missed. The study was powered to assess for stage migration of 15-20% from Stage I/II to Stage III/IV. There was no significant change in stage distribution for patients with and without MHC in the entire study group (p = 0.9442) and in each individual tumor type. There were no significant differences in the time intervals from onset of symptoms to initiation of treatment between patients with and without MHC (p = 0.1135, 0.2042 and 0.2352, respectively). We conclude that at VACHS, stage at diagnosis for patients with colorectal, urothelial and head and neck cancers did not differ significantly between patients with and without MHC. Patients with MHC did not experience significant delays in care. Our study indicates that in a medical system in which mental health is integrated into routine care, patients with Axis I MHC do not experience delays in cancer care.

  5. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... November 21, 2011 (76 FR 71920), VA proposed to amend its regulations concerning the billing methodology... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA...

  6. 76 FR 70831 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... Care)) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs... Efficiency of VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of... necessary to promote quality and efficient delivery of health care through the use of health...

  7. 76 FR 71439 - Amendment to an Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... the Development of Permanent Housing in Battle Creek, MI AGENCY: Department of Veterans Affairs... Battle Creek VA Medical Center in Michigan. The existing lessee will finance, design, develop,...

  8. Characteristics and VA Health Care Utilization of U.S. Veterans Who Completed Suicide in Oregon between 2000 and 2005

    ERIC Educational Resources Information Center

    Basham, Chandra; Denneson, Lauren M.; Millet, Lisa; Shen, Xun; Duckart, Jonathan; Dobscha, Steven K.

    2011-01-01

    Oregon Violent Death Reporting System data were linked with Veterans Affairs (VA) administrative data to identify and describe veterans who completed suicide in Oregon from 2000 to 2005 (n = 968), and to describe their VA health care utilization in the year prior to death. Twenty-two percent had received health care in the VA system. Of these, 57%…

  9. 38 CFR 58.15 - VA Form 10-0143-Department of Veterans Affairs Certification Regarding Drug-Free Workplace...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0143-Department of Veterans Affairs Certification Regarding Drug-Free Workplace Requirements for Grantees Other Than Individuals. 58.15 Section 58.15 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.15 VA Form...

  10. 75 FR 72871 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...) in Salt Lake City, UT AGENCY: Department of Veterans Affairs. ACTION: Notice of Intent to enter into... of land at the George E. Wahlen VAMC in Salt Lake City, Utah. The selected lessee will...

  11. VA Health Care Facilities Locator

    MedlinePlus

    ... Financial Report (AFR) Budget Submission Recovery Act Resources Business Congressional Affairs Jobs Benefits Booklet Data & Statistics National Resource Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Media ...

  12. VA Puget Sound Telemental Health Service to rural veterans: a growing program.

    PubMed

    Barnwell, Sara V Smucker; Juretic, Meghan A; Hoerster, Katherine D; Van de Plasch, Richard; Felker, Bradford L

    2012-05-01

    The VA Puget Sound Health Care System Telemental Health program connects veterans with psychologists, psychiatrists, and social workers via live clinical video teleconferencing. Providers deliver care to veterans in rural Veteran Affairs medical centers, community-based outpatient clinics and residences, and thus, increase access to specialty mental health care for rural and medically underserved veteran communities.

  13. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development of Space for Community Services and Parking in Memphis, TN AGENCY: Department of Veterans...

  14. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    PubMed

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.

  15. VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility Professional Scholarship Programs. Final rule.

    PubMed

    2013-08-20

    The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations. PMID:23977714

  16. VA Health Care and Health Manpower Training Legislation. Hearing before the Subcommittee on Health and Hospitals of the Committee on Veterans' Affairs; United States Senate, Ninety-second Congress. First Session on S.2219, S.2354, S.2355, S.1924, S.2304, S.1635, S.2340, H. J. Res. 748, H. R. 481, and Related Bills.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Veteran's Affairs.

    Ten legislative bills related to VA health manpower training and education and to veterans' health care were considered at this hearing. The bills concerned the following: (1) establishment of new public nonprofit medical, health profession, and allied health schools and the expansion and improvement of health manpower training programs in VA…

  17. 76 FR 67557 - Proposed Information Collection (Survey of Veteran Enrollees' Health and Reliance Upon VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... ; or to Cynthia Harvey-Pryor, Veterans Health Administration (10P7B), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420; or email: cynthia.harvey-pryor@va.gov . Please refer to... online through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor at (202) 461-5870 or fax...

  18. Prevalence and costs of chronic conditions in the VA health care system.

    PubMed

    Yu, Wei; Ravelo, Arliene; Wagner, Todd H; Phibbs, Ciaran S; Bhandari, Aman; Chen, Shuo; Barnett, Paul G

    2003-09-01

    Chronic conditions are among the most common causes of death and disability in the United States. Patients with such conditions receive disproportionate amounts of health care services and therefore cost more per capita than the average patient. This study assesses the prevalence among the Department of Veterans Affairs (VA) health care users and VA expenditures (costs) of 29 common chronic conditions. The authors used regression to identify the marginal impact of these conditions on total, inpatient, outpatient, and pharmacy costs. Excluding costs of contracted medical services at non-VA facilities, total VA health care expenditures in fiscal year 1999 (FY1999) were $14.3 billion. Among the 3.4 million VA patients in FY1999, 72 percent had 1 or more of the 29 chronic conditions, and these patients accounted for 96 percent of the total costs ($13.7 billion). In addition, 35 percent (1.2 million) of VA health care users had 3 or more of the 29 chronic conditions. These individuals accounted for 73 percent of the total cost. Overall, VA health care users have more chronic diseases than the general population. PMID:15095551

  19. Veterans Affairs Health System Enrollment and Health Care Utilization After the Affordable Care Act: Initial Insights.

    PubMed

    Silva, Abigail; Tarlov, Elizabeth; French, Dustin D; Huo, Zhiping; Martinez, Rachael N; Stroupe, Kevin T

    2016-05-01

    The Affordable Care Act (ACA) was signed into law in 2010 and its individual mandate and expanded health care coverage options were implemented in 2014. These provisions may affect Veterans Affairs (VA) enrollment and health care utilization. Using data from two VA regional networks, we examined recent patterns in the number of new VA enrollees and their primary care use. Trends were assessed by enrollment priority group (based on the veteran's severity of service-connected disabilities, exposures, and income level) and a state's Medicaid expansion status. Compared to the same time period in the previous year, the number of new enrollees from low-income priority groups was higher during the open enrollment period and the increase was sharper in Medicaid non-expansion states (25-42%) than in expansion states (20-32%). In addition, low-income patients with a copay requirement who enrolled in the VA during the ACA open enrollment had a lower average number of primary care visits than counterparts who had enrolled in prior time periods (1.73 versus 1.87, p < 0.0001). Although this study is an initial step, more research is required to better understand veterans' decision making and behavior in regard to health care coverage through the ACA and related impacts on VA and non-VA health care utilization and care coordination. PMID:27136655

  20. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans AffairsVA Manhattan Campus

    SciTech Connect

    Stephen Schey; Jim Francfort

    2014-10-01

    This report focuses on the Department of Veterans Affairs, VA Manhattan Campus (VA- Manhattan) fleet to identify the daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support successful introduction of plug-in electric vehicles (PEVs) into the agency’s fleet. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively called PEVs) can fulfill the mission requirements.

  1. Gap analysis: transition of health care from Department of Defense to Department of Veterans Affairs.

    PubMed

    Randall, Marjorie J

    2012-01-01

    This study examined the effectiveness of Public Law 110-181, "National Defense Authorization Act of Fiscal Year 2008, Title XVI-Wounded Warriors Matter," as it relates to health care for returning Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combat veterans. Specifically, it examined the gap between the time an OEF/OIF combat service member left active service and subsequently obtained health care within the Veteran Affairs (VA) Healthcare System, and which factors influenced or impeded the veteran from obtaining health care sooner. Data were collected from 376 OEF/OIF combat veterans who sought health care at the Nashville or Murfreesboro VA Medical Centers. A questionnaire was designed exclusively for this study. The average time gap for an OEF/OIF combat veteran to transition from Department of Defense to VA health care was 3.83 months (SD 7.17). Twenty-six percent of respondents reported there were factors that impeded them from coming to the VA sooner. Factors included lack of knowledge about VA benefits, transportation/distance, perceptions of losing military career, seeking help as sign of weakness, and VA reputation. The study provided some evidence to support that Department of Defense and VA are meeting mandates for providing seamless transition of health care set forth by "Public Law 110-181, National Defense Authorization Act of Fiscal Year 2008." PMID:22338972

  2. US Veterans' Use Of VA Mental Health Services And Disability Compensation Increased From 2001 To 2010.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2016-06-01

    There has been concern about the capacity of the Department of Veterans Affairs (VA) health care system to provide care for veterans returning from war zones in the Middle East and Afghanistan. We used two nationally representative surveys of US veterans in 2001 and 2010 to examine changes in the veteran population and veterans' use of health care services after a decade of war. The population was older and more diverse in 2010 than in 2001. In both years, veterans who served in the World War II era or earlier were more likely to have been exposed to combat-related trauma than veterans of more recent service eras. In 2010 veterans who served in the Persian Gulf War era (1990 through the wars in Iraq and Afghanistan) were more likely to have used VA mental health services and to have received VA disability compensation than veterans of previous service eras. Compared to veterans in 2001, those in 2010 were two times more likely to have used any VA health services and were more likely to have received VA disability compensation. These findings highlight changes in the veteran population over time that are important to consider in planning for future VA services. PMID:27269011

  3. Considering child care and parenting needs in Veterans Affairs mental health services.

    PubMed

    Tsai, Jack; David, Daryn H; Edens, Ellen L; Crutchfield, Audra

    2013-08-01

    Child care and parenting needs of adults with mental illness are of growing concern, especially among those seeking Department of Veterans Affairs (VA) mental health services. One area of interest concerns the possible benefits that on-site child care could have for improving veterans' access to VA mental health care. Child care programs are currently being piloted at the VA for the first time, although the need for them has not been evaluated. We conducted a brief survey of a convenience sample of 147 veterans (132 men, 15 women) seeking mental health care at outpatient clinics and/or at a psychiatric rehabilitation center at one VA. Participants were asked about their attitudes and experiences regarding child care and parenting support at the VA. Of the 52 (35.4%) participants who responded and had children under 18, the majority of both men and women surveyed agreed that the VA should offer child care services and that they would use child care services at the VA if it were available. These results are based on a small sample of participants, but they may contribute to ongoing discussion and efforts to develop "family-friendly" mental health services.

  4. National Dissemination of Cognitive Behavioral Therapy for Depression in the Department of Veterans Affairs Health Care System: Therapist and Patient-Level Outcomes

    ERIC Educational Resources Information Center

    Karlin, Bradley E.; Brown, Gregory K.; Trockel, Mickey; Cunning, Darby; Zeiss, Antonette M.; Taylor, C. Barr

    2012-01-01

    Objective: The Department of Veterans Affairs (VA) health care system is nationally disseminating and implementing cognitive behavioral therapy for depression (CBT-D). The current article evaluates therapist and patient-level outcomes associated with national training in and implementation of CBT-D in the VA health care system. Method: Therapist…

  5. 76 FR 72048 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for a Mixed-Use...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for a Mixed-Use..., operate, and maintain a mixed-use development. A permanent housing facility will be included in...

  6. The VA Maryland Health Care System's telemental health program.

    PubMed

    Koch, Edward F

    2012-05-01

    The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.

  7. The future role of the health sciences library in the Department of Veterans Affairs.

    PubMed Central

    Wiesenthal, D

    1993-01-01

    The Department of Veterans Affairs (VA) conducted a survey to ascertain the perceptions of 322 library service chiefs and health care administrators within the VA health care system. Participants were asked to rate the desirability and probability of twenty-five predetermined statements and to identify the forces that would have an impact, either positive or negative, on whatever statements became reality. The response rate was 93%. Analysis of the data indicated that there was no significant difference between the library managers and health care administrators in their perceptions. Results indicate that both groups believe libraries serve an integral role in VA medical centers and that library services cannot be provided as successfully off site. The data also appear to reveal a clear consensus on the part of both groups for increased library involvement in educational activities and information delivery. PMID:8471999

  8. Innovation in veterans' health care and assistance: the Department of Veterans Affairs 10 years after the Gulf War.

    PubMed

    Brown, Mark A; Murphy, Frances M; Mather, Susan H

    2002-03-01

    The Department of Veterans Affairs (VA) has responded to significant challenges in treating and compensating Persian Gulf War veterans by adapting existing programs and developing new ones. The VA established a Gulf War health examination registry and expanded existing "Vet Centers" to provide assistance to Gulf War veterans. Health care eligibility income limitations were eliminated. Outreach efforts included a national newsletter, veterans' organization briefings, and other products. The VA is developing targeted training programs and continuing medical education for health care providers. Numerous major research initiatives have begun. Innovations include the establishment of environmental hazards research centers, clinical demonstration projects, and centers for the study of war-related illness. These efforts required increased coordination among federal agencies and collaboration with other countries. In a precedent-setting development, Congress gave the VA authority to compensate certain veterans with undiagnosed illnesses. Veterans from future conflicts and peacekeeping missions can expect improved services from the VA as a result of these initiatives. PMID:11901564

  9. Chaplains' Engagement with Suicidality among Their Service Users: Findings from the VA/DoD Integrated Mental Health Strategy.

    PubMed

    Kopacz, Marek S; Nieuwsma, Jason A; Jackson, George L; Rhodes, Jeffrey E; Cantrell, William C; Bates, Mark J; Meador, Keith G

    2016-04-01

    Chaplains play an important role in supporting the mental health of current and former military personnel; in this study, the engagement of Department of Veterans Affairs (VA), Army, Navy, and Air Force chaplains with suicidality among their service users were examined. An online survey was used to collect data from 440 VA and 1,723 Department of Defense (DoD) chaplains as part of the VA/DoD Integrated Mental Health Strategy. Differences were noted for demographics, work setting characteristics, encountering suicidality, and self-perceived preparation for dealing with suicidality. Compared to DoD chaplains, VA chaplains encounter more at-risk service users, yet feel less prepared for dealing with suicidality. PMID:26255592

  10. Variations in the Use of mHealth Tools: The VA Mobile Health Study

    PubMed Central

    2016-01-01

    Background Mobile health (mHealth) technologies exhibit promise for offering patients and their caregivers point-of-need tools for health self-management. This research study involved the dissemination of iPads containing a suite of mHealth apps to family caregivers of veterans who receive care from the Veterans Affairs (VA) Health Administration and have serious physical or mental injuries. Objective The goal of the study was to identify factors and characteristics of veterans and their family caregivers that predict the use of mHealth apps. Methods Veteran/family caregiver dyads (N=882) enrolled in VA’s Comprehensive Assistance for Family Caregivers program were recruited to participate in an mHealth pilot program. Veterans and caregivers who participated and received an iPad agreed to have their use of the apps monitored and were asked to complete a survey assessing Caregiver Preparedness, Caregiver Traits, and Caregiver Zarit Burden Inventory baseline surveys. Results Of the 882 dyads, 94.9% (837/882) of caregivers were women and 95.7% (844/882) of veteran recipients were men. Mean caregiver age was 40 (SD 10.2) years and mean veteran age was 39 (SD 9.15) years, and 39.8% (351/882) lived in rural locations. Most (89%, 788/882) of the caregivers were spouses. Overall, the most frequently used app was Summary of Care, followed by RX Refill, then Journal, Care4Caregivers, VA Pain Coach, and last, VA PTSD Coach. App use was significantly predicted by the caregiver being a spouse, increased caregiver computer skills, a rural living location, lower levels of caregiver preparedness, veteran mental health diagnosis (other than posttraumatic stress disorder), and veteran age. Conclusions This mHealth Family Caregiver pilot project effectively establishes the VA’s first patient-facing mHealth apps that are integrated within the VA data system. Use varied considerably, and apps that were most used were those that assisted them in their caregiving responsibilities

  11. 76 FR 61151 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... enter into an EUL on a 16-acre parcel of land at the VA New Jersey Health Care System--Lyons Campus... services program that guides resident Veterans toward attaining long-term self-sufficiency. FOR FURTHER... for applying the consideration under such a lease for the provision of medical care and services...

  12. The relationship between local area labor market conditions and the use of Veterans Affairs health services

    PubMed Central

    2013-01-01

    Background In the U.S., economic conditions are intertwined with labor market decisions, access to health care, health care utilization and health outcomes. The Veterans Affairs (VA) health care system has served as a safety net provider by supplying free or reduced cost care to qualifying veterans. This study examines whether local area labor market conditions, measured using county-level unemployment rates, influence whether veterans obtain health care from the VA. Methods We used survey data from the Behavioral Risk Factor Surveillance System in years 2000, 2003 and 2004 to construct a random sample of 73,964 respondents self-identified as veterans. VA health service utilization was defined as whether veterans received all, some or no care from the VA. Hierarchical ordered logistic regression was used to address unobserved state and county random effects while adjusting for individual characteristics. Local area labor market conditions were defined as the average 12-month unemployment rate in veterans’ county of residence. Results The mean unemployment rate for veterans receiving all, some and no care was 5.56%, 5.37% and 5.24%, respectively. After covariate adjustment, a one percentage point increase in the unemployment rate in a veteran’s county of residence was associated with an increase in the probability of receiving all care (0.34%, p-value = 0.056) or some care (0.29%, p-value = 0.023) from the VA. Conclusions Our findings suggest that the important role of the VA in providing health care services to veterans is magnified in locations with high unemployment. PMID:23496888

  13. Veterans Affairs Research on Health Information Technologies for Diabetes Self-Management Support

    PubMed Central

    Piette, John D.; Kerr, Eve; Richardson, Caroline; Heisler, Michele

    2008-01-01

    Background Like many patients with diabetes, Department of Veterans Affairs (VA) patients frequently fall short of self-management goals and experience multiple barriers to self-care. Health information technologies (HITs) may provide the tools that patients need to manage their illness under the direction of their primary care team. Methods We describe several ongoing projects focused on HIT resources for self-management in VA. VA researchers are developing HITs that seek to bolster a variety of potential avenues for self-management support, including patients′ relationships with other patients, connections with their informal care networks, and communication with their health care teams. Results Veterans Affairs HIT research projects are developing services that can address the needs of patients with multiple challenges to disease self-care, including multimorbidity, health literacy deficits, and limited treatment access. These services include patient-to-patient interactive voice response (IVR) calling systems, IVR assessments with feedback to informal caregivers, novel information supports for clinical pharmacists based on medication refill data, and enhanced pedometers. Conclusion Large health care systems such as the VA can play a critical role in developing HITs for diabetes self-care. To be truly effective, these efforts should include a continuum of studies: observational research to identify barriers to self-management, developmental studies (e.g., usability testing), efficacy trials, and implementation studies to evaluate utility in real-world settings. VA HIT researchers partner with operations to promote the dissemination of efficacious services, and such relationships will be critical to move HIT innovations into practice. PMID:19885173

  14. Time trends and predictors of suicide among mental health outpatients in the Department of Veterans Affairs.

    PubMed

    Desai, Mayur M; Rosenheck, Robert A; Desai, Rani A

    2008-01-01

    Using merged Veterans Affairs (VA) and National Death Index data, this study examined changes in suicide rate among three cohorts of VA mental health outpatients during a time of extensive bed closures and system-wide reorganization (1995, N = 76,105; 1997, N = 81,512; and 2001, N = 102,184). There was a decreasing but nonsignificant trend in suicide rates over time-13.2, 11.4, and 10.3 per 10,000 person-years, respectively. Multivariable predictors of suicide included both younger and older ages (U-shaped association). At the facility level, there was an association between greater per capita outpatient mental health expenditure and reduced suicide risk. The model also showed a protective effect associated with increased mental health spending on inpatient services, and that outpatients at facilities with larger mental health programs, as measured by patient volume, were at greater risk for suicide than were those in smaller programs. Although more chronic patients may have been underrepresented to some extent as a result of the sampling methodology, these findings provide generally reassuring evidence that overall suicide rates have not been adversely affected by VA system changes. Nevertheless, they highlight the importance of funding for mental health services as well as the implications of changing demographics in the VA population.

  15. Using GIS to profile health-care costs of VA Quality-Enhancement Research Initiative diseases.

    PubMed

    Yu, Wei; Cowper, Diane; Berger, Magdalena; Kuebeler, Mark; Kubal, Joe; Manheim, Larry

    2004-06-01

    The Health Services Research and Development (HSR&D) Service at the Department of Veterans Affairs (VA) Health Care System launched a Quality Enhancement Research Initiative (QUERI) in 1998. This study estimated health-care costs of nine diseases under the QUERI project and analyzed geographic differences in health-care costs and utilization across 22 VA Integrated Service Networks (VISNs), using a geographic information system (GIS). Patients with these diseases were identified from diagnoses recorded between October 1999 and September 2000. Annual health-care costs for each disease were estimated in four categories: inpatient medical or surgical, other inpatient, outpatient, and outpatient pharmacy. Geographic differences of costs and health-care utilization across the 22 VISNs for chronic heart failure, diabetes, and spinal-cord injury were mapped using a GIS package. Average costs and patterns of health-care utilization varied substantially across the 22 VISNs. The observed differences in health-care utilization across geographic regions raised questions for further investigation. PMID:15446617

  16. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for Department of Veterans Affairs. James J. Peters VA Medical Center, Bronx, NY

    SciTech Connect

    Schey, Stephen; Francfort, Jim

    2014-10-01

    This report focuses on the Department of Veterans Affairs, James J. Peters VA Medical Center (VA - Bronx) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of PEVs into the agencies’ fleets. Individual observations of these selected vehicles provide the basis for recommendations related to electric vehicle adoption and whether a battery electric vehicle or plug-in hybrid electric vehicle (collectively referred to as PEVs) can fulfill the mission requirements.

  17. Veterans Affairs databases are accurate for gout-related health care utilization: a validation study

    PubMed Central

    2013-01-01

    Introduction The aim of this study was to assess the accuracy of Veterans Affairs (VA) databases for gout-related health care utilization. Methods This retrospective study utilized VA administrative and clinical databases. A random sample of gout patients with visits (outpatient, inpatient or emergent/urgent care) with or without the diagnosis of gout (International Classification of Diseases, ninth revision, common modification ICD-9-CM code of 274.x or 274.xx) at the Birmingham VA hospital was selected. A blinded abstractor performed a review of VA electronic health records for the documentation of gout or gout-related terms (gouty arthritis, tophaceous gout, tophus/tophi, acute gout, chronic gout, podagra, urate stones, urate or uric acid crystals and so on) in the chief complaint, history of present illness or assessment and plan for the visit; this constituted the gold standard for gout-related utilization. The accuracy of database-derived gout-related claims was assessed by calculating sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Results Of 108 potential visits, 85 outpatient, inpatient or urgent care/emergency room visits to a health care provider (85 patients: 84 men and 1 woman with a mean age of 63 years) and retrievable data from medical records constituted the analyzed dataset. Administrative claims for gout-related utilization with ICD-9 code for gout were accurate with a PPV of 86%, specificity of 95%, sensitivity of 86% and NPV of 95%. Conclusions VA databases are accurate for gout-related visits. These findings support their use for studies of health services and outcome studies. It remains to be seen if these findings are generalizable to other settings and databases. PMID:24377421

  18. Mental Health Disorders and Treatment Seeking Among Veterans in Non-VA Facilities: Results and Implications from the Veterans’ Health Study

    PubMed Central

    Boscarino, Joseph A.; Hoffman, Stuart N.; Pitcavage, James M.; Urosevich, Thomas G.

    2015-01-01

    We surveyed 700 veterans who were outpatients in a non–Veterans Affairs (VA) multihospital system. Our objective was to assess the prevalence of mental disorders and service use among these veterans. The majority were Vietnam veterans (72.0%), and male (95.9%), and 40.4% reported recently using the VA for care. The prevalence of lifetime post-traumatic stress disorder (PTSD) was 9.6%, lifetime depression 18.4%, and lifetime mental health service use 50.1%. In multivariate analyses, significant factors associated with PTSD, depression, and mental health service use were low self-esteem, use of alcohol/drugs to cope, history of childhood adversity, high combat exposure, and low psychological resilience. VA service use was associated with greater mental health service use and combat exposure. With the exception of alcohol misuse, the mental health status of veterans seen in non-VA facilities appeared to be better than reported in past studies. Because most veterans have access to both VA and non-VA services, these findings have implications for veterans and outcomes research. PMID:26640743

  19. 76 FR 67257 - Computer Matching Program Between the Department of Veterans Affairs (VA) and the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... education benefit payments under the Post-9/11 GI Bill. These benefit records are contained in a VA system of records identified as 58VA21/ 22/28 entitled: Compensation, Pension, Education and Vocational Rehabilitation and Employment Records--VA, first published in the Federal Register at 74 FR 9294 (March 3,...

  20. Access to the US Department of Veterans Affairs health system: self-reported barriers to care among returnees of Operations Enduring Freedom and Iraqi Freedom

    PubMed Central

    2013-01-01

    Background The U.S. Department of Veterans Affairs (VA) implemented the Polytrauma System of Care to meet the health care needs of military and veterans with multiple injuries returning from combat operations in Afghanistan and Iraq. Studies are needed to systematically assess barriers to use of comprehensive and exclusive VA healthcare services from the perspective of veterans with polytrauma and with other complex health outcomes following their service in Afghanistan and Iraq. These perspectives can inform policy with regard to the optimal delivery of care to returning veterans. Methods We studied combat veterans (n = 359) from two polytrauma rehabilitation centers using structured clinical interviews and qualitative open-ended questions, augmented with data collected from electronic health records. Our outcomes included several measures of exclusive utilization of VA care with our primary exposure as reported access barriers to care. Results Nearly two thirds of the veterans reported one or more barriers to their exclusive use of VA healthcare services. These barriers predicted differences in exclusive use of VA healthcare services. Experiencing any barriers doubled the returnees’ odds of not using VA exclusively, the geographic distance to VA barrier resulted in a 7 fold increase in the returnees odds of not using VA, and reporting a wait time barrier doubled the returnee’s odds of not using VA. There were no striking differences in access barriers for veterans with polytrauma compared to other returning veterans, suggesting the barriers may be uniform barriers that predict differences in using the VA exclusively for health care. Conclusions This study provides an initial description of utilization of VA polytrauma rehabilitation and other medical care for veteran returnees from all military services who were involved in combat operations in Afghanistan or Iraq. Our findings indicate that these veterans reported important stigmatization and barriers to

  1. Multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak and its control after use of the Veterans Affairs (VA) MRSA bundle in a VA long-term care facility, 2004-2014.

    PubMed

    Webb, Risa M; Denton, Carmelita; Spruill, Emily; Henson, Gay; Bruce, Lisa; Woods, Gail L; Swiatlo, Andrea; Walker, Erica D; Peel, Chere; Sullivan, Donna

    2016-06-01

    A multiclonal methicillin-resistant Staphylococcus aureus (MRSA) outbreak with 91 infections occurred in our Veterans Affairs (VA) community living center over 46 months. Both similar and unique strains were shown by repetitive polymerase chain reaction to contribute to the outbreak, including 1 strain causing infections over a 33-month period. Most infections were soft tissue infections (67%). For 21 months after the initiation of the VA MRSA bundle, no infections were identified, and low rates of infection have been sustained an additional 4 years. The average annual rate of MRSA infection decreased by 62% (P < .001) from 0.6 per 1,000 resident days for 4 years prior to the bundle implementation to 0.09 per 1,000 resident days for 4 years after the bundle implementation.

  2. 77 FR 3841 - Proposed Information Collection (Survey of Veteran Enrollees (Quality and Efficiency of VA Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... Care)) Activities Under OMB Review AGENCY: Veterans Health Administration, Department of Veterans... VA Health Care), VA Form 10-21088. OMB Control Number: 2900-0725. Type of Review: Extension of a... promote quality and efficient delivery of health care through the use of health information...

  3. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... of a Permanent Housing Facility in Fort Harrison, MT AGENCY: Department of Veterans Affairs. ACTION... System in Fort Harrison, Montana. The selected lessee will finance, design, develop, construct,...

  4. The Effect of Increased Travel Reimbursement Rates on Health Care Utilization in the VA

    ERIC Educational Resources Information Center

    Nelson, Richard E.; Hicken, Bret; West, Alan; Rupper, Randall

    2012-01-01

    Purpose: The reimbursement rate that eligible veterans receive for travel to Department of Veterans Affairs (VA) facilities increased from 11 to 28.5 cents per mile on February 1, 2008. We examined the effect of this policy change on utilization of outpatient, inpatient, and pharmacy services, stratifying veterans based on distance from a VA…

  5. Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans Affairs Health Care System

    PubMed Central

    Zulman, Donna M; Pal Chee, Christine; Wagner, Todd H; Yoon, Jean; Cohen, Danielle M; Holmes, Tyson H; Ritchie, Christine; Asch, Steven M

    2015-01-01

    Objectives To investigate the relationship between multimorbidity and healthcare utilisation patterns among the highest cost patients in a large, integrated healthcare system. Design In this retrospective cross-sectional study of all patients in the U.S. Veterans Affairs (VA) Health Care System, we aggregated costs of individuals’ outpatient and inpatient care, pharmacy services and VA-sponsored contract care received in 2010. We assessed chronic condition prevalence, multimorbidity as measured by comorbidity count, and multisystem multimorbidity (number of body systems affected by chronic conditions) among the 5% highest cost patients. Using multivariate regression, we examined the association between multimorbidity and healthcare utilisation and costs, adjusting for age, sex, race/ethnicity, marital status, homelessness and health insurance status. Setting USA VA Health Care System. Participants 5.2 million VA patients. Measures Annual total costs; absolute and share of costs generated through outpatient, inpatient, pharmacy and VA-sponsored contract care; number of visits to primary, specialty and mental healthcare; number of emergency department visits and hospitalisations. Results The 5% highest cost patients (n=261 699) accounted for 47% of total VA costs. Approximately two-thirds of these patients had chronic conditions affecting ≥3 body systems. Patients with cancer and schizophrenia were less likely to have documented comorbid conditions than other high-cost patients. Multimorbidity was generally associated with greater outpatient and inpatient utilisation. However, increased multisystem multimorbidity was associated with a higher outpatient share of total costs (1.6 percentage points per affected body system, p<0.01) but a lower inpatient share of total costs (−0.6 percentage points per affected body system, p<0.01). Conclusions Multisystem multimorbidity is common among high-cost VA patients. While some patients might benefit from disease

  6. Toward a Virtual Lifetime Electronic Record: the Department of Veterans Affairs experience with the Nationwide Health Information Network.

    PubMed

    Bouhaddou, Omar; Bennett, Jamie; Teal, Jennifer; Pugh, Margaret; Sands, Melissa; Fontaine, Frank; Swall, Marie; Dhar, Sanjay; Mallia, Tony; Morgan, Brian; Cromwell, Tim

    2012-01-01

    Health information exchange is expected of all electronic health records (EHRs) in order to ensure safe, quality care coordination. The U.S. Department of Veterans Affairs (VA) has a long history of information exchange across VA facilities and with the U.S. Department of Defense (DoD). However, since a majority of VA and DoD patients receive a portion of their health care from the private sector, it is essential that both agencies enable health information exchange with private sector providers. This has been made possible by the use of the specifications and trust agreement developed by the Nationwide Health Information Network (NwHIN) initiative. Currently, VA has 12 medical centers exchanging information with the private sector and is evaluating the value of the exchange. The authors report on the success of these pilots as well as on the challenges, which include stricter technical specifications and a more efficient approach to patient identification (ID) matching and consent management.

  7. Toward a Virtual Lifetime Electronic Record: The Department of Veterans Affairs Experience with the Nationwide Health Information Network

    PubMed Central

    Bouhaddou, Omar; Bennett, Jamie; Teal, Jennifer; Pugh, Margaret; Sands, Melissa; Fontaine, Frank; Swall, Marie; Dhar, Sanjay; Mallia, Tony; Morgan, Brian; Cromwell, Tim

    2012-01-01

    Health information exchange is expected of all electronic health records (EHRs) in order to ensure safe, quality care coordination. The U.S. Department of Veterans Affairs (VA) has a long history of information exchange across VA facilities and with the U.S. Department of Defense (DoD). However, since a majority of VA and DoD patients receive a portion of their health care from the private sector, it is essential that both agencies enable health information exchange with private sector providers. This has been made possible by the use of the specifications and trust agreement developed by the Nationwide Health Information Network (NwHIN) initiative. Currently, VA has 12 medical centers exchanging information with the private sector and is evaluating the value of the exchange. The authors report on the success of these pilots as well as on the challenges, which include stricter technical specifications and a more efficient approach to patient identification (ID) matching and consent management. PMID:23304272

  8. Mentoring health information professionals in the Department of Veterans Affairs.

    PubMed

    Lloyd, Susan S; Fenton, Susan H

    2008-01-01

    As a major employer of health information professionals, the VA faces significant recruitment and retention challenges. The authors evaluated mentoring as a retention tool through a review of existing literature and the retrospective review of a VA health information management mentoring program. The literature review showed a link between employer mentorship and employee retention, regardless of the nature and structure of the mentoring relationship. Most organizations support employees who are willing to serve as mentors through increased compensation, recognition, and other types of support. No literature was found that studied retention rates for more than three years after a mentoring experience. The review of the VA mentoring program showed increased retention in the three years following enrollment in the program, but the increase was not statistically significant. The review did not demonstrate improvement in retention over a seven-year period. The combined evaluation gives mixed findings for mentorship as a retention tool and demonstrates the need for more research on the topic. PMID:18418462

  9. Use of RxNorm to exchange codified drug allergy information between Department of Veterans Affairs (VA) and Department of Defense (DoD).

    PubMed

    Warnekar, Pradnya P; Bouhaddou, Omar; Parrish, Fola; Do, Nhan; Kilbourne, John; Brown, Steven H; Lincoln, Michael J

    2007-01-01

    Under a congressional mandate, VA and DoD have built a framework to exchange standardized, codified patient drug allergy information through a mediation terminology. Initially, the Unified Medical Language System (UMLS) was deemed to be the most appropriate translator. After both agency files were mapped to UMLS, DoD could understand 45 percent of VA's mapped terms and VA could understand 26 percent of DoD's mapped terms. A significant portion of the non-mediated information was brand names in DoD with generic counterparts in VA. Recently, a Consolidated Health Informatics (CHI) group designated RxNorm as the standard for trade name allergies. An analysis was conducted to estimate mediation improvement using RxNorm. Both agency files were re-mapped to RxNorm. By utilizing the RxNorm defined relationships between brand names and generics and between variants of therapeutic moieties , DoD will understand 74 percent of VA terms and VA will understand 58 percent of DoD terms. PMID:18693943

  10. House Committee on Veterans' Affairs

    MedlinePlus

    ... operations and activities. Read More Vets-Affairs-2.jpg Trials in Transparency Trials in Transparency is designed ... of Veterans Affairs officials. Read More VACities_Wide.jpg VA Accountability Watch Is VA Holding Its Executives ...

  11. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    ERIC Educational Resources Information Center

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  12. 75 FR 69742 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Restoration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ...The Secretary of VA intends to enter into an EUL of the 1889 Soldiers Home Chapel (Building 12), the 1901 Chaplain's Quarters (Building 16), and the surrounding approximately 2.5 acres at the Clement J. Zablocki VAMC in Milwaukee, Wisconsin. The selected Lessee will finance, design, develop, construct, manage, maintain, and operate the Soldiers Home Chapel and Chaplain's......

  13. 75 FR 30915 - Computer Matching Program Between the Department of Veterans Affairs (VA) and the Department of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-02

    ... records ] of benefit recipients under the Post-9/11 GI Bill. The goal of these matches is to identify the... or who are receiving education benefit payments under the Post-9/11 GI Bill. The purpose of the match... criteria for payment of benefits determined by VA under the Post-9/11 GI Bill. DATES: This match...

  14. 76 FR 72047 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... at the Chillicothe VA Medical Center in Chillicothe, Ohio. As consideration for the EUL, the lessee... placement for senior, disabled, homeless and/or at-risk Veterans and their families. FOR FURTHER INFORMATION... consideration under such a lease for the provision of medical care and services would result in a...

  15. Building strong research partnerships between public health and researchers: a VA case study.

    PubMed

    Midboe, Amanda M; Elwy, A Rani; Durfee, Janet M; Gifford, Allen L; Yakovchenko, Vera; Martinello, Richard A; Ross, David; Czarnogorski, Maggie; Goetz, Matthew B; Asch, Steven M

    2014-12-01

    We are in a new era of partner-based implementation research, and we need clear strategies for how to navigate this new era. Drawing on principles from community-based participatory research, the Clinical Public Health group of the Department of Veterans Affairs and the HIV/Hepatitis Quality Enhancement Research Initiative (HHQUERI) forged a longstanding partnership that has improved the care of Veterans with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus. An exemplar HIV testing project epitomizes this partnership and is discussed in terms of the lessons learned as a result of our high level of collaboration around design, analysis, implementation, and dissemination across projects over the past several years. Lessons learned through this partnered testing program involve respecting different time horizons among the partners, identifying relevant research questions for both parties, designing flexible studies, engaging all partners throughout the research, and placing an emphasis on relationship building at all times. These lessons and strategies can benefit others conducting partner-based research both within the Veterans Health Administration (VA) and in other integrated healthcare systems.

  16. Building strong research partnerships between public health and researchers: a VA case study.

    PubMed

    Midboe, Amanda M; Elwy, A Rani; Durfee, Janet M; Gifford, Allen L; Yakovchenko, Vera; Martinello, Richard A; Ross, David; Czarnogorski, Maggie; Goetz, Matthew B; Asch, Steven M

    2014-12-01

    We are in a new era of partner-based implementation research, and we need clear strategies for how to navigate this new era. Drawing on principles from community-based participatory research, the Clinical Public Health group of the Department of Veterans Affairs and the HIV/Hepatitis Quality Enhancement Research Initiative (HHQUERI) forged a longstanding partnership that has improved the care of Veterans with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus. An exemplar HIV testing project epitomizes this partnership and is discussed in terms of the lessons learned as a result of our high level of collaboration around design, analysis, implementation, and dissemination across projects over the past several years. Lessons learned through this partnered testing program involve respecting different time horizons among the partners, identifying relevant research questions for both parties, designing flexible studies, engaging all partners throughout the research, and placing an emphasis on relationship building at all times. These lessons and strategies can benefit others conducting partner-based research both within the Veterans Health Administration (VA) and in other integrated healthcare systems. PMID:25355082

  17. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... of a Transitional and Permanent Housing Facility in Bath, NY AGENCY: Department of Veterans Affairs..., renovate, manage, operate and maintain the EUL development. As consideration for the lease, the lessee will be required to construct, renovate, operate, and maintain a transitional and permanent...

  18. Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

    PubMed

    Koenig, Kristi L

    2003-01-01

    The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted.

  19. Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

    PubMed

    Koenig, Kristi L

    2003-01-01

    The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted. PMID:15310045

  20. Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense biosurveillance application

    PubMed Central

    2011-01-01

    Background The establishment of robust biosurveillance capabilities is an important component of the U.S. strategy for identifying disease outbreaks, environmental exposures and bioterrorism events. Currently, U.S. Departments of Defense (DoD) and Veterans Affairs (VA) perform biosurveillance independently. This article describes a joint VA/DoD biosurveillance project at North Chicago-VA Medical Center (NC-VAMC). The Naval Health Clinics-Great Lakes facility physically merged with NC-VAMC beginning in 2006 with the full merger completed in October 2010 at which time all DoD care and medical personnel had relocated to the expanded and remodeled NC-VAMC campus and the combined facility was renamed the Lovell Federal Health Care Center (FHCC). The goal of this study was to evaluate disease surveillance using a biosurveillance application which combined data from both populations. Methods A retrospective analysis of NC-VAMC/Lovell FHCC and other Chicago-area VAMC data was performed using the ESSENCE biosurveillance system, including one infectious disease outbreak (Salmonella/Taste of Chicago-July 2007) and one weather event (Heat Wave-July 2006). Influenza-like-illness (ILI) data from these same facilities was compared with CDC/Illinois Sentinel Provider and Cook County ESSENCE data for 2007-2008. Results Following consolidation of VA and DoD facilities in North Chicago, median number of visits more than doubled, median patient age dropped and proportion of females rose significantly in comparison with the pre-merger NC-VAMC facility. A high-level gastrointestinal alert was detected in July 2007, but only low-level alerts at other Chicago-area VAMCs. Heat-injury alerts were triggered for the merged facility in June 2006, but not at the other facilities. There was also limited evidence in these events that surveillance of the combined population provided utility above and beyond the VA-only and DoD-only components. Recorded ILI activity for NC-VAMC/Lovell FHCC was more

  1. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... Health Care System in Minnesota. The selected lessee will finance, design, develop, construct, manage... construct, renovate, operate and maintain a permanent supportive housing facility with priority...

  2. Data Quality and Interoperability Challenges for eHealth Exchange Participants: Observations from the Department of Veterans Affairs' Virtual Lifetime Electronic Record Health Pilot Phase.

    PubMed

    Botts, Nathan; Bouhaddou, Omar; Bennett, Jamie; Pan, Eric; Byrne, Colene; Mercincavage, Lauren; Olinger, Lois; Hunolt, Elaine; Cullen, Theresa

    2014-01-01

    Authors studied the United States (U.S.) Department of Veterans Affairs' (VA) Virtual Lifetime Electronic Record (VLER) Health pilot phase relative to two attributes of data quality - the adoption of eHealth Exchange data standards, and clinical content exchanged. The VLER Health pilot was an early effort in testing implementation of eHealth Exchange standards and technology. Testing included evaluation of exchange data from the VLER Health pilot sites partners: VA, U.S. Department of Defense (DoD), and private sector health care organizations. Domains assessed data quality and interoperability as it relates to: 1) conformance with data standards related to the underlying structure of C32 Summary Documents (C32) produced by eHealth Exchange partners; and 2) the types of C32 clinical content exchanged. This analysis identified several standards non-conformance issues in sample C32 files and informed further discourse on the methods needed to effectively monitor Health Information Exchange (HIE) data content and standards conformance.

  3. 77 FR 19975 - VA Acquisition Regulation: Simplified Acquisition Procedures for Health-Care Resources (Section...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... Procedures for Health-Care Resources (Section 610 Review) AGENCY: Department of Veterans Affairs. ACTION... acquisition of health-care resources, consisting of commercial services or the use of medical equipment or space, pursuant to the Veterans' Health Care Eligibility Reform Act of 1996 (38 U.S.C. 8151-8153)....

  4. 76 FR 5432 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the Charlie...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ..., develop, renovate, manage, maintain and operate the EUL development. As consideration for the lease, the...; provide preference and priority placement for homeless Veterans and Veterans at risk of homelessness; and... by the Under Secretary for Health for applying the consideration under such a lease for the...

  5. 76 FR 72046 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ..., Virginia. As consideration, the selected lessee will be required to finance, design, develop, construct... provide preference and priority placement for homeless and at-risk Veterans, and provide on-site... plan proposed by the Under Secretary for Health for applying the consideration under such a lease...

  6. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., construct, manage, maintain and operate the EUL development. As consideration for the lease, the lessee will... will be set aside to provide transitional housing and supportive services for homeless and at-risk... business plan proposed by the Under Secretary for Health for applying the consideration under such a...

  7. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... and operate the EUL development. As consideration for the lease, the lessee will be required to... placement for senior Veterans, homeless Veterans and Veterans at risk of homelessness and their families... business plan proposed by the Under Secretary for Health for applying the consideration under such a...

  8. 76 FR 72045 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... Center (Uptown Division) in Augusta, Georgia. As consideration, the selected lessee will be required to... required to provide preference and priority placement for Veterans at risk for homelessness, and provide on... business plan proposed by the Under Secretary for Health for applying the consideration under such a...

  9. 76 FR 67023 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... EUL development. As consideration for the lease, the lessees will be required to construct, renovate... placement for homeless Veterans and Veterans at risk of homelessness and their families; and provide a... by the Under Secretary for Health for applying the consideration under such a lease for the...

  10. 76 FR 71439 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... placement for homeless and/or at-risk Veterans and their families; and provide a supportive services program... by the Under Secretary for Health for applying the consideration under such a lease for the...

  11. 76 FR 71443 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... and operate the EUL development. As consideration for the lease, the lessee will be required to... placement for homeless and/or at-risk Veterans and their families; and provide a supportive services program... by the Under Secretary for Health for applying the consideration under such a lease for the...

  12. 76 FR 72045 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... Dayton, Ohio. As consideration for the lease, the lessee will be required to construct, operate, and... preference and priority placement for homeless, at-risk, disabled, and senior Veterans and their families and... business plan proposed by the Under Secretary for Health for applying the consideration under such a...

  13. Telephone Enrollment in the VA Healthcare System. Final rule.

    PubMed

    2016-09-12

    The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its medical regulations. Specifically, this rule allows veterans to complete applications for health care enrollment by providing application information, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided to a VA employee over the phone. This action makes it easier for veterans to apply to enroll and speeds VA processing of applications. PMID:27632804

  14. Telephone Enrollment in the VA Healthcare System. Final rule.

    PubMed

    2016-09-12

    The Department of Veterans Affairs (VA) adopts as final, without change, an interim final rule amending its medical regulations. Specifically, this rule allows veterans to complete applications for health care enrollment by providing application information, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided to a VA employee over the phone. This action makes it easier for veterans to apply to enroll and speeds VA processing of applications.

  15. Integrating patient voices into health information for self-care and patient-clinician partnerships: Veterans Affairs design recommendations for patient-generated data applications.

    PubMed

    Woods, Susan S; Evans, Neil C; Frisbee, Kathleen L

    2016-05-01

    Electronic health record content is created by clinicians and is driven largely by intermittent and brief encounters with patients. Collecting data directly from patients in the form of patient-generated data (PGD) provides an unprecedented opportunity to capture personal, contextual patient information that can supplement clinical data and enhance patients' self-care. The US Department of Veterans Affairs (VA) is striving to implement the enterprise-wide capability to collect and use PGD in order to partner with patients in their care, improve the patient healthcare experience, and promote shared decision making. Through knowledge gained from Veterans' and healthcare teams' perspectives, VA created a taxonomy and an evolving framework on which to design and develop applications that capture and help physicians utilize PGD. Ten recommendations for effectively collecting and integrating PGD into patient care are discussed, addressing health system culture, data value, architecture, policy, data standards, clinical workflow, data visualization, and analytics and population reach.

  16. VA Community Mental Health Service Providers' Utilization of and Attitudes toward Telemental Health Care: The Gatekeeper's Perspective

    ERIC Educational Resources Information Center

    Jameson, John Paul; Farmer, Mary Sue; Head, Katharine J.; Fortney, John; Teal, Cayla R.

    2011-01-01

    Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined. Purpose: The purpose of this study was to investigate the…

  17. Setting the stage for a new strategic plan for geriatrics and extended care in the Veterans Health Administration: summary of the 2008 VA State of the Art Conference, "The changing faces of geriatrics and extended care: meeting the needs of veterans in the next decade".

    PubMed

    Shay, Kenneth; Burris, James F

    2008-12-01

    The Department of Veterans Affairs (VA) assumed an early leadership role in focusing on care of elderly adults. In 1998, the Federal Advisory Committee on the Future of VA Long-Term Care, appointed by the VA Undersecretary for Health, recommended redirection of VA's extended care programs toward noninstitutional forms. A decade later, VA's Office of Geriatrics and Extended Care (GEC) initiated a strategic planning process by convening experts in geriatrics and health care, policy, and finance in Virginia on March 25 to 27, 2008, to present to VA clinicians and clinical managers the "State of the Art" of VA GEC. Recurring clinical themes included rising numbers and complexity of aging veterans, recent addition of younger veterans to VA's extended care mix, challenges that dementia and mental illness exert throughout GEC, and need for seamlessness in delivery of care across multiple venues. Ongoing research efforts quantifying demand and resources and validating models of care will remain indispensible for meeting clinical challenges. Serious undersupply of clinicians of all disciplines with general or specialty geriatrics knowledge persists. Much of VA's healthcare workforce and leadership are approaching retirement age, driving the need for new educational approaches, recruitment and retention strategies, and innovative delivery systems. Growing dependence on informal caregivers highlights the need for supporting these partners. VA's healthcare budget allocation illustrates how national policy dictates systemic, regional, and local clinical decisions. Rehabilitation of the newest veterans is resulting in systemwide efficiencies. Educating and empowering patients and families results in optimized utilization of health resources. PMID:19093933

  18. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... medical charges associated with non-VA outpatient care, provided under 38 CFR 17.52 or 17.120. 75 FR 78901.... See 75 FR 78901. We explained: Home Health Care and Hospice Care he pricing methodology adopted by...-day period was $2,537.40 in FY 2010. The average Medicare reimbursement level for skilled home...

  19. 38 CFR 17.56 - Payment for non-VA physician and other health care professional services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...' (CMS) participating physician fee schedule for the period in which the service is provided (see 42 CFR...-VA physician and other health care professional services. (a) Except for anesthesia services, and... schedule or if the services constitute anesthesia services, payment for such non-VA health...

  20. Predicting Adoption of Telemedicine by VA Mental Health Professionals

    ERIC Educational Resources Information Center

    Pak, Wesley Chong Y.

    2013-01-01

    Providing primary health and specialty services to 3.4 million rural and highly rural veterans is a challenging task because of geographic barriers and the uneven distribution of rural healthcare providers. Although the Veterans Health Administration is hoping that technology such as telemedicine expands availability of specialties' access to…

  1. Disruptive Innovation: Implementation of Electronic Consultations in a Veterans Affairs Health Care System

    PubMed Central

    Clark, Justice

    2016-01-01

    Background Electronic consultations (e-consults) offer rapid access to specialist input without the need for a patient visit. E-consult implementation began in 2011 at VA Boston Healthcare System (VABHS). By early 2013, e-consults were available for all clinical services. In this implementation, the requesting clinician selects the desired consultation within the electronic health record (EHR) ordering menu, which creates an electronic form that is pre-populated with patient demographic information and allows free-text entry of the reason for consult. This triggers a message to the requesting clinician and requested specialty, thereby enabling bidirectional clinician-clinician communication. Objective The aim of this study is to examine the utilization of e-consults in a large Veterans Affairs (VA) health care system. Methods Data from the electronic health record was used to measure frequency of e-consult use by provider type (physician or nurse practitioner (NP) and/or physician assistant), and by the requesting and responding specialty from January 2012 to December 2013. We conducted chart reviews for a purposive sample of e-consults and semi-structured interviews with a purposive sample of clinicians and hospital leaders to better characterize the process, challenges, and usability of e-consults. Results A total of 7097 e-consults were identified, 1998 from 2012 and 5099 from 2013. More than one quarter (27.56%, 1956/7097) of the e-consult requests originated from VA facilities in New England other than VABHS and were excluded from subsequent analysis. Within the VABHS e-consults (72.44%, 5141/7097), variability in frequency and use of e-consults across provider types and specialties was found. A total of 64 NPs requested 2407 e-consults (median 12.5, range 1-415). In contrast, 448 physicians (including residents and fellows) requested 2349 e-consults (median 2, range 1-116). More than one third (37.35%, 1920/5141) of e-consults were sent from primary care to

  2. Attitudes about the VA health-care setting, mental illness, and mental health treatment and their relationship with VA mental health service use among female and male OEF/OIF veterans.

    PubMed

    Fox, Annie B; Meyer, Eric C; Vogt, Dawne

    2015-02-01

    In the present study, the authors explored gender differences in attitudinal barriers to and facilitators of care for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans and examined the relationship of those factors with VA mental health service use among female and male veterans with probable mental health conditions. Data were collected as part of a national cross-sectional survey of OEF/OIF veterans; the current sample was limited to participants with a probable diagnosis of posttraumatic stress disorder, depression, or alcohol abuse (N = 278). Although negligible gender differences were observed in attitudes about VA care and perceived fit in the VA setting, men reported slightly more negative beliefs about mental illness and mental health treatment than women. In addition, logistic regressions revealed different associations with VA mental health service use for women and men. For women only, positive perceptions of VA care were associated with increased likelihood of seeking mental health treatment. For men only, perceived similarity to other VA care users and negative beliefs about mental health treatment were associated with increased likelihood of service use, whereas negative beliefs about mental illness were associated with lower likelihood of service use. For both women and men, perceived entitlement to VA care was associated with increased likelihood of service use and negative beliefs about treatment-seeking were associated with a reduced likelihood of seeking mental health care in the past 6 months. Results support the need for tailored outreach to address unique barriers to mental health treatment for female and male OEF/OIF veterans.

  3. Impact of Rural Residence on Survival of Male Veterans Affairs Patients after Age 65

    ERIC Educational Resources Information Center

    MacKenzie, Todd A.; Wallace, Amy E.; Weeks, William B.

    2010-01-01

    Objectives: More than 1 in 5 Veterans Affairs (VA) users lives in a rural setting. Rural veterans face different barriers to health care than their urban counterparts, but their risk of death relative to their urban counterparts is unknown. The objective of our study was to compare survival between rural and urban VA users. Methods: We linked the…

  4. Performance of a Natural Language Processing (NLP) Tool to Extract Pulmonary Function Test (PFT) Reports from Structured and Semistructured Veteran Affairs (VA) Data

    PubMed Central

    Sauer, Brian C.; Jones, Barbara E.; Globe, Gary; Leng, Jianwei; Lu, Chao-Chin; He, Tao; Teng, Chia-Chen; Sullivan, Patrick; Zeng, Qing

    2016-01-01

    Introduction/Objective: Pulmonary function tests (PFTs) are objective estimates of lung function, but are not reliably stored within the Veteran Health Affairs data systems as structured data. The aim of this study was to validate the natural language processing (NLP) tool we developed—which extracts spirometric values and responses to bronchodilator administration—against expert review, and to estimate the number of additional spirometric tests identified beyond the structured data. Methods: All patients at seven Veteran Affairs Medical Centers with a diagnostic code for asthma Jan 1, 2006–Dec 31, 2012 were included. Evidence of spirometry with a bronchodilator challenge (BDC) was extracted from structured data as well as clinical documents. NLP’s performance was compared against a human reference standard using a random sample of 1,001 documents. Results: In the validation set NLP demonstrated a precision of 98.9 percent (95 percent confidence intervals (CI): 93.9 percent, 99.7 percent), recall of 97.8 percent (95 percent CI: 92.2 percent, 99.7 percent), and an F-measure of 98.3 percent for the forced vital capacity pre- and post pairs and precision of 100 percent (95 percent CI: 96.6 percent, 100 percent), recall of 100 percent (95 percent CI: 96.6 percent, 100 percent), and an F-measure of 100 percent for the forced expiratory volume in one second pre- and post pairs for bronchodilator administration. Application of the NLP increased the proportion identified with complete bronchodilator challenge by 25 percent. Discussion/Conclusion: This technology can improve identification of PFTs for epidemiologic research. Caution must be taken in assuming that a single domain of clinical data can completely capture the scope of a disease, treatment, or clinical test. PMID:27376095

  5. Payment for non-VA physician services associated with either outpatient or inpatient care provided at non-VA facilities--VA. Proposed rule.

    PubMed

    1997-07-22

    This document proposes to amend Department of Veterans Affairs (VA) medical regulations concerning payment for non-VA physician services that are associated with either outpatient or inpatient care provided to eligible VA beneficiaries at non-VA facilities. We propose that when a service specific reimbursement amount has been calculated under Medicare's Participating Physician Fee Schedule, VA would pay the lesser of the actual billed charge or the calculated amount. We also propose that when an amount has not been calculated, VA would pay the amount calculated under a 75th percentile formula or, in certain limited circumstances, VA would pay the usual and customary rate. In our view, adoption of this proposal would establish reimbursement consistency among federal health benefits programs, would ensure that amounts paid to physicians better represent the relative resource inputs used to furnish a service, and, would, as reflected by a recent VA Office of Inspector General (OIG) audit of the VA fee-basis program, achieve program cost reductions. Further, consistent with statutory requirements, the regulations would continue to specify that VA payment constitutes payment in full.

  6. Department of Veterans Affairs' Implementation of Information Security Education Assistance Program. GAO-10-170R

    ERIC Educational Resources Information Center

    Wilshusen, Gregory C.; Melvin, Valerie C.

    2009-01-01

    The Veterans Benefits, Health Care, and Information Technology Act of 2006 authorizes the Secretary of Veterans Affairs to establish an educational assistance program for information security. The Information Security Education Assistance Program is envisioned as a means for the Department of Veterans Affairs (VA) to attract and retain individuals…

  7. Lessons learned from usability testing of the VA's personal health record

    PubMed Central

    Saleem, Jason J; Russ, Alissa L; Jones, Josette; Russell, Scott A; Chumbler, Neale R

    2011-01-01

    In order to create user-centered design information to guide the development of personal health records (PHRs), 24 patients participated in usability assessments of VA's MyHealtheVet program. Observational videos and efficiency measures were collected among users performing four PHR scenarios: registration and log-in, prescription refill, tracking health, and searching for health information. Twenty-five percent of users successfully completed registration. Individuals preferred prescription numbers over names, sometimes due to privacy concerns. Only efficiency in prescription refills was significantly better than target values. Users wanted to print their information to share with their doctors, and questioned the value of MyHealtheVet search functions over existing online health information. In summary, PHR registration must balance simplicity and security, usability tests guide how PHRs can tailor functions to individual preferences, PHRs add value to users' data by making information more accessible and understandable, and healthcare organizations should build trust for PHR health content. PMID:21984604

  8. Suicide risk in Iraq and Afghanistan veterans with mental health problems in VA care.

    PubMed

    Maguen, Shira; Madden, Erin; Cohen, Beth E; Bertenthal, Daniel; Neylan, Thomas C; Seal, Karen H

    2015-09-01

    Suicide rates among U.S. military personnel and veterans are a public health concern, and those with mental health conditions are at particular risk. We examined demographic, military, temporal, and diagnostic associations with suicidality in veterans. We conducted a population-based, retrospective cohort study of all Iraq and Afghanistan war veterans who screened positive for posttraumatic stress disorder (PTSD) and/or depression, received a suicide risk assessment, and endorsed hopelessness about the present or future after their last deployment and between January 1, 2010 and June 29, 2014 (N = 45,741). We used bivariate and multivariate logistic regression analyses to examine variables associated with having endorsed suicidal thoughts and a plan. Multiple factors were associated with suicidality outcomes, including longer time from last deployment to screening (proxy for time to seeking VA care), an alcohol use disorder diagnosis, further distance from VA (rurality), and being active duty during military service. Hispanic veterans were at decreased risk of having suicidal ideation and a plan, compared to their white counterparts. In high-risk veterans, some of the strongest associations with suicidality were with modifiable risk factors, including time to VA care and alcohol use disorder diagnoses. Promising avenues for suicide prevention efforts can include early engagement/intervention strategies with a focus on amelioration of high-risk drinking. PMID:26228410

  9. To designate the facility of the Department of Veterans Affairs located at 9800 West Commercial Boulevard in Sunrise, Florida, as the "William 'Bill' Kling VA Clinic".

    THOMAS, 112th Congress

    Rep. Wasserman Schultz, Debbie [D-FL-20

    2012-09-19

    12/21/2012 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  10. VA Health Service Utilization for Homeless and Low-income Veterans

    PubMed Central

    Gabrielian, Sonya; Yuan, Anita H.; Andersen, Ronald M.; Rubenstein, Lisa V.; Gelberg, Lillian

    2016-01-01

    Background The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program—the VA’s Housing First effort—is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. Objectives We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. Research Design We performed a secondary database analysis of Veterans (n = 62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. Results HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Conclusions Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care. PMID:24714583

  11. Health Foods: Facts and Fakes. Public Affairs Pamphlet No. 498.

    ERIC Educational Resources Information Center

    Margolius, Sidney

    In this booklet the author states that the health food industry has reached a stage where consumers must be wary of false advertising, misleading labelling devices, and other techniques used by manufacturers attempting to capitalize on the popularity of health foods. Included are nearly two dozen examples of health food products which are…

  12. Local Area Unemployment and the Demand for Inpatient Care Among Veterans Affairs Enrollees.

    PubMed

    Wong, Edwin S; Hebert, Paul L; Nelson, Karin M; Hernandez, Susan E; Sylling, Philip W; Fihn, Stephan D; Liu, Chuan-Fen

    2015-08-01

    Prior research examining the relationship between economic conditions and health service demand has focused primarily on outpatient use. This study examines whether local area unemployment, as an indicator of economic conditions, was associated with use of inpatient care, which is theoretically less subject to discretionary use. Using a random sample of 131,603 patients dually enrolled in the Veterans Affairs (VA) Health System and fee-for-service Medicare, we measured VA, Medicare, and total (VA and Medicare) hospitalizations. Overall, local unemployment was not associated with VA, Medicare, or total hospitalization probability. Among low-income veterans exempt from VA copayments, higher local unemployment was moderately associated with a lower probability of hospitalization through Medicare. For veterans subject to VA copayments, higher local unemployment was moderately associated with a higher likelihood of VA hospitalization. These results suggest inpatient use is less sensitive to the economy, although worse economic conditions slightly affected inpatient demand for select veterans.

  13. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and outpatient health care professional services at non-departmental facilities and other medical... inpatient and outpatient health care professional services at non-departmental facilities and other medical charges associated with non-VA outpatient care. (a) Except for health care professional services...

  14. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and outpatient health care professional services at non-departmental facilities and other medical... inpatient and outpatient health care professional services at non-departmental facilities and other medical charges associated with non-VA outpatient care. (a) Except for health care professional services...

  15. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and outpatient health care professional services at non-departmental facilities and other medical... inpatient and outpatient health care professional services at non-departmental facilities and other medical charges associated with non-VA outpatient care. (a) Except for health care professional services...

  16. 38 CFR 17.56 - VA payment for inpatient and outpatient health care professional services at non-departmental...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... and outpatient health care professional services at non-departmental facilities and other medical... inpatient and outpatient health care professional services at non-departmental facilities and other medical charges associated with non-VA outpatient care. (a) Except for health care professional services...

  17. Unintended Consequences of Health Information Technology: Evidence From Veterans Affairs Colorectal Cancer Oncology Watch Intervention

    PubMed Central

    Bian, John; Bennett, Charles L.; Fisher, Deborah A.; Ribeiro, Maria; Lipscomb, Joseph

    2012-01-01

    Purpose We evaluated the Colorectal Cancer (CRC) Oncology Watch intervention, a clinical reminder implemented in Veterans Integrated Service Network 7 (including eight hospitals) to improve CRC screening rates in 2008. Patients and Methods Veterans Affairs (VA) administrative data were used to construct four cross-sectional groups of veterans at average risk, age 50 to 64 years; one group was created for each of the following years: 2006, 2007, 2009, and 2010. We applied hospital fixed effects for estimation, using a difference-in-differences model in which the eight hospitals served as the intervention sites, and the other 121 hospitals served as controls, with 2006 to 2007 as the preintervention period and 2009 to 2010 as the postintervention period. Results The sample included 4,352,082 veteran-years in the 4 years. The adherence rates were 37.6%, 31.6%, 34.4%, and 33.2% in the intervention sites in 2006, 2007, 2009, and 2010, respectively, and the corresponding rates in the controls were 31.0%, 30.3%, 32.3%, and 30.9%. Regression analysis showed that among those eligible for screening, the intervention was associated with a 2.2–percentage point decrease in likelihood of adherence (P < .001). Additional analyses showed that the intervention was associated with a 5.6–percentage point decrease in likelihood of screening colonoscopy among the adherent, but with increased total colonoscopies (all indicators) of 3.6 per 100 veterans age 50 to 64 years. Conclusion The intervention had little impact on CRC screening rates for the studied population. This absence of favorable impact may have been caused by an unintentional shift of limited VA colonoscopy capacity from average-risk screening to higher-risk screening and to CRC surveillance, or by physician fatigue resulting from the large number of clinical reminders implemented in the VA. PMID:23045582

  18. Sleep characteristics of Veterans Affairs Adult Day Health Care participants.

    PubMed

    Hughes, Jaime M; Martin, Jennifer L

    2015-01-01

    Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants. PMID:24654988

  19. Sleep characteristics of Veterans Affairs Adult Day Health Care participants.

    PubMed

    Hughes, Jaime M; Martin, Jennifer L

    2015-01-01

    Addressing sleep disturbance can help to slow functional decline, delay nursing home admission, and improve overall health among older adults; however, sleep is not widely studied in high-risk older adults such as Adult Day Health Care (ADHC) participants. Sixty-eight ADHC participants were interviewed for sleep disturbance using a 28-item screening questionnaire. More than two thirds (n = 48, 70.6%) reported one or more characteristics of poor sleep, and 38% of participants met basic criteria for insomnia. Individuals with insomnia attended ADHC less frequently, reported worse sleep quality and shorter sleep duration, and were more likely to endorse trouble falling asleep, staying asleep, and waking up too early (ps < 0.001). Research is needed to better understand perceptions, predictors, and outcomes of sleep disturbance within ADHC participants.

  20. The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program.

    PubMed Central

    Khuri, S F; Daley, J; Henderson, W; Hur, K; Demakis, J; Aust, J B; Chong, V; Fabri, P J; Gibbs, J O; Grover, F; Hammermeister, K; Irvin, G; McDonald, G; Passaro, E; Phillips, L; Scamman, F; Spencer, J; Stremple, J F

    1998-01-01

    OBJECTIVE: To provide reliable risk-adjusted morbidity and mortality rates after major surgery to the 123 Veterans Affairs Medical Centers (VAMCs) performing major surgery, and to use risk-adjusted outcomes in the monitoring and improvement of the quality of surgical care to all veterans. SUMMARY BACKGROUND DATA: Outcome-based comparative measures of the quality of surgical care among surgical services and surgical subspecialties have been elusive. METHODS: This study included prospective assessment of presurgical risk factors, process of care during surgery, and outcomes 30 days after surgery on veterans undergoing major surgery in 123 medical centers; development of multivariable risk-adjustment models; identification of high and low outlier facilities by observed-to-expected outcome ratios; and generation of annual reports of comparative outcomes to all surgical services in the Veterans Health Administration (VHA). RESULTS: The National VA Surgical Quality Improvement Program (NSQIP) data base includes 417,944 major surgical procedures performed between October 1, 1991, and September 30, 1997. In FY97, 11 VAMCs were low outliers for risk-adjusted observed-to-expected mortality ratios; 13 VAMCs were high outliers for risk-adjusted observed-to-expected mortality ratios. Identification of high and low outliers by unadjusted mortality rates would have ascribed an outlier status incorrectly to 25 of 39 hospitals, an error rate of 64%. Since 1994, the 30-day mortality and morbidity rates for major surgery have fallen 9% and 30%, respectively. CONCLUSIONS: Reliable, valid information on patient presurgical risk factors, process of care during surgery, and 30-day morbidity and mortality rates is available for all major surgical procedures in the 123 VAMCs performing surgery in the VHA. With this information, the VHA has established the first prospective outcome-based program for comparative assessment and enhancement of the quality of surgical care among multiple

  1. Validity Assessment of Referral Decisions at a VA Health Care System Polytrauma System of Care.

    PubMed

    Chung, Joyce; Aguila, Fatima; Harris, Odette

    2015-01-01

    There has been intensive interest to ensure equitable and appropriate access to the specialized rehabilitative services of the VA Polytrauma System of Care (PSC) for patients sustaining polytrauma and traumatic brain injuries (TBI). A retrospective cohort study with prospective data acquisition was conducted to assess validity and objectivity of the acceptance decision algorithm to the VA Palo Alto Health Care System (VAPAHCS) PSC. Our hypotheses are (1) VAPAHCS PSC referral decisions were appropriate and without bias and (2) the identified needs of redirected referrals were addressed. This analysis included 1,025 referrals (906 patients); 813 patients (89.7%) were accepted, and 93 (10.3%) were redirected. Redirected cases were older, were more often active duty service members, and were not from the West Coast. There were more females redirected due to concomitant spinal cord injury. These are rationale differences. In redirected patients, the most commonly identified rehabilitation needs were psychological support, mobility/physical therapy, and communication/speech services; >75% of patients had these services offered elsewhere outside of the PSC resources. While balancing financial stewardship and meeting our mission to provide outstanding rehabilitative care to veterans and service members, we demonstrated that acceptance decisions were valid and without bias, and redirected patients received appropriate alternate resources. PMID:26180664

  2. Health Insurance and the Labor Supply Decisions of Older Workers: Evidence from a U.S. Department of Veterans Affairs Expansion

    PubMed Central

    Boyle, Melissa A.; Lahey, Joanna N.

    2010-01-01

    This paper exploits a major mid-1990s expansion in the U.S. Department of Veterans Affairs health care system to provide evidence on the labor market effects of expanding health insurance availability. Using data from the Current Population Survey, we employ a difference-in-differences strategy to compare the labor market behavior of older veterans and non-veterans before and after the VA health benefits expansion to test the impact of public health insurance on labor supply. We find that older workers are significantly more likely to decrease work both on the extensive and intensive margins after receiving access to non-employer based insurance. Workers with some college education or a college degree are more likely to transition into self-employment, a result consistent with “job-lock” effects. However, less-educated workers are more likely to leave self-employment, a result suggesting that the positive income effect from receiving public insurance dominates the “job-lock” effect for these workers. Some relatively disadvantaged sub-populations may also increase their labor supply after gaining greater access to public insurance, consistent with complementary positive health effects of health care access or decreased work disincentives for these groups. We conclude that this reform has affected employment and retirement decisions, and suggest that future moves toward universal coverage or expansions of Medicare are likely to have significant labor market effects. PMID:20694047

  3. Evaluating the Effectiveness of Mental Health First Aid Training among Student Affairs Staff at a Canadian University

    ERIC Educational Resources Information Center

    Massey, Jennifer; Brooks, Meghan; Burrow, Jeff

    2014-01-01

    This study evaluates the effectiveness of providing the Mental Health First Aid training program to student affairs staff. The objective of the training was to increase knowledge of mental health, enhance sensitivity, and raise confidence to intervene and assist individuals experiencing a mental health issue. We found the training successfully met…

  4. Cost of VA adult day health care programs and their effect on utilization and cost of care.

    PubMed

    Ehreth, J; Chapko, M; Hedrick, S C; Savarino, J E

    1993-09-01

    The VA-ADHC Evaluation included a detailed assessment of the cost of the VA-ADHC programs and an evaluation of their effect on patients' utilization and costs of other health care services. Although each VA-ADHC program had little variation in its program costs over the 3 years of the study, there were large variations between the programs in total costs, their costs per patient day, and in some cost components. The 3 most important factors in determining the level of program costs were: the way patients were transported to and from ADHC, the availability of space to house the program, and the staff-to-patient ratio. The total cost of health care for patients randomly assigned to VA-ADHC was significantly (15.5%) higher than those assigned to customary care. Although ADHC care did substitute for certain other forms of care (i.e., home care and clinic visits), there was not enough of a substitution effect to offset the additional costs of ADHC services.

  5. Expanded Access to Non-VA Care Through the Veterans Choice Program. Interim final rule.

    PubMed

    2015-12-01

    The Department of Veterans Affairs (VA) revises its medical regulations that implement section 101 of the Veterans Access, Choice, and Accountability Act of 2014 (hereafter referred to as "the Choice Act"), which requires VA to establish a program to furnish hospital care and medical services through eligible non-VA health care providers to eligible veterans who either cannot be seen within the wait-time goals of the Veterans Health Administration (VHA) or who qualify based on their place of residence (hereafter referred to as the "Veterans Choice Program" or the "Program"). These regulatory revisions are required by the most recent amendments to the Choice Act made by the Construction Authorization and Choice Improvement Act of 2014, and by the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. The Construction Authorization and Choice Improvement Act of 2014 amended the Choice Act to define additional criteria that VA may use to determine that a veteran's travel to a VA medical facility is an "unusual or excessive burden," and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 amended the Choice Act to cover all veterans enrolled in the VA health care system, remove the 60-day limit on an episode of care, modify the wait-time and 40-mile distance eligibility criteria, and expand provider eligibility based on criteria as determined by VA. This interim final rule revises VA regulations consistent with the changes made to the Choice Act as described above.

  6. Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

    PubMed

    Boyle, Melissa A; Lahey, Joanna N

    2016-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act.

  7. Spousal labor market effects from government health insurance: Evidence from a veterans affairs expansion.

    PubMed

    Boyle, Melissa A; Lahey, Joanna N

    2016-01-01

    Measuring the total impact of health insurance receipt on household labor supply is important in an era of increased access to publicly provided and subsidized insurance. Although government expansion of health insurance to older workers leads to direct labor supply reductions for recipients, there may be spillover effects on the labor supply of uncovered spouses. While the most basic model predicts a decrease in overall household work hours, financial incentives such as credit constraints, target income levels, and the need for own health insurance suggest that spousal labor supply might increase. In contrast, complementarities of spousal leisure would predict a decrease in labor supply for both spouses. Utilizing a mid-1990s expansion of health insurance for U.S. veterans, we provide evidence on the effects of public insurance availability on the labor supply of spouses. Using data from the Current Population Survey and Health and Retirement Study, we employ a difference-in-differences strategy to compare the labor market behavior of the wives of older male veterans and non-veterans before and after the VA health benefits expansion. Although husbands' labor supply decreases, wives' labor supply increases, suggesting that financial incentives dominate complementarities of spousal leisure. This effect is strongest for wives with lower education levels and lower levels of household wealth and those who were not previously employed full-time. These findings have implications for government programs such as Medicare and Social Security and the Affordable Care Act. PMID:26734757

  8. 76 FR 21768 - Privacy Act of 1974; Department of Homeland Security/Office of Health Affairs-001 Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-18

    ... 19, 2006, 71 FR 35360). Categories of records in the system: Categories of records in this system... Affairs--001 Contractor Occupational Health and Immunization Records System of Records AGENCY: Privacy... Contractor Occupational Health and Immunization Records System of Records.'' This system...

  9. Improving trends in gender disparities in the Department of Veterans Affairs: 2008-2013.

    PubMed

    Whitehead, Alison M; Czarnogorski, Maggie; Wright, Steve M; Hayes, Patricia M; Haskell, Sally G

    2014-09-01

    Increasing numbers of women veterans using Department of Veterans Affairs (VA) services has contributed to the need for equitable, high-quality care for women. The VA has evaluated performance measure data by gender since 2006. In 2008, the VA launched a 5-year women's health redesign, and, in 2011, gender disparity improvement was included on leadership performance plans. We examined data from VA Office of Analytics and Business Intelligence quarterly gender reports for trends in gender disparities in gender-neutral performance measures from 2008 to 2013. Through reporting of data by gender, leadership involvement, electronic reminders, and population management dashboards, VA has seen a decreasing trend in gender inequities on most Health Effectiveness Data and Information Set performance measures.

  10. Helping safeguard Veterans Affairs' hospital buildings by advanced earthquake monitoring

    USGS Publications Warehouse

    Kalkan, Erol; Banga, Krishna; Ulusoy, Hasan S.; Fletcher, Jon Peter B.; Leith, William S.; Blair, James L.

    2012-01-01

    In collaboration with the U.S. Department of Veterans Affairs (VA), the National Strong Motion Project of the U.S. Geological Survey has recently installed sophisticated seismic systems that will monitor the structural integrity of hospital buildings during earthquake shaking. The new systems have been installed at more than 20 VA medical campuses across the country. These monitoring systems, which combine sensitive accelerometers and real-time computer calculations, are capable of determining the structural health of each structure rapidly after an event, helping to ensure the safety of patients and staff.

  11. Agreement Between HEDIS Performance Assessments in the VA and Medicare Advantage: Is Quality in the Eye of the Beholder?

    PubMed

    Trivedi, Amal N; Wilson, Ira B; Charlton, Mary E; Kizer, Kenneth W

    2016-01-01

    Medicare Advantage (MA) plans and the Veterans Affairs (VA) health care system assess quality of care using standardized Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Little is known, however, about the relative accuracy of quality indicators for persons receiving care in more than one health care system. Among Veterans dually enrolled in an MA plan, we examined the agreement between MA and VA HEDIS assessments. Our study tested the hypothesis that private health plans underreport quality of care relative to a fully integrated delivery system utilizing a comprehensive electronic health record. Despite assessing the same individuals using identical measure specifications, reported VA performance was significantly better than reported MA performance for all 12 HEDIS measures. The VA's performance advantage ranged from 9.8% (glycosylated hemoglobin [HbA1c] < 7.0% in diabetes) to 54.7% (blood pressure < 140/90 mm Hg in diabetes). The overall agreement between VA and MA HEDIS assessments ranged from 38.5% to 62.6%. Performance rates derived from VA and MA aggregate data were 1.6% to 14.3% higher than those reported by VA alone. This analysis suggests that neither MA plans nor the VA fully capture quality of care information for dually enrolled persons. However, the VA's system-wide electronic health record may allow for more complete capture of quality information across multiple providers and settings. PMID:27033565

  12. Agreement Between HEDIS Performance Assessments in the VA and Medicare Advantage: Is Quality in the Eye of the Beholder?

    PubMed

    Trivedi, Amal N; Wilson, Ira B; Charlton, Mary E; Kizer, Kenneth W

    2016-01-01

    Medicare Advantage (MA) plans and the Veterans Affairs (VA) health care system assess quality of care using standardized Healthcare Effectiveness Data and Information Set (HEDIS) performance measures. Little is known, however, about the relative accuracy of quality indicators for persons receiving care in more than one health care system. Among Veterans dually enrolled in an MA plan, we examined the agreement between MA and VA HEDIS assessments. Our study tested the hypothesis that private health plans underreport quality of care relative to a fully integrated delivery system utilizing a comprehensive electronic health record. Despite assessing the same individuals using identical measure specifications, reported VA performance was significantly better than reported MA performance for all 12 HEDIS measures. The VA's performance advantage ranged from 9.8% (glycosylated hemoglobin [HbA1c] < 7.0% in diabetes) to 54.7% (blood pressure < 140/90 mm Hg in diabetes). The overall agreement between VA and MA HEDIS assessments ranged from 38.5% to 62.6%. Performance rates derived from VA and MA aggregate data were 1.6% to 14.3% higher than those reported by VA alone. This analysis suggests that neither MA plans nor the VA fully capture quality of care information for dually enrolled persons. However, the VA's system-wide electronic health record may allow for more complete capture of quality information across multiple providers and settings.

  13. Use of VA and Medicare Services By Dually Eligible Veterans with Psychiatric Problems

    PubMed Central

    Carey, Kathleen; Montez-Rath, Maria E; Rosen, Amy K; Christiansen, Cindy L; Loveland, Susan; Ettner, Susan L

    2008-01-01

    Objective To examine how service accessibility measured by geographic distance affects service sector choices for veterans who are dually eligible for veterans affairs (VA) and Medicare services and who are diagnosed with mental health and/or substance abuse (MH/SA) disorders. Data Sources Primary VA data sources were the Patient Treatment (acute care), Extended Care (long-term care), and Outpatient Clinic files. VA cost data were obtained from (1) inpatient and outpatient cost files developed by the VA Health Economics and Resource Center and (2) outpatient VA Decision Support System files. Medicare data sources were the denominator, Medicare Provider Analysis Review (MEDPAR), Provider-of-Service, Outpatient Standard Analytic and Physician/Supplier Standard Analytic files. Additional sources included the Area Resource File and Census Bureau data. Study Design We identified dually eligible veterans who had either an inpatient or outpatient MH/SA diagnosis in the VA system during fiscal year (FY)'99. We then estimated one- and two-part regression models to explain the effects of geographic distance on both VA and Medicare total and MH/SA costs. Principal Findings Results provide evidence for substitution between the VA and Medicare, demonstrating that poorer geographic access to VA inpatient and outpatient clinics decreased VA expenditures but increased Medicare expenditures, while poorer access to Medicare-certified general and psychiatric hospitals decreased Medicare expenditures but increased VA expenditures. Conclusions As geographic distance to VA medical facility increases, Medicare plays an increasingly important role in providing mental health services to veterans. PMID:18355256

  14. Indian Health. Hearing Before the Select Committee on Indian Affairs. United States Senate, Ninety-Sixth Congress. First Session on Indian Health.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Select Committee on Indian Affairs.

    The Senate Select Committee on Indian Affairs held its first session on Indian health on August 2, 1979, to consider the Indian Health Service (IHS) and to receive testimony from organizations concerned about the status of Indian health. The National Indian Health Board representatives discussed difficulties related to tribal efforts to achieve an…

  15. 48 CFR 801.690 - VA's COCP.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA's COCP. 801.690 Section 801.690 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF... Responsibilities 801.690 VA's COCP....

  16. The VA Point-of-Care Precision Oncology Program: Balancing Access with Rapid Learning in Molecular Cancer Medicine.

    PubMed

    Fiore, Louis D; Brophy, Mary T; Turek, Sara; Kudesia, Valmeek; Ramnath, Nithya; Shannon, Colleen; Ferguson, Ryan; Pyarajan, Saiju; Fiore, Melissa A; Hornberger, John; Lavori, Philip

    2016-01-01

    The Department of Veterans Affairs (VA) recognized the need to balance patient-centered care with responsible creation of generalizable knowledge on the effectiveness of molecular medicine tools. Embracing the principles of the rapid learning health-care system, a new clinical program called the Precision Oncology Program (POP) was created in New England. The POP integrates generalized knowledge about molecular medicine in cancer with a database of observations from previously treated veterans. The program assures access to modern genomic oncology practice in the veterans affairs (VA), removes disparities of access across the VA network of clinical centers, disseminates the products of learning that are generalizable to non-VA settings, and systematically presents opportunities for patients to participate in clinical trials of targeted therapeutics. PMID:26949343

  17. The VA Point-of-Care Precision Oncology Program: Balancing Access with Rapid Learning in Molecular Cancer Medicine

    PubMed Central

    Fiore, Louis D.; Brophy, Mary T.; Turek, Sara; Kudesia, Valmeek; Ramnath, Nithya; Shannon, Colleen; Ferguson, Ryan; Pyarajan, Saiju; Fiore, Melissa A.; Hornberger, John; Lavori, Philip

    2016-01-01

    The Department of Veterans Affairs (VA) recognized the need to balance patient-centered care with responsible creation of generalizable knowledge on the effectiveness of molecular medicine tools. Embracing the principles of the rapid learning health-care system, a new clinical program called the Precision Oncology Program (POP) was created in New England. The POP integrates generalized knowledge about molecular medicine in cancer with a database of observations from previously treated veterans. The program assures access to modern genomic oncology practice in the veterans affairs (VA), removes disparities of access across the VA network of clinical centers, disseminates the products of learning that are generalizable to non-VA settings, and systematically presents opportunities for patients to participate in clinical trials of targeted therapeutics. PMID:26949343

  18. 78 FR 51067 - VA Health Professional Scholarship and Visual Impairment and Orientation and Mobility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-20

    ...; (504) 565-4900. (This is not a toll- free number.) SUPPLEMENTARY INFORMATION: Pursuant to 38 U.S.C... Federal Register on December 26, 2012 (77 FR 75918), VA proposed to amend part 17 of 38 CFR by amending... high numbers of Hispanic students and to historically ] black colleges and universities, but there...

  19. 48 CFR 801.690 - VA's COCP.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA's COCP. 801.690 Section 801.690 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM Career Development, Contracting Authority,...

  20. 75 FR 78806 - Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... AFFAIRS Agency Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA... Officer, OMB Human Resources and Housing Branch, New Executive Office Building, Room 10235, Washington, DC... Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted...

  1. Health promotion practices as perceived by primary healthcare professionals at the Ministry of National Guard Health Affairs, Saudi Arabia

    PubMed Central

    Altamimi, Samar; Alshoshan, Feda; Al Shaman, Ghada; Tawfeeq, Nasser; Alasmary, May; Ahmed, Anwar E.

    2016-01-01

    Introduction: In recent years, several research studies have investigated health promotion practices in Saudi healthcare organizations, yet no published literature exists on health promotion practices of primary healthcare professionals working for the Ministry of National Guard Health Affairs (MNG-HA). Methods: A cross-sectional study was conducted in a convenience sample of 206 primary healthcare professionals at the MNG-HA. A self-reporting questionnaire was used to investigate the attitudes, awareness, satisfaction, and methods regarding health promotion practices of primary healthcare professionals. Results: Of the 206 primary healthcare professionals surveyed, 58.1% reported awareness of health promotion programs conducted in the hospitals and 64.6% reported that the health promotion system in the hospitals needs to be improved. Language barriers and cultural beliefs were viewed as obstacles to carrying out effective health promotion by 65% and 64.6% of primary healthcare professionals, respectively. The majority (79.9%) of the primary healthcare professionals perceived themselves as having the necessary skills to promote health and 80.6% believed that printed educational materials are the most prevalent method of health promotion/education, whereas 55.8% reported that counseling was the most preferred method of health promotion. Conclusion: The awareness level of health promotion policies, strategies, and programs conducted in the hospitals was not found to be satisfactory. Therefore, widespread training programs are recommended to improve the health promotion system in the hospitals. These programs include facilitating behavioral change, introducing health promotion policies and strategies in hospitals, mandatory workshops, and systematic reminders. PMID:27482512

  2. 75 FR 52751 - Office of Global Health Affairs; Trans-Atlantic Task Force on Antimicrobial Resistance (TATFAR)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... HUMAN SERVICES Office of Global Health Affairs; Trans-Atlantic Task Force on Antimicrobial Resistance.... Background On November 3, 2009, the United States and the European Union (EU) agreed to establish a task force to focus ``on urgent antimicrobial resistance issues focused on appropriate therapeutic use...

  3. The Role of Veterans Affairs in Emergency Management: A Systematic Literature Review

    PubMed Central

    Claver, Maria; Friedman, Darya; Dobalian, Aram; Ricci, Karen; Horn Mallers, Melanie

    2012-01-01

    The Department of Veterans Affairs (VA) is a key player in emergency management for both veterans and civilians. Unfortunately, limited evidence-based research findings exist regarding the role and experience of VA during disasters. The present study is a systematic literature review of 41 published, peer-reviewed articles regarding VA and emergency management. Trained researchers utilized a data abstraction tool and conducted a qualitative content analysis. A description of article characteristics include methodology, phase of emergency management addressed in the research, and study design. Five topic categories emerged from the review including effects of disaster on mental health status and services use, effects of disaster on general health services use, patient tracking, evacuation, and disaster planning/preparation. Findings were used to generate suggestions for future research. Keywords: Veterans Affairs, veterans, disaster, emergency PMID:24678439

  4. 76 FR 36955 - West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Master Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-23

    ... homeless veterans, especially those coping with mental health problems such as PTSD. The WLA campus is a... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS West Los Angeles VA Medical Center Veterans Programs Enhancement Act of 1998; Master Plan...

  5. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... rehabilitation counseling, in collaboration with VA programs and community resources. (c) Quality of life, room... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Duties of, and standards... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  6. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... rehabilitation counseling, in collaboration with VA programs and community resources. (c) Quality of life, room... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Duties of, and standards... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  7. 38 CFR 63.15 - Duties of, and standards applicable to, non-VA community-based providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... rehabilitation counseling, in collaboration with VA programs and community resources. (c) Quality of life, room... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Duties of, and standards... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) HEALTH CARE FOR HOMELESS VETERANS (HCHV) PROGRAM § 63.15 Duties...

  8. 77 FR 6625 - Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-08

    ...The Department of Veterans Affairs (VA) through its National Center for Ethics in Health Care (NCEHC) invites interested parties to comment on a guidance document entitled ``Meeting the Challenge of Pandemic Influenza: Ethical Guidance for Leaders and Health Care Professionals in the Veterans Health Administration.'' (Guidance). VA is committed to an open and engaged stakeholder process and......

  9. 76 FR 63356 - Proposed Information Collection (Locality Pay System for Nurses and Other Health Care Personnel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... AFFAIRS Proposed Information Collection (Locality Pay System for Nurses and Other Health Care Personnel...: Locality Pay System for Nurses and Other Health Care Personnel, VA Form 10-0132. OMB Control Number: 2900... determine locality pay system for certain health care personnel. VA medical facility Directors will use...

  10. Identifying Homelessness among Veterans Using VA Administrative Data: Opportunities to Expand Detection Criteria.

    PubMed

    Peterson, Rachel; Gundlapalli, Adi V; Metraux, Stephen; Carter, Marjorie E; Palmer, Miland; Redd, Andrew; Samore, Matthew H; Fargo, Jamison D

    2015-01-01

    Researchers at the U.S. Department of Veterans Affairs (VA) have used administrative criteria to identify homelessness among U.S. Veterans. Our objective was to explore the use of these codes in VA health care facilities. We examined VA health records (2002-2012) of Veterans recently separated from the military and identified as homeless using VA conventional identification criteria (ICD-9-CM code V60.0, VA specific codes for homeless services), plus closely allied V60 codes indicating housing instability. Logistic regression analyses examined differences between Veterans who received these codes. Health care services and co-morbidities were analyzed in the 90 days post-identification of homelessness. VA conventional criteria identified 21,021 homeless Veterans from Operations Enduring Freedom, Iraqi Freedom, and New Dawn (rate 2.5%). Adding allied V60 codes increased that to 31,260 (rate 3.3%). While certain demographic differences were noted, Veterans identified as homeless using conventional or allied codes were similar with regards to utilization of homeless, mental health, and substance abuse services, as well as co-morbidities. Differences were noted in the pattern of usage of homelessness-related diagnostic codes in VA facilities nation-wide. Creating an official VA case definition for homelessness, which would include additional ICD-9-CM and other administrative codes for VA homeless services, would likely allow improved identification of homeless and at-risk Veterans. This also presents an opportunity for encouraging uniformity in applying these codes in VA facilities nationwide as well as in other large health care organizations.

  11. Better governance in academic health sciences centres: moving beyond the Olivieri/Apotex Affair in Toronto.

    PubMed

    Ferris, L E; Singer, P A; Naylor, C D

    2004-02-01

    The Toronto experience suggests that there may be several general lessons for academic health sciences complexes to learn from the Olivieri/Apotex affair (OAA) regarding the ethics, independence, and integrity of clinical research sponsored by for profit enterprises. From a local perspective, the OAA occurred when there already was a focus on the complex and changing relationships among the University of Toronto, its medical school, the fully affiliated teaching hospitals, and off campus faculty because of intertwined interests and responsibilities. The OAA became a catalyst that accelerated various systemic reforms, particularly concerning academic/industry relations. In this article, the evolving governance framework for the Toronto academic health sciences complex is reviewed and these policy and process reforms discussed. These reforms have created collaborative activity among research ethics boards and contract research offices of the partner institutions, and allowed the joint university/hospital ethics centre to play a role in governance and policy, while respecting the missions and mandates of the involved institutions. Although few of the policies are dramatically innovative, what is arguably novel is the elaboration of an overarching governance framework that aims to move ethics to a central focus in the academic complex. Time alone will tell how sustainable and effective these changes are. PMID:14872067

  12. 76 FR 63357 - VA National Academic Affiliations Council; Notice of Establishment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ... AFFAIRS VA National Academic Affiliations Council; Notice of Establishment As required by Section 9(a)(2... establishment of the Department of Veterans Affairs (VA) National Academic Affiliations Council. The Secretary... partnerships between VA and its academic affiliates. The Council will provide a forum for discussion and...

  13. 77 FR 50551 - Agency Information Collection: Emergency Submission for OMB Review (PACT VISN20 Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-21

    ... AFFAIRS Agency Information Collection: Emergency Submission for OMB Review (PACT VISN20 Health Care... No. 2900-New (VA Form 10-0535). SUPPLEMENTARY INFORMATION: Title: PACT VISN20 Health Care Experiences...); Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION:...

  14. 77 FR 70967 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-28

    ..., Alcoholism, Claims, Day care, Dental health, Drug abuse, Government contracts, Grant programs--health... its regulation governing payment by VA for non-VA outpatient care under VA's statutory authority to provide non-VA care. Under this authority, VA may contract for certain hospital care (inpatient care)...

  15. 78 FR 55777 - Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... AFFAIRS Proposed Information Collection (VA, National Veterans Sports Programs and Special Events, Event... Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Veterans Sports Programs and Special Events (NVSP), Department of Veterans Affairs (VA), is announcing an opportunity...

  16. Using average cost methods to estimate encounter-level costs for medical-surgical stays in the VA.

    PubMed

    Wagner, Todd H; Chen, Shuo; Barnett, Paul G

    2003-09-01

    The U.S. Department of Veterans Affairs (VA) maintains discharge abstracts, but these do not include cost information. This article describes the methods the authors used to estimate the costs of VA medical-surgical hospitalizations in fiscal years 1998 to 2000. They estimated a cost regression with 1996 Medicare data restricted to veterans receiving VA care in an earlier year. The regression accounted for approximately 74 percent of the variance in cost-adjusted charges, and it proved to be robust to outliers and the year of input data. The beta coefficients from the cost regression were used to impute costs of VA medical-surgical hospital discharges. The estimated aggregate costs were reconciled with VA budget allocations. In addition to the direct medical costs, their cost estimates include indirect costs and physician services; both of these were allocated in proportion to direct costs. They discuss the method's limitations and application in other health care systems. PMID:15095543

  17. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    PubMed

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system.

  18. 78 FR 18425 - Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-26

    ... AFFAIRS Proposed Information Collection VA Police Officer Pre-Employment Screening Checklist); Comment... applicant's qualification and suitability as a VA police officer. DATES: Written comments and... information technology. Title: VA Police Officer Pre-Employment Screening Checklist, VA Form 0120. OMB...

  19. 78 FR 38452 - Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-26

    ... AFFAIRS Agency Information Collection (VA Police Officer Pre-Employment Screening Checklist) Activities... ``OMB Control No. 2900-0524.'' SUPPLEMENTARY INFORMATION: Title: VA Police Officer Pre-Employment... checks on applicants seeking employment as VA police officers. VA will use the data collected...

  20. 77 FR 24268 - Agency Information Collection (Dependents' Application for VA Educational Benefits) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... AFFAIRS Agency Information Collection (Dependents' Application for VA Educational Benefits) Activity Under... INFORMATION: Title: Dependents' Application for VA Educational Benefits (Under Provisions of Chapters 33 and... spouses and children of veterans or servicemembers to apply for Survivors' and Dependents'...

  1. Prevalence and treatment of chronic hepatitis C virus infection in the US Department of Veterans Affairs.

    PubMed

    Beste, Lauren A; Ioannou, George N

    2015-01-01

    Chronic hepatitis C virus (HCV) is the most common blood-borne pathogen in the United States. HCV disproportionately affects Veterans Affairs (VA) health-care users: 174,302 HCV-infected veterans were in VA care in 2013, making the VA the world's largest HCV care provider. This systematic review identified 546 articles related to HCV in the VA. After assessment by 2 independent reviewers, 28 articles describing prevalence and treatment of HCV in VA users ultimately met inclusion criteria. Most VA patients currently living with HCV infection were born between 1945 and 1965 and were infected with HCV between 1970 and 1990. To prevent HCV-related complications such as cirrhosis, hepatocellular carcinoma, and death, medical personnel must identify and treat HCV. However, antiviral therapy has historically been limited by medication side effects, contraindications, and patient acceptance. Although treatment initiation rates are higher in the VA than in the general United States, only 23% of VA HCV patients have received treatment and, of those, only a minority were cured. Recent development of more effective and tolerable antiviral agents represents a major pharmacological breakthrough. Eradication of HCV is theoretically possible for the majority of HCV patients for the first time, although new barriers, such as high drug costs, may limit future uptake. PMID:25600415

  2. 78 FR 36642 - Proposed Information Collection (VA Loan Electronic Reporting Interface (VALERI) System) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS...: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans Affairs (VA), is announcing...

  3. 75 FR 9277 - Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... AFFAIRS Proposed Information Collection (VA National Rehabilitation Special Events, Event Registration Applications); Comment Request AGENCY: Office of National Programs and Special Events, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Office of National Programs and Special Events (NPSE), Department...

  4. Homeless and nonhomeless VA service users likely eligible for Medicaid expansion.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2014-01-01

    Administrative data on the population of Department of Veterans Affairs (VA) service users in 2010 under the age of 65 (n = 3,841,225) were analyzed to identify the number and characteristics of homeless and nonhomeless VA service users who are likely to be eligible for the Medicaid expansion (LEME) option under the Affordable Care Act. Results showed that, estimating conservatively, about 1.2 million (21%) current VA users are LEME if all states implement the expansion. Homeless service users were twice as likely to be eligible than nonhomeless users (64% vs 30%). VA service users who are LEME, regardless of housing status, were physically healthier than those not LEME but were more likely to have substance use disorders and posttraumatic stress disorder. These findings suggest that many VA service users are LEME, particularly those who are homeless and/or have mental health needs. Cross-system use of VA and Medicaid-funded services may be advantageous for veterans with extensive medical and psychiatric needs but also risks fragmented care. Information and education for VA clinicians and their patients about possible implications of the Affordable Care Act may be important. PMID:25358031

  5. American Indian Veterans' Views about Their Choices in Health Care: VA, IHS, and Medicare

    ERIC Educational Resources Information Center

    Reifel, Nancy; Bayhylle, Ruth; Harada, Nancy; Villa, Valentine

    2009-01-01

    Legislation during the past three decades has gradually drawn Indian Health Service (IHS)-funded clinics into the mainstream of the US medical care environment. The Indian Self-Determination and Education Reform Act of 1973 and its Indian Education Amendments of 1984 began a movement away from federal management of health services to local tribal…

  6. Studying outcomes and hospital utilization in the elderly. The advantages of a merged data base for Medicare and Veterans Affairs hospitals.

    PubMed

    Fleming, C; Fisher, E S; Chang, C H; Bubolz, T A; Malenka, D J

    1992-05-01

    That veterans aged 65 years and older are eligible to receive care either in the Veteran Affairs (VA) health care system or in the private sector under Medicare confounds the analysis of veterans' health services utilization and outcomes in two ways. First, changes in eligibility or financial barriers to access with regard to either system influence veterans' decisions about where to seek needed care. Second, analyses of VA care for elderly veterans that rely solely on VA data sources underestimate both overall utilization and treatment complications. Similarly, failure to consider the contribution of health care delivery in the VA system may confound analyses of health care utilization by the Medicare-eligible population. To study the magnitude of such confounding influences, we linked the Medicare and VA health care administrative databases for residents of New England and New York. Results indicated that, for ten surgical procedures commonly performed in the elderly, as well as for hospitalizations resulting from acute myocardial infarction and hip fracture, VA patients receive from 17.6% to 37.4% of hospital care outside the VA system. Private hospitalizations account for 5.5% to 19.5% of the care received by veterans within 6 months after an initial episode of care in a VA hospital. It was also found that initial hospitalizations for study conditions in the VA accounted for 3.6% of all such hospitalizations among elderly Medicare-eligible men. Although overall hospital utilization appears to be underestimated in VA data sources, it was found that ascertaining mortality from sources available within the VA produced excellent results when compared with deaths recorded in the Medicare enrollment files. A national, merged VA-Medicare data base is feasible and would enhance the validity of analyses of health care delivery both for elderly veterans and for the Medicare population.

  7. 76 FR 625 - Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-05

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF VETERANS AFFAIRS Proposed Information Collection (Veterans Health Benefits Handbook Satisfaction Survey) Activity... Satisfaction Survey, VA Form 10-0507. OMB Control Number: 2900--New (VA Form 10-0507). Type of Review:...

  8. Group Cognitive-Behavioral Therapy for Insomnia in a VA Mental Health Clinic

    ERIC Educational Resources Information Center

    Perlman, Lawrence M.; Arnedt, J. Todd; Earnheart, Kristie L.; Gorman, Ashley A.; Shirley, Katherine G.

    2008-01-01

    Effective cognitive-behavioral therapies for insomnia have been developed over the past 2 decades, but they have not been systematically evaluated in some clinical settings. While insomnia is common among veterans with mental health problems, the availability of effective treatments is limited. We report on the group application of a…

  9. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation.

  10. The concentration of hospital care for black veterans in Veterans Affairs hospitals: implications for clinical outcomes.

    PubMed

    Jha, Ashish K; Stone, Roslyn; Lave, Judith; Chen, Huanyu; Klusaritz, Heather; Volpp, Kevin

    2010-01-01

    Where minorities receive their care may contribute to disparities in care, yet, the racial concentration of care in the Veterans Health Administration is largely unknown. We sought to better understand which Veterans Affairs (VA) hospitals treat Black veterans and whether location of care impacted disparities. We assessed differences in mortality rates between Black and White veterans across 150 VA hospitals for any of six conditions (acute myocardial infarction, hip fracture, stroke, congestive heart failure, gastrointestinal hemorrhage, and pneumonia) between 1996 and 2002. Just 9 out of 150 VA hospitals (6% of all VA hospitals) cared for nearly 30% of Black veterans, and 42 hospitals (28% of all VA hospitals) cared for more than 75% of Black veterans. While our findings show that overall mortality rates were comparable between minority-serving and non-minority-serving hospitals for four conditions, mortality rates were higher in minority-serving hospitals for acute myocardial infarction (AMI) and pneumonia. The ratio of mortality rates for Blacks compared with Whites was comparable across all VA hospitals. In contrast to the private sector, there is little variation in the degree of racial disparities in 30-day mortality across VA hospitals, although higher mortality among patients with AMI and pneumonia requires further investigation. PMID:20946426

  11. Early Lessons Learned in Implementing a Women's Health Educational and Virtual Consultation Program in VA

    PubMed Central

    Cordasco, Kristina M.; Zuchowski, Jessica L.; Hamilton, Alison B.; Kirsh, Susan; Veet, Laure; Saavedra, Joann O.; Altman, Lisa; Knapp, Herschel; Canning, Mark; Washington, Donna L.

    2016-01-01

    Background Many Veterans Health Administration primary care providers (PCPs) have small female patient caseloads, making it challenging for them to build and maintain their women's health (WH) knowledge and skills. To address this issue, we implemented a longitudinal WH-focused educational and virtual consultation program using televideo conferencing. Objective To perform a formative evaluation of the program's development and implementation. Research Design We used mixed methods including participant surveys, semi-structured interviews, stakeholder meeting field notes, and participation logs. We conducted qualitative content analysis for interviews and field notes, and quantitative tabulation for surveys and logs. Subjects Veterans Health Administration WH PCPs. Results In 53 postsession surveys received, 47(89%) agreed with the statement, “The information provided in the session would influence my patient care.” Among 18 interviewees, all reported finding the program useful for building and maintaining WH knowledge. All interviewees also reported that sessions being conducted during their lunch hour limited consistent participation. Logs showed that PCPs participated more consistently in the 1 health care system that provided time specifically allocated for this program. Key stakeholder discussions revealed that rotating specialists and topics across the breadth of WH limited submission of cases. Conclusions Our WH education and virtual consultation program is a promising modality for building and maintaining PCP knowledge of WH, and influencing patient care. However, allocated time for PCPs to participate is essential for robust and consistent participation. Narrowing the modality's focus to gynecology, rather than covering the breadth WH topics, may facilitate PCPs having active cased–based questions for sessions. PMID:25767983

  12. 38 CFR 74.27 - How will VA store information?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false How will VA store information? 74.27 Section 74.27 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.27 How will VA store information?...

  13. 78 FR 63143 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-23

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO86 VA Dental Insurance Program--Federalism AGENCY: Department of... its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and dependents of...

  14. 78 FR 62441 - VA Dental Insurance Program-Federalism

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AO85 VA Dental Insurance Program--Federalism AGENCY: Department of... direct final action to amend its regulations related to the VA Dental Insurance Program (VADIP), a pilot program to offer premium-based dental insurance to enrolled veterans and certain survivors and...

  15. 76 FR 60965 - Veterans' Rural Health Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... AFFAIRS Veterans' Rural Health Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that the Veterans' Rural... Hotel, 363 Maine Mall Road, Portland, ME. The sessions will begin at 8 a.m. each day and adjourn at 4...

  16. 77 FR 37839 - Veterans' Group Life Insurance (VGLI) No-Health Period Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... AFFAIRS 38 CFR Part 9 RIN 2900-AO24 Veterans' Group Life Insurance (VGLI) No-Health Period Extension... Affairs (VA) proposes to amend its regulations governing eligibility for Veterans' Group Life Insurance... indicate that they are submitted in response to ``RIN 2900-AO24--Veterans' Group Life Insurance (VGLI)...

  17. Veterans Affairs methicillin-resistant Staphylococcus aureus prevention initiative associated with a sustained reduction in transmissions and health care-associated infections.

    PubMed

    Evans, Martin E; Kralovic, Stephen M; Simbartl, Loretta A; Freyberg, Ron W; Obrosky, D Scott; Roselle, Gary A; Jain, Rajiv

    2013-11-01

    Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) Prevention Initiative was associated with significant declines in MRSA transmission and MRSA health care-associated infection rates in Veterans Affairs acute care facilities nationwide in the 33-month period from October 2007 through June 2010. Here, we show continuing declines in MRSA transmissions (P = .004 for trend, Poisson regression) and MRSA health care-associated infections (P < .001) from July 2010 through June 2012. The Veterans Affairs Initiative was associated with these effects, sustained over 57 months, in a large national health care system.

  18. 78 FR 56271 - FY 2014-2020 Draft VA Strategic Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... AFFAIRS FY 2014-2020 Draft VA Strategic Plan AGENCY: Department of Veterans Affairs. ACTION: Notice of... availability of the FY 2014-2020 Draft VA Strategic Plan (Strategic Plan) for public review and comment, as...). The Strategic Plan provides the Department's long-term direction and places a stronger emphasis...

  19. 78 FR 27882 - VA Veteran-Owned Small Business (VOSB) Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... AFFAIRS 38 CFR Part 74 RIN 2900-AO63 VA Veteran-Owned Small Business (VOSB) Verification Guidelines AGENCY... and Disadvantaged Business Utilization (OSDBU) is currently reviewing its regulations governing the Department of Veterans Affairs (VA) Veteran-Owned Small Business (VOSB) Verification Program. OSDBU...

  20. 48 CFR 801.695 - VA's Appointment of HCAs Program.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA's Appointment of HCAs Program. 801.695 Section 801.695 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM Career Development,...

  1. Improving the Health Status of Native Hawaiians, and for Other Purposes. Select Committee on Indian Affairs. Senate, Ninety-Ninth Congress, Second Session (October 6, 1986).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Select Committee on Indian Affairs.

    The purpose of U.S. Senate Bill S. 2243 is to improve the health status of native Hawaiians through the authorization of programs designed to provide a comprehensive health promotion and disease prevention system of services for them. The Select Committee on Indian Affairs reported on the following points, including pertinent statistics: (1)…

  2. 48 CFR 853.236-70 - VA Form 10-6298, Architect-Engineer Fee Proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false VA Form 10-6298, Architect... VETERANS AFFAIRS CLAUSES AND FORMS FORMS Prescription of Forms 853.236-70 VA Form 10-6298, Architect-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in...

  3. 75 FR 78808 - Agency Information Collection (VA Request for Determination of Reasonable Value) Activity Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... AFFAIRS Agency Information Collection (VA Request for Determination of Reasonable Value) Activity Under... comment. The PRA submission describes the nature of the information collection and its expected cost and... INFORMATION: Title: VA Request for Determination of Reasonable Value VA Form 26- 1805 and 26-1805-1....

  4. 78 FR 59773 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... AFFAIRS Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity... solicits comments for information needed to determine the reasonable value of properties for guaranteed or... information technology. Title: VA Request for Determination of Reasonable Value, VA Form 26-1805 and...

  5. 38 CFR 26.9 - Information on and public participation in VA environmental process.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... participation in VA environmental process. 26.9 Section 26.9 Pensions, Bonuses, and Veterans' Relief DEPARTMENT...) ACTIONS § 26.9 Information on and public participation in VA environmental process. (a) During the..., the Office of Environmental Affairs, or a VA element, information is available by writing to...

  6. Extreme makeover: Transformation of the veterans health care system.

    PubMed

    Kizer, Kenneth W; Dudley, R Adams

    2009-01-01

    The veterans health care system administered by the U.S. Department of Veterans Affairs (VA) was established after World War I to provide health care for veterans who suffered from conditions related to their military service. It has grown to be the nation's largest integrated health care system. As the system grew, a number of factors contributed to its becoming increasingly dysfunctional. By the mid-1990s, VA health care was widely criticized for providing fragmented and disjointed care of unpredictable and irregular quality, which was expensive, difficult to access, and insensitive to individual needs. Between 1995 and 1999, the VA health care system was reengineered, focusing especially on management accountability, care coordination, quality improvement, resource allocation, and information management. Numerous systemic changes were implemented, producing dramatically improved quality, service, and operational efficiency. VA health care is now considered among the best in America, and the VA transformation is viewed as a model for health care reform. PMID:19296778

  7. Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites

    ERIC Educational Resources Information Center

    Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

    2009-01-01

    Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

  8. 77 FR 39346 - Proposed Information Collection (Statement of Accredited Representative in Appealed Case, VA Form...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... AFFAIRS Proposed Information Collection (Statement of Accredited Representative in Appealed Case, VA Form 646) Activity: Comment Request AGENCY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Board of Veterans' Appeals (BVA), Department of Veterans Affairs...

  9. Veteran internet use and engagement with health information online.

    PubMed

    Houston, Thomas K; Volkman, Julie E; Feng, Hua; Nazi, Kim M; Shimada, Stephanie L; Fox, Susannah

    2013-04-01

    Veterans represent a unique population in need of accessing health services online. Data from a random-digit dialed survey conducted by the Pew Research Center's Internet & American Life Project were used to assess differences in online use of health information among Veterans in the Veterans Health Administration (VHA) of the U.S. Department of Veteran Affairs (VA), Veterans not in VA, and non-Veterans. This survey of 3,001 U.S. citizens oversampled lower-income households. Questions assessed Veteran status and use of VA health care services, self-reported Internet use and Internet searching for health-related information, and social engagement related to health online. Overall results suggest Veterans represent an opportune population to utilize personal health records and health services via the Internet. Veterans in VA are more likely to search for health issues related to Alzheimer's disease and memory loss (odds ratio = 3.07; confidence interval = 1.41-8.28) compared to Veterans not in VA. Veterans receiving VA health care also reported higher proportions of social engagement related to health about tracking diet, weight, and exercise than Veterans not in VA, although not statistically significant. Veterans in VA are using the Internet for health information, and there is an opportunity to engage them more.

  10. 76 FR 27379 - Proposed Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-11

    ... AFFAIRS Proposed Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine...: Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine Claims), VA Form 21-4169. OMB Control Number: 2900-0094. Type of Review: Extension of a currently approved collection. Abstract: VA Form...

  11. Firearms injuries and deaths: a critical public health issue. American Medical Association Council on Scientific Affairs.

    PubMed Central

    1989-01-01

    The prevention of firearm deaths and injuries is one of the most complex and controversial issues facing the public health profession in recent years. Laws have been enacted to control or discourage private gun ownership, and especially to eliminate guns from the hands of criminals, but the laws' effects in reducing crime and firearm-related injuries and deaths have been disappointing. Gunshot wounds are the 12th leading cause of death in the United States and more than half of all suicides are committed with guns. There are virtually no reliable data on the number of nonfatal firearm injuries. One of the most troubling aspects of handgun violence is that children often are the victims. Educational efforts have been attempted to promote the safer use of firearms, but they have not led to a significant reduction in the number of fatalities, since most firearm incidents are intended to do harm. PMID:2495544

  12. Translating standards into practice: experience and lessons learned at the Department of Veterans Affairs.

    PubMed

    Bouhaddou, Omar; Cromwell, Tim; Davis, Mike; Maulden, Sarah; Hsing, Nelson; Carlson, David; Cockle, Jennifer; Hoang, Catherine; Fischetti, Linda

    2012-08-01

    The increased need for interoperable electronic health records in health care organizations underscores the importance of standards. The US Department of Veterans Affairs (VA) has a long history of developing and adopting various types of health care data standards. The authors present in detail their experience in this domain. A formal organization within VA is responsible for helping to develop and implement standards. This group has produced a Standards Life Cycle (SLC) process endorsed by VA key business and information technology (IT) stakeholders. It coordinates the identification, description, and implementation of standards aligned with VA business requirements. In this paper, we review the adoption of four standards in the categories of security and privacy, terminology, health information exchange, and modeling tools; emphasizing the implementation approach used in each. In our experience, adoption is facilitated by internal staff with expertise in standards development and adoption. Use of processes such as an SLC and tools such as an enterprise requirement repository help formally track and ensure that IT development and acquisition incorporate these standards. An organization should adopt standards that are aligned with its business priorities and favor those that are more readily implementable. To assist with this final point, we offer a standard "Likelihood of Adoption Scale," which changes as standards specifications evolve from PDF documents only, to PDF documents with construction and testing tools, to fully functional reference implementations. PMID:22285982

  13. Health effects of radon exposure. Report of the Council on Scientific Affairs, American Medical Association

    SciTech Connect

    Not Available

    1991-04-01

    The consensus of scientists is that exposure to radon is hazardous, but disagreement exists about the effects of lower radon concentrations. Studies of underground miners have indicated that the risk of lung cancer increases in proportion to the intensity and duration of exposure to radon, and a recent authoritative report (BEIR IV) has concluded that estimates based on those studies are appropriate for estimating risks for occupants of homes. The BEIR IV report concluded that smoking cigarettes increases the risk of lung cancer associated with radon. Average radon levels in US homes range from 0.055 to 0.148 Bq/L (1.5 to 4 pCi/L), depending on the circumstances of measurement. Few studies have investigated health outcomes in occupants of homes with high radon levels. In advising patients about reducing the risks associated with radon, physicians should consider the costs, as well as the benefits, of remedial actions, and they should emphasize that, by far, the best way to avoid lung cancer is to stop smoking.

  14. American Medical Association concepts of nutrition and health. Council on Scientific Affairs.

    PubMed

    1979-11-23

    problems. The medical profession should assume a more active role in teaching people how to achieve and maintain good health habits through behavioral modification. PMID:490837

  15. 76 FR 20822 - Proposed Information Collection (Living Will and Durable Power of Attorney for Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... AFFAIRS Proposed Information Collection (Living Will and Durable Power of Attorney for Health Care... information needed to record patient's specific instructions about health care decisions in the event he or... Power of Attorney for Health Care, VA Form 10-0137. OMB Control Number: 2900-0556. Type of...

  16. 75 FR 7218 - Payment for Inpatient and Outpatient Health Care Professional Services at Non-Departmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-18

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN37 Payment for Inpatient and Outpatient Health Care Professional... calculate VA payments for inpatient and outpatient health care professional services and other medical... other health facility furnishing the care or services if such care or services were provided in...

  17. 76 FR 78738 - Agency Information Collection (Locality Pay System for Nurses and Other Health Care Personnel...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-19

    ... AFFAIRS Agency Information Collection (Locality Pay System for Nurses and Other Health Care Personnel... INFORMATION: Title: Locality Pay System for Nurses and Other Health Care Personnel. OMB Control Number: 2900... determine locality pay system for certain health care personnel. VA medical facility Directors will use...

  18. To designate the community based outpatient clinic of the Department of Veterans Affairs located at 310 Home Boulevard in Galesburg, Illinois, as the "Lane A. Evans VA Community Based Outpatient Clinic".

    THOMAS, 113th Congress

    Rep. Bustos, Cheri [D-IL-17

    2014-11-13

    11/25/2014 Referred to the Subcommittee on Health. (All Actions) Notes: For further action, see S.2921, which became Public Law 113-234 on 12/16/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. 78 FR 76061 - Authorization for Non-VA Medical Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ... Administrative practice and procedure, Alcohol abuse, Alcoholism, Claims, Day care, Dental health, Drug abuse...-VA medical care. In the Federal Register on November 28, 2012, VA proposed to remove an outdated regulatory limitation on veterans' eligibility to be referred for non- VA medical care. On the same date,...

  20. Results from the multisite implementation of STAR-VA: a multicomponent psychosocial intervention for managing challenging dementia-related behaviors of veterans.

    PubMed

    Karlin, Bradley E; Visnic, Stephanie; McGee, Jocelyn Shealy; Teri, Linda

    2014-05-01

    Dementia is often associated with challenging behaviors that can significantly impact the quality of life of individuals with dementia and pose great difficulty for long-term care staff. Antipsychotic medications, historically the mainstay approach for managing such behaviors, have increasingly been associated with limited efficacy and increased death risk with older dementia patients. In an effort to promote and realize the promise of nonpharmacological management of challenging dementia-related behaviors, the U.S. Department of Veterans Affairs (VA) health care system has developed and implemented STAR-VA, an interdisciplinary behavioral intervention for managing challenging dementia-related behaviors of veterans, in 17 VA nursing homes, as part of a pilot implementation initiative. Sixty-four veterans with challenging behaviors associated with dementia participated in the STAR-VA intervention coordinated by Mental Health Providers completing specialized training. Challenging behaviors clustered into 6 behavior types: resistance to care, agitation, violence/aggression, vocalization, wandering, and other. Results indicate that STAR-VA led to significant reductions in the frequency and severity of challenging dementia-related behaviors, with overall effect sizes of approximately 1. In addition, the intervention led to significant reductions in depression and anxiety. Overall, the results support the feasibility and effectiveness of STAR-VA for managing challenging dementia-related behaviors in veterans in real-world, nursing home settings.

  1. 78 FR 60379 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ... Guaranteed Loans) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits Administration (VBA), Department of Veterans... the notice. This notice solicits comments on information needed to underwrite VA-guaranteed...

  2. 38 CFR 74.25 - What types of personally identifiable information will VA collect?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.25 What types of personally identifiable information will VA collect? In order to establish owner... in a specific business seeking to obtain verified status....

  3. 76 FR 35950 - Agency Information Collection Activity (Living Will and Durable Power of Attorney for Health Care...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-20

    ... AFFAIRS Agency Information Collection Activity (Living Will and Durable Power of Attorney for Health Care... Health Care, VA Form 10-0137. OMB Control Number: 2900-0556. Type of Review: Extension of a currently... appoint a health care agent to make decision about his or her medical treat and to record...

  4. 75 FR 1120 - Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ... AFFAIRS Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi...: Health-Care Use Survey for Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans. OMB Control... study are to: (1) Examine the stigma-related barriers to VA health care; (2) document unique barriers...

  5. Telephone Enrollment in the VA Healthcare System. Interim final rule.

    PubMed

    2016-03-16

    This rulemaking amends VA's medical regulations to allow veterans to complete applications for health care enrollment by telephone by providing application information to a VA employee, agreeing to VA's provisions regarding copayment liability and assignment of third-party insurance benefits, and attesting to the accuracy and authenticity of the information provided over the phone. This action will make it easier for veterans to apply to enroll and will speed VA processing of applications. PMID:26987128

  6. Contraceptive Provision in the VA Healthcare System to Women Who Report Military Sexual Trauma

    PubMed Central

    Mattocks, Kristin; Schwarz, Eleanor Bimla; Borrero, Sonya; Skanderson, Melissa; Zephyrin, Laurie; Brandt, Cynthia; Haskell, Sally

    2014-01-01

    Abstract Background: Women Veterans who suffered military sexual trauma (MST) may be at high risk for unintended pregnancy and benefit from contraceptive services. The objective of this study is to compare documented provision of contraceptives to women Veterans using the Department of Veterans Affairs (VA) health system who report or deny MST. Methods: This retrospective cohort study included women Veterans aged 18–45 years who served in Operation Enduring or Iraqi Freedom and had at least one visit to a VA medical center between 2002 and 2010. Data were obtained from VA administrative and clinical databases. Chi-squared tests and logistic regression were conducted to evaluate the association between MST, ascertained by routine clinical screening, and first documented receipt of hormonal or long-acting contraception. Results: Of 68,466 women Veterans, 13% reported, 59% denied and 28% had missing data for the MST screen. Among the entire study cohort, 30% of women had documented receipt of a contraceptive method. Women reporting MST were significantly more likely than those denying MST to receive a method of contraception (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.07–1.18) including an intrauterine device (odds ratio [OR] 1.29, 95% CI 1.17–1.41) or contraceptive injection (OR 1.17, 95% CI 1.05–1.29). Women who were younger, unmarried, seen at a women's health clinic, or who had more than one visit were more likely to receive contraception. Conclusions: A minority of women Veterans of reproductive age receive contraceptive services from the VA. Women Veterans who report MST, and particularly those who seek care at VA women's health clinics, are more likely to receive contraception. PMID:24787680

  7. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: Protocol for a Randomized Study Funded by the US Department of Veterans Affairs Health Services Research and Development Program

    PubMed Central

    Krein, Sarah L; Striplin, Dana; Marinec, Nicolle; Kerns, Robert D; Farris, Karen B; Singh, Satinder; An, Lawrence; Heapy, Alicia A

    2016-01-01

    Background Cognitive behavioral therapy (CBT) is one of the most effective treatments for chronic low back pain. However, only half of Department of Veterans Affairs (VA) patients have access to trained CBT therapists, and program expansion is costly. CBT typically consists of 10 weekly hour-long sessions. However, some patients improve after the first few sessions while others need more extensive contact. Objective We are applying principles from “reinforcement learning” (a field of artificial intelligence or AI) to develop an evidence-based, personalized CBT pain management service that automatically adapts to each patient’s unique and changing needs (AI-CBT). AI-CBT uses feedback from patients about their progress in pain-related functioning measured daily via pedometer step counts to automatically personalize the intensity and type of patient support. The specific aims of the study are to (1) demonstrate that AI-CBT has pain-related outcomes equivalent to standard telephone CBT, (2) document that AI-CBT achieves these outcomes with more efficient use of clinician resources, and (3) demonstrate the intervention’s impact on proximal outcomes associated with treatment response, including program engagement, pain management skill acquisition, and patients’ likelihood of dropout. Methods In total, 320 patients with chronic low back pain will be recruited from 2 VA healthcare systems and randomized to a standard 10 sessions of telephone CBT versus AI-CBT. All patients will begin with weekly hour-long telephone counseling, but for patients in the AI-CBT group, those who demonstrate a significant treatment response will be stepped down through less resource-intensive alternatives including: (1) 15-minute contacts with a therapist, and (2) CBT clinician feedback provided via interactive voice response calls (IVR). The AI engine will learn what works best in terms of patients’ personally tailored treatment plans based on daily feedback via IVR about their

  8. Correlates of VA mental health treatment utilization among OEF/OIF/OND veterans: Resilience, stigma, social support, personality, and beliefs about treatment.

    PubMed

    DeViva, Jason C; Sheerin, Christina M; Southwick, Steven M; Roy, Alicia M; Pietrzak, Robert H; Harpaz-Rotem, Ilan

    2016-05-01

    Veterans of Operations Iraqi Freedom/Enduring Freedom/New Dawn (OEF/OIF/OND) tend not to engage in mental health care. Identifying modifiable factors related to mental health service utilization could facilitate development of interventions to increase utilization. The current study examined the relationship between mental health care utilization and measures of PTSD symptoms, resilience, stigma, beliefs about mental health care, perceived barriers to mental health care, posttraumatic growth and meaning, social support, and personality factors in a sample of 100 OEF/OIF/OND veterans with PTSD symptoms referred to VA mental health care. Participants who received psychotherapy and pharmacotherapy (PP) scored higher on measures of PTSD symptoms, stigma, and adaptive beliefs about mental health treatment, and lower on measures of resilience, postdeployment social support, emotional stability, and conscientiousness, than participants who received no treatment (NT). Participants who received psychotherapy only (PT) scored higher on a measure of PTSD symptoms than NT participants. PT participants scored higher on an emotional stability measure and lower on measures of PTSD symptoms and stigma than PP participants. Multinomial logistic regression including all variables significantly related to treatment utilization indicated that PTSD symptoms and adaptive beliefs about psychotherapy and pharmacotherapy were higher in the PT and PP groups than in the NT group, and concerns about discrimination were higher in the PP group than the NT group. Interventions targeting beliefs about mental health care could increase mental health treatment utilization among OEF/OIF/OND veterans. Concerns about stigma may affect the utilization process differently at different decision points. (PsycINFO Database Record PMID:26237497

  9. The Impact of VA and Navy Hospital Collaboration on Medical School Education

    ERIC Educational Resources Information Center

    Atre-Vaidya, Nutan; Ross, Arthur, III; Sandu, Ioana C.; Hassan, Tariq

    2009-01-01

    Objective: The U.S. Department of Veterans Affairs (VA) is the largest single provider of medical education in the United States and is often the preferred training site for medical students and residents. However, changing priorities of patients and the marketplace are forcing medical schools and the VA to consider new ways of practicing medicine…

  10. 77 FR 21158 - VA Directive 0005 on Scientific Integrity: Availability for Review and Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-09

    ... AFFAIRS VA Directive 0005 on Scientific Integrity: Availability for Review and Comment AGENCY: Office of... (VA) Directive 0005 on Scientific Integrity. The Draft Directive incorporates the principles of scientific integrity contained in the Presidential Memorandum of March 9, 2009, and the Director, Office...

  11. 78 FR 28949 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... AFFAIRS Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation) AGENCY... announces the availability of rehabilitation funds under VA's Homeless Providers Grant and Per Diem Program... local or state codes. Each rehabilitation funded program will submit quarterly reports to the Grant...

  12. 77 FR 12697 - VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ...We propose to revise and reorganize regulations which contain the Department of Veterans Affairs' (VA) Homeless Providers Grant and Per Diem Program. This rulemaking would update our current regulations, implement and authorize new VA policies, and generally improve the clarity of part...

  13. 78 FR 77204 - Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ... AFFAIRS Proposed Information Collection (VA National Veterans Sports Programs and Special Event Surveys... solicits comments on the information needed to evaluate the National Veterans Sports Programs and Special... ``OMB Control No. 2900-NEW (VA National Veterans Sports Programs and Special Event Surveys)'' in...

  14. 38 CFR 74.26 - What types of business information will VA collect?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... VETERANS AFFAIRS (CONTINUED) VETERANS SMALL BUSINESS REGULATIONS Records Management § 74.26 What types of business information will VA collect? VA will examine a variety of business records. See § 74.12, “What is... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false What types of...

  15. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medication prescribed by non-VA physicians. 17.96 Section 17.96 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any prescription, which is not part of...

  16. 75 FR 61858 - Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... AFFAIRS Proposed Information Collection (VA Request for Determination of Reasonable Value) Activity... solicits comments for information needed to determine the reasonable value of properties for guaranteed or... Request for Determination of Reasonable Value, VA Form 26-1805 and 26-1805-1. OMB Control Number:...

  17. Geropsychology Training in a VA Nursing Home Setting

    ERIC Educational Resources Information Center

    Karel, Michele J.; Moye, Jennifer

    2005-01-01

    There is a growing need for professional psychology training in nursing home settings, and nursing homes provide a rich environment for teaching geropsychology competencies. We describe the nursing home training component of our Department of Veterans Affairs (VA) Predoctoral Internship and Geropsychology Postdoctoral Fellowship programs. Our…

  18. 77 FR 30050 - VA National Academic Affiliations Council, Notice of meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... AFFAIRS VA National Academic Affiliations Council, Notice of meeting The Department of Veterans Affairs... the National Academic Affiliations Council will be held on June 5-6, 2012, in Suite 878 at 1800 G.... on June 5 and at 1 p.m. on June 6. The purpose of the Council is to advise the Secretary on...

  19. 78 FR 12600 - VA Homeless Providers Grant and Per Diem Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... of Veterans Affairs. ACTION: Final rule. SUMMARY: This document adopts as a final rule, with changes, the proposed rule to amend the Department of Veterans Affairs (VA) regulations concerning...

  20. 77 FR 14600 - Public Availability of the Department of Veterans Affairs Fiscal Year (FY) 2011 Service Contract...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-12

    ... AFFAIRS Public Availability of the Department of Veterans Affairs Fiscal Year (FY) 2011 Service Contract... Contract Inventories. SUMMARY: In accordance with Section 743 of Division C of the Consolidated Appropriations Act of 2010 (Public Law 111-117), Department of Veterans Affairs (VA) is publishing this notice...

  1. Determining VA physician requirements through empirically based models.

    PubMed Central

    Lipscomb, J; Kilpatrick, K E; Lee, K L; Pieper, K S

    1995-01-01

    OBJECTIVE: As part of a project to estimate physician requirements for the Department of Veterans Affairs, the Institute of Medicine (IOM) developed and tested empirically based models of physician staffing, by specialty, that could be applied to each VA facility. DATA SOURCE/STUDY SETTING. These analyses used selected data on all patient encounters and all facilities in VA's management information systems for FY 1989. STUDY DESIGN. Production functions (PFs), with patient workload dependent on physicians, other providers, and nonpersonnel factors, were estimated for each of 14 patient care areas in a VA medical center. Inverse production functions (IPFs), with physician staffing levels dependent on workload and other factors, were estimated for each of 11 specialty groupings. These models provide complementary approaches to deriving VA physician requirements for patient care and medical education. DATA COLLECTION/EXTRACTION METHODS. All data were assembled by VA and put in analyzable SAS data sets containing FY 1989 workload and staffing variables used in the PFs and IPFs. All statistical analyses reported here were conducted by the IOM. PRINCIPAL FINDINGS. Existing VA data can be used to develop statistically strong, clinically plausible, empirically based models for calculating physician requirements, by specialty. These models can (1) compare current physician staffing in a given setting with systemwide norms and (2) yield estimates of future staffing requirements conditional on future workload. CONCLUSIONS. Empirically based models can play an important role in determining VA physician staffing requirements. VA should test, evaluate, and revise these models on an ongoing basis. PMID:7860320

  2. Iraq and Afghanistan War Veterans with Reintegration Problems: Differences by Veterans Affairs Healthcare User Status.

    PubMed

    Sayer, Nina A; Orazem, Robert J; Noorbaloochi, Siamak; Gravely, Amy; Frazier, Patricia; Carlson, Kathleen F; Schnurr, Paula P; Oleson, Heather

    2015-07-01

    We studied 1,292 Iraq and Afghanistan War veterans who participated in a clinical trial of expressive writing to estimate the prevalence of perceived reintegration difficulty and compare Veterans Affairs (VA) healthcare users to nonusers in terms of demographic and clinical characteristics. About half of participants perceived reintegration difficulty. VA users and nonusers differed in age and military background. Levels of mental and physical problems were higher in VA users. In multivariate analysis, military service variables and probable traumatic brain injury independently predicted VA use. Findings demonstrate the importance of research comparing VA users to nonusers to understand veteran healthcare needs.

  3. 38 CFR 21.8015 - Notification by VA of necessary information or evidence when a claim is filed; time for claimant...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Notification by VA of necessary information or evidence when a claim is filed; time for claimant response and VA action; and VA's duty to assist claimants in obtaining evidence. 21.8015 Section 21.8015 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  4. 76 FR 44087 - Agency Information Collection (Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... AFFAIRS Agency Information Collection (Supplement to VA Forms 21-526, 21- 534, and 21-535 (For Philippine... refer to ``OMB Control No. 2900-0094.'' SUPPLEMENTARY INFORMATION: Title: Supplement to VA Forms 21-526, 21-534, and 21-535 (For Philippine Claims), VA Form 21-4169. OMB Control Number: 2900-0094. Type...

  5. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... related VA healthcare program activities; and (6) Access to the record by the requester is required for VA...' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Confidentiality of Healthcare Quality Assurance Review... disclosure or access is requested. The request must be in writing and signed by the requestor. Except...

  6. Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

    PubMed

    Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

    2016-03-01

    We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.

  7. Evaluating a New Distribution System for Department of Veterans Affairs Depots.

    ERIC Educational Resources Information Center

    Weaver, Frances M.; And Others

    1993-01-01

    Effectiveness of a new 72-hour delivery system (USXPRESS) for pharmaceuticals purchased by the Department of Veterans Affairs (VA) from VA depots was evaluated by comparing 33 test sites with 11 matched sites using a pretest posttest quasiexperimental design. The USXPRESS system reduced inventory, decreased space needs, and satisfied service…

  8. VA Quagmire Persists.

    PubMed

    Sorrel, Amy Lynn

    2016-01-01

    Ongoing U.S. Department of Veterans Affairs roadblocks mean veterans still end up on long waiting lists to get care, and the physicians treating them end up on long waiting lists to get paid. PMID:27295292

  9. Cost-benefit study of culling claim folders at the Department of Veterans Affairs

    SciTech Connect

    Charles, P.; Hill, L.G.; Johnson, P.; Riemer, C.A.

    1990-04-01

    Culling is the process of sorting through material to separate significant from insignificant information. Argonne National Laboratory (ANL) conducted a study on culling Veterans Benefits Administration (VBA) claim folders for two reasons. The first was to help the Department of Veterans Affairs (VA) learn about culling strategies that could be applied to veterans' claim folders located at the VA's regional offices (ROs) throughout the United States. The second was to show the VA the benefits that could be derived from culling. 24 tabs.

  10. A population approach to mitigating the long-term health effects of combat deployments.

    PubMed

    Reisinger, Heather Schacht; Hunt, Stephen C; Burgo-Black, A Lucile; Agarwal, Madhulika A

    2012-01-01

    A major focus of the mission of the US Department of Veterans Affairs (VA) is to respond to the needs of military personnel returning from war. Given the broad spectrum of the potential effects of combat deployment on the health and well being of service members, VA is increasingly oriented toward comprehensive postcombat support, health promotion, disease prevention, and proactive approaches to caring for combat veterans. This article briefly summarizes the health care needs of service members returning from Afghanistan and Iraq, describes VA's approaches to addressing their needs, and outlines VA's evolving vision for how to apply principles of population health management to ensure prompt and effective response to the postdeployment needs of veterans returning from future conflicts. At the heart of postcombat care will be population-based approaches oriented to health recovery using interdisciplinary, team-based platforms.

  11. Advanced earthquake monitoring system for U.S. Department of Veterans Affairs medical buildings--instrumentation

    USGS Publications Warehouse

    Kalkan, Erol; Banga, Krishna; Ulusoy, Hasan S.; Fletcher, Jon Peter B.; Leith, William S.; Reza, Shahneam; Cheng, Timothy

    2012-01-01

    In collaboration with the U.S. Department of Veterans Affairs (VA), the National Strong Motion Project (NSMP; http://nsmp.wr.usgs.gov/) of the U.S. Geological Survey has been installing sophisticated seismic systems that will monitor the structural integrity of 28 VA hospital buildings located in seismically active regions of the conterminous United States, Alaska, and Puerto Rico during earthquake shaking. These advanced monitoring systems, which combine the use of sensitive accelerometers and real-time computer calculations, are designed to determine the structural health of each hospital building rapidly after an event, helping the VA to ensure the safety of patients and staff. This report presents the instrumentation component of this project by providing details of each hospital building, including a summary of its structural, geotechnical, and seismic hazard information, as well as instrumentation objectives and design. The structural-health monitoring component of the project, including data retrieval and processing, damage detection and localization, automated alerting system, and finally data dissemination, will be presented in a separate report.

  12. Black Health Issues in New York State: Condition, Prognosis, Prescription. Executive Summary. Preliminary Report, Health Subcommittee. The Governor's Advisory Committee for Black Affairs. Volume 1, Health.

    ERIC Educational Resources Information Center

    New York Governor's Advisory Committee for Black Affairs, Albany.

    This document summarizes a review of the health problems of blacks in New York. The review comprises the first volume of a study of the needs of the two million blacks in New York. The health status of blacks is examined in each of the following phases of the life cycle: (1) maternal; (2) infancy; (3) childhood; (4) adolescence; (5) adulthood; and…

  13. Black Health Issues in New York State: Condition, Prognosis, Prescription. Preliminary Report, Health Subcommittee. The Governor's Advisory Committee for Black Affairs. Volume 1, Health.

    ERIC Educational Resources Information Center

    New York Governor's Advisory Committee for Black Affairs, Albany.

    This document, which reviews the health problems of blacks in New York State, is the first volume of a study of the needs of the two million blacks in New York. The health status of blacks is examined in each of the following phases of the life cycle: (1) maternal; (2) infancy; (3) childhood; (4) adolescence; (5) adulthood; and (6) the elder…

  14. 77 FR 64388 - Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Agency Information Collection (Former POW Medical History), VA Form 10-0048 Activities Under OMB....'' SUPPLEMENTARY INFORMATION: Title: Former POW Medical History, VA Form 10-0048. OMB Control Number:...

  15. Partnerships in Health Promotion for Black Americans. Proceedings of the Annual Meeting of the National Society of Allied Health (Virginia Beach, VA, March 29-30, 1985).

    ERIC Educational Resources Information Center

    Douglas, Harry E., III, Comp.

    This conference report of the National Society of Allied Health focusses on the theme of health promotion for black Americans, with emphasis on creating cooperative partnerships to address the various social and environmental conditions adversely affecting minority group health status. The keynote speaker provided an historical perspective on…

  16. Veterans' use of Department of Veterans Affairs care and perceptions of outsourcing inpatient care.

    PubMed

    Wakefield, Bonnie J; Tripp-Reimer, Toni; Rosenbaum, Marcy E; Rosenthal, Gary E

    2007-06-01

    The objective of the study was to examine veterans' perceptions of problems and benefits of outsourcing inpatient care from Veterans Affairs (VA) hospitals to private sector hospitals. Primary data were collected from a cross-section of 42 veterans who were VA users and nonusers using focus groups. Focus group discussion examined reasons patients use VA care, differences between VA and civilian care, positive and negative impacts of outsourcing, and special needs of veterans. Analyses revealed five domains related both to use of VA services and perceptions of outsourcing: costs, access, quality of care, contract (i.e., a covenant between veterans and the U.S. government), veteran milieu, and special needs. Participants identified a variety of potential positive and negative impacts. In general, veterans perceived more advantages than disadvantages to outsourcing VA care but still expressed significant concerns related to outsourcing. These issues should be considered in the development of future policy toward outsourcing VA care to the private sector.

  17. Health Care for Certain Children of Vietnam Veterans and Certain Korea Veterans--Covered Birth Defects and Spina Bifida. Final rule.

    PubMed

    2016-04-01

    This rule adopts as final a proposed rule of the Department of Veterans Affairs (VA) to amend its regulations concerning the provision of health care to birth children of Vietnam veterans and veterans of covered service in Korea diagnosed with spina bifida, except for spina bifida occulta, and certain other birth defects. In the proposed rule published on May 15, 2015, VA proposed changes to more clearly define the types of health care VA provides, including day health care and health-related services, which we defined as homemaker or home health aide services that provide assistance with Activities of Daily Living or Instrumental Activities of Daily Living that have therapeutic value. We also proposed changes to the list of health care services that require preauthorization by VA. This final rule addresses comments received from the public and adopts as final the proposed rule, without change.

  18. Health Care for Certain Children of Vietnam Veterans and Certain Korea Veterans--Covered Birth Defects and Spina Bifida. Final rule.

    PubMed

    2016-04-01

    This rule adopts as final a proposed rule of the Department of Veterans Affairs (VA) to amend its regulations concerning the provision of health care to birth children of Vietnam veterans and veterans of covered service in Korea diagnosed with spina bifida, except for spina bifida occulta, and certain other birth defects. In the proposed rule published on May 15, 2015, VA proposed changes to more clearly define the types of health care VA provides, including day health care and health-related services, which we defined as homemaker or home health aide services that provide assistance with Activities of Daily Living or Instrumental Activities of Daily Living that have therapeutic value. We also proposed changes to the list of health care services that require preauthorization by VA. This final rule addresses comments received from the public and adopts as final the proposed rule, without change. PMID:27051894

  19. 76 FR 63352 - Proposed Information Collection (Health Surveillance for a New Generation of U.S. Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ....Regulations.gov ; or to Cynthia Harvey Pryor, Veterans Health Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420 or e-mail: cynthia.harvey-pryor@va.gov . Please... through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or fax (202)...

  20. 77 FR 64389 - Proposed Information Collection (Health Surveillance for a New Generation of U.S. Veterans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-19

    ....Regulations.gov ; or to Cynthia Harvey Pryor, Veterans Health Administration (10P7BFP), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420 or email: cynthia.harvey-pryor@va.gov . Please refer... through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or Fax (202)...

  1. Benchmarking in Student Affairs.

    ERIC Educational Resources Information Center

    Mosier, Robert E.; Schwarzmueller, Gary J.

    2002-01-01

    Discusses the use of benchmarking in student affairs, focusing on issues related to student housing. Provides examples of how benchmarking has influenced administrative practice at many institutions. (EV)

  2. Use of the Blue Button Online Tool for Sharing Health Information: Qualitative Interviews With Patients and Providers

    PubMed Central

    Fix, Gemmae M; Hogan, Timothy P; Simon, Steven R; Nazi, Kim M; Turvey, Carolyn L

    2015-01-01

    Background Information sharing between providers is critical for care coordination, especially in health systems such as the United States Department of Veterans Affairs (VA), where many patients also receive care from other health care organizations. Patients can facilitate this sharing by using the Blue Button, an online tool that promotes patients’ ability to view, print, and download their health records. Objective The aim of this study was to characterize (1) patients’ use of Blue Button, an online information-sharing tool in VA’s patient portal, My HealtheVet, (2) information-sharing practices between VA and non-VA providers, and (3) how providers and patients use a printed Blue Button report during a clinical visit. Methods Semistructured qualitative interviews were conducted with 34 VA patients, 10 VA providers, and 9 non-VA providers. Interviews focused on patients’ use of Blue Button, information-sharing practices between VA and non-VA providers, and how patients and providers use a printed Blue Button report during a clinical visit. Qualitative themes were identified through iterative rounds of coding starting with an a priori schema based on technology adoption theory. Results Information sharing between VA and non-VA providers relied primarily on the patient. Patients most commonly used Blue Button to access and share VA laboratory results. Providers recognized the need for improved information sharing, valued the Blue Button printout, and expressed interest in a way to share information electronically across settings. Conclusions Consumer-oriented technologies such as Blue Button can facilitate patients sharing health information with providers in other health care systems; however, more education is needed to inform patients of this use to facilitate care coordination. Additional research is needed to explore how personal health record documents, such as Blue Button reports, can be easily shared and incorporated into the clinical workflow of

  3. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    PubMed

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record PMID:27214172

  4. Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

    PubMed

    Gentes, Emily L; Schry, Amie R; Hicks, Terrell A; Clancy, Carolina P; Collie, Claire F; Kirby, Angela C; Dennis, Michelle F; Hertzberg, Michael A; Beckham, Jean C; Calhoun, Patrick S

    2016-05-01

    Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record

  5. Physical activity in postdeployment Operation Iraqi Freedom/Operation Enduring Freedom veterans using Department of Veterans Affairs services.

    PubMed

    Buis, Lorraine R; Kotagal, Lindsey V; Porcari, Carole E; Rauch, Sheila A M; Krein, Sarah L; Richardson, Caroline R

    2011-01-01

    Veteran activity levels may decrease between Active Duty and postdeployment. We examined attitudes and changes in self-reported activities between the two in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans using Department of Veterans Affairs (VA) services. We conducted an online cross-sectional survey (June-August 2008) of postdeployment OIF/OEF veterans registered with the VA Ann Arbor Healthcare System, Ann Arbor, Michigan. Descriptive statistics summarized demographic data and attitudes, while regression analyses compared physical activities during Active Duty with physical activities postdeployment. Participants (n = 319, 15.6% response rate) reported that they believe staying physically fit is important, they worry about gaining weight, and they believe exercise will keep them healthy (77%, 72%, and 90% agree or strongly agree, respectively). Running (30.0%), Exercise with Gym Equipment (21.5%), Occupational Activities (14.9%), and Walking (13.0%) were the most frequently reported Active Duty physical activities. The most frequently reported postdeployment physical activities included Walking (21.1%), Running (18.5%), and Exercise with Gym Equipment (17.9%). Health problems (39%) and chronic pain (52%) were common barriers to physical activity. Postdeployment OIF/OEF veterans using the VA believe physical activity is beneficial, yet many report health problems and/or chronic pain that makes exercise difficult. Physical activity promotes health, and strategies are needed to facilitate physical activity in this population. PMID:22068369

  6. Issues in defining and measuring veteran community reintegration: proceedings of the Working Group on Community Reintegration, VA Rehabilitation Outcomes Conference, Miami, Florida.

    PubMed

    Resnik, Linda; Bradford, Daniel W; Glynn, Shirley M; Jette, Alan M; Johnson Hernandez, Caitlin; Wills, Sharon

    2012-01-01

    In January 2010, the Department of Veterans Affairs (VA) Rehabilitation Research and Development Service convened a State of the Art (SOTA) conference to advance the field of outcome measurement for rehabilitation-related studies. This article reports on the proceedings of the SOTA Working Group on Community Reintegration. We explored the use of the International Classification of Health, Disability, and Functioning as a theoretical framework for measuring community reintegration; identified key dimensions of community reintegration that could and/or should be measured; discussed challenges in measuring community reintegration; suggested steps to enhance community reintegration measurement; proposed future research that focuses on outcomes measures for community reintegration and the study of community reintegration outcomes; and made policy recommendations that would facilitate community reintegration research within the VA.

  7. Department of Veterans Affairs

    MedlinePlus

    ... a variety of benefits and services that provide financial and other forms of assistance to Servicemembers, Veterans, their dependents and survivors. Compensation Education & Training Home Loans Life Insurance Vocational Rehabilitation Get Started Burials & Memorials VA operates ...

  8. A Participatory Approach to Designing and Enhancing Integrated Health Information Technology Systems for Veterans: Protocol

    PubMed Central

    Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

    2015-01-01

    Background The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. Objective The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans’ preferences for using VA HIT to manage their health conditions and exchange health information. Methods The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. Results This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2

  9. Decree No. 88-390/PCMS/MSP/AS/CF determining the duties of the Secretary of State for Public Health and Social Affairs, charged with social affairs and the status of women, 24 November 1988.

    PubMed

    1988-01-01

    This Order provides that the Secretary of State of the Niger is charged with the following, among other things: 1) overseeing the formulation and implementation of legislation relating to social affairs, family planning (FP), and the condition of women; 2) contributing to the formulation of a Family Code in concert with the concerned ministries; 3) promoting research in FP; 4) participating in the promotion of information, sensitization, and education of the population, particularly youth, with a view of combating social diseases, in concert with concerned ministries; 5) ensuring the integration of women into the process of the economic, social, and cultural development of the country; 6) promoting the organization and mobilization of women with a view towards their full participation in carrying out activities and programs that work toward their development, in collaboration with women's institutions, movements, and associations; 7) intensifying and/or supervising all development projects essentially executed by women, in collaboration with concerned ministries; 8) ensuring the supervision and control of women's associations, movements, and institutions; and coordinating the activities undertaken by these organizations with respect to women; and 9) controlling the management of projects relating to social affairs, FP, and the status of women.

  10. 78 FR 76412 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ...-0759''. SUPPLEMENTARY INFORMATION: Titles: a. National Disabled Veterans Winter Sports Clinic... sports Clinic Event Application, VA Form 0928a, c. l. Volunteer Application, VA Form 0928h. m. Surfing... already approved collection. Abstract: Veterans who are enrolled for VA health care may apply...

  11. Use of mental health services by veterans disabled by auditory disorders.

    PubMed

    Kendall, Caroline J; Rosenheck, Robert

    2008-01-01

    This study examined whether veterans disabled by auditory disorders face barriers to receipt of Department of Veterans Affairs (VA) mental health services. We compared use of VA mental health services by veterans disabled by auditory disorders with use of such services by veterans disabled by four other chronic illnesses. We hypothesized that disabled veterans with auditory disorders, including tinnitus and/or hearing loss, would be less likely to use VA mental health services than other disabled veterans because of communication difficulties. The study sample was based on national VA administrative data for veterans with a diagnosed mental health disorder who were not receiving VA compensation for that disorder but who were receiving VA compensation for another disorder, either physical or auditory, at the end of fiscal year 2005. After controlling for potentially confounding factors, we unexpectedly found that veterans disabled by auditory disorders were more likely than other disabled veterans to use VA mental health services at least once. Among users, however, those with auditory disorders accessed slightly fewer visits than those disabled by other conditions, although the reasons for the difference remain unclear. PMID:19319759

  12. Initial Results from the Survey of Organizational Research Climates (SOuRCe) in the U.S. Department of Veterans Affairs Healthcare System

    PubMed Central

    Martinson, Brian C.; Nelson, David; Hagel-Campbell, Emily; Mohr, David; Charns, Martin P.; Bangerter, Ann; Thrush, Carol R.; Ghilardi, Joseph R.; Bloomfield, Hanna; Owen, Richard; Wells, James A.

    2016-01-01

    Background In service to its core mission of improving the health and well-being of veterans, Veterans Affairs (VA) leadership is committed to supporting research best practices in the VA. Recognizing that the behavior of researchers is influenced by the organizational climates in which they work, efforts to assess the integrity of research climates and share such information with research leadership in VA may be one way to support research best practices. The Survey of Organizational Research Climate (SOuRCe) is the first validated survey instrument specifically designed to assess the organizational climate of research integrity in academic research organizations. The current study reports on an initiative to use the SOuRCe in VA facilities to characterize the organizational research climates and pilot test the effectiveness of using SOuRCe data as a reporting and feedback intervention tool. Methods We administered the SOuRCe using a cross-sectional, online survey, with mailed follow-up to non-responders, of research-engaged employees in the research services of a random selection of 42 VA facilities (e.g., Hospitals/Stations) believed to employ 20 or more research staff. We attained a 51% participation rate, yielding more than 5,200 usable surveys. Results We found a general consistency in organizational research climates across a variety of sub-groups in this random sample of research services in the VA. We also observed similar SOuRCe scale score means, relative rankings of these scales and their internal reliability, in this VA-based sample as we have previously documented in more traditional academic research settings. Results also showed more substantial variability in research climate scores within than between facilities in the VA research service as reflected in meaningful subgroup differences. These findings suggest that the SOuRCe is suitable as an instrument for assessing the research integrity climates in VA and that the tool has similar patterns of

  13. The VA Hypertension Primary Care Longitudinal Cohort: Electronic medical records in the post-genomic era

    PubMed Central

    Salem, Rany M.; Pandey, Braj; Richard, Erin; Fung, Maple M.; Garcia, Erin P.; Brophy, Victoria H.; Schork, Nicholas J.; O'Connor, Daniel T.; Bhatnagar, Vibha

    2011-01-01

    The Veterans Affairs Hypertension Primary Care Longitudinal Cohort (VAHC) was initiated in 2003 as a pilot study designed to link the VA electronic medical record system with individual genetic data. Between June 2003 and December 2004, 1,527 hypertensive participants were recruited. Protected health information (PHI) was extracted from the regional VA data warehouse. Differences between the clinic and mail recruits suggested that clinic recruitment resulted in an over-sampling of African Americans. A review of medical records in a random sample of study participants confirmed that the data warehouse accurately captured most selected diagnoses. Genomic DNA was acquired non-invasively from buccal cells in mouthwash; ~ 96.5 per cent of samples contained DNA suitable for genotyping, with an average DNA yield of 5.02 ± 0.12 micrograms, enough for several thousand genotypes. The coupling of detailed medical databases with genetic information has the potential to facilitate the genetic study of hypertension and other complex diseases. PMID:21216807

  14. 48 CFR 852.219-71 - VA mentor-protégé program.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Electronic Subcontracting Reporting System (eSRS). (e) Contractors interested in participating in the program... AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of Provisions and Clauses 852... contracts and subcontracts. (d) Large business prime contractors serving as mentors in the VA...

  15. 78 FR 52085 - VA Veteran-Owned Small Business Verification Guidelines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-22

    ... requires the Department of Veterans Affairs (VA) to verify ownership and control of veteran- ] owned small... (77 FR 38181) an interim final rule that revised the requirement for re-verification of SDVOSB/VOSB... examination, the regulatory requirement of participants to report changes to ownership and control...

  16. 48 CFR 852.219-71 - VA mentor-protégé program.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA mentor-protégé program. 852.219-71 Section 852.219-71 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts of Provisions and Clauses...

  17. 48 CFR 852.219-9 - VA Small business subcontracting plan minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false VA Small business subcontracting plan minimum requirements. 852.219-9 Section 852.219-9 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Texts...

  18. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  19. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  20. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  1. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  2. 38 CFR 21.9510 - Claims, VA's duty to assist, and time limits.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Claims, VA's duty to assist, and time limits. 21.9510 Section 21.9510 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Post-9/11 GI Bill Claims...

  3. Veterans, children first. Consolidation of federal healthcare services leads some VA clinics to expand patient mix.

    PubMed

    Gardner, J

    1998-06-01

    Facing flat federal appropriations, the Department of Veterans Affairs is fattening its budget through service contracts with other agencies. That's meant young children and World War II veterans mix in some of its clinics. Although conceding that new funds are needed, veterans groups fear the VA's traditional customers will be shortchanged in the transition. PMID:10180477

  4. 78 FR 53506 - Agency Information Collection (HUD/VA Addendum to Uniform Residential Loan Application) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... application for both VA and the Department of Housing and Urban Development (HUD). Lenders and Veterans use... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... Under OMB Review AGENCY: Veterans Benefits Administration, Department of Veterans Affairs....

  5. Veterans, children first. Consolidation of federal healthcare services leads some VA clinics to expand patient mix.

    PubMed

    Gardner, J

    1998-06-01

    Facing flat federal appropriations, the Department of Veterans Affairs is fattening its budget through service contracts with other agencies. That's meant young children and World War II veterans mix in some of its clinics. Although conceding that new funds are needed, veterans groups fear the VA's traditional customers will be shortchanged in the transition.

  6. 75 FR 76082 - Agency Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-07

    ... a veteran's credit history in order to properly underwrite the veteran's loan. VA loans may not be guaranteed unless the veteran is a satisfactory credit risk. The data collected on the following forms are... AFFAIRS Agency Information Collection (Credit Underwriting Standards and Procedures for Processing...

  7. 75 FR 60171 - Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-29

    ... specific information concerning a veteran's credit history in order to properly underwrite the veteran's loan. VA loans may not be guaranteed unless the veteran is a satisfactory credit risk. The data... AFFAIRS Proposed Information Collection (Credit Underwriting Standards and Procedures for Processing...

  8. 38 CFR 21.1032 - VA has a duty to assist claimants in obtaining evidence.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA has a duty to assist claimants in obtaining evidence. 21.1032 Section 21.1032 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Claims and Applications for Educational Assistance Claims § 21.1032...

  9. 75 FR 25321 - Agency Information Collection (VA National Rehabilitation Special Events, Event Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-07

    ... AFFAIRS Agency Information Collection (VA National Rehabilitation Special Events, Event Registration Applications) Activities Under OMB Review AGENCY: Office of National Programs and Special Events, Department of... U.S.C. 3501-21), this notice announces that the Office of National Programs and Special...

  10. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  11. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  12. 38 CFR 17.107 - VA response to disruptive behavior of patients.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false VA response to disruptive behavior of patients. 17.107 Section 17.107 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Disciplinary Control of Beneficiaries Receiving Hospital, Domiciliary Or Nursing Home...

  13. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND...

  14. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND...

  15. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID FOR THE ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION AND...

  16. 38 CFR 39.5 - Submission of information and documents to VA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Submission of information and documents to VA. 39.5 Section 39.5 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID TO STATES FOR ESTABLISHMENT, EXPANSION, AND IMPROVEMENT, OR OPERATION...

  17. 38 CFR 39.4 - Submissions of information and documents to VA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Submissions of information and documents to VA. 39.4 Section 39.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AID TO STATES FOR ESTABLISHMENT, EXPANSION, AND IMPROVEMENT OF...

  18. “Will Employers Drop Health Insurance Coverage because of the Affordable Care Act?” Health Affairs 32(9): 1522–1530

    PubMed Central

    Buchmueller, Thomas; Carey, Colleen; Levy, Helen G.

    2014-01-01

    Since the passage of the Affordable Care Act, there has been considerable speculation about how many employers will stop offering health insurance once the major coverage provisions of the Act take effect. While some observers predict little aggregate effect, others believe that 2014 marks the beginning of the end for our current system of employer- sponsored insurance. We address the question “how will employer health insurance offering respond to health reform?” using theoretical and empirical evidence. First, we describe economic models of why employers offer insurance. Second, we recap the relevant provisions of health reform and use our economic framework to consider how they may affect employer offers. Third, we review the various predictions that have been made on this subject. Finally, we offer some observations on interpreting early data from 2014. PMID:24019355

  19. Health Care for Homeless Veterans program. Final rule.

    PubMed

    2015-05-01

    The Department of Veterans Affairs (VA) amends its medical regulations concerning eligibility for the Health Care for Homeless Veterans (HCHV) program. The HCHV program provides per diem payments to non-VA community-based facilities that provide housing, outreach services, case management services, and rehabilitative services, and may provide care and/or treatment to homeless veterans who are enrolled in or eligible for VA health care. The rule modifies VA's HCHV regulations to conform to changes enacted in the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012. Specifically, the rule removes the requirement that homeless veterans be diagnosed with a serious mental illness or substance use disorder to qualify for the HCHV program. This change makes the program available to all homeless veterans who are enrolled in or eligible for VA health care. The rule also updates the definition of homeless to match in part the one used by the Department of Housing and Urban Development (HUD). The rule further clarifies that the services provided by the HCHV program through non-VA community-based providers must include case management services, including non-clinical case management, as appropriate. PMID:25985477

  20. Assessing the value of laboratory electronic data interchange in the department of veterans affairs.

    PubMed

    Byrne, Colene M; Rudin, Robert S; Johnston, Douglas S; Pan, Eric C

    2010-01-01

    We modeled the adoption, costs and monetezied benefits of the Department of Veterans Affairs' (VA's) internally developed Laboratory Electronic Data Interchange (LEDI) application from 2001-2007. LEDI provides standards-based electronic exchange of laboratory data and secure transmission of laboratory test orders and results. Once the initial development and installation costs were accounted for, LEDI likely produced value for the VA in savings of laboratory staff time for test ordering and results processing. We estimate that the VA needed to realize 20 percent of projected labor saving to recover its investment in LEDI. PMID:21346944

  1. Managing Legal Affairs.

    ERIC Educational Resources Information Center

    Weeks, Richard H.

    2001-01-01

    Discusses school administrators' legal-affairs management responsibilities regarding legal advice, law versus ethics, and sources of law. Suggests strategies for retaining and managing legal counsel and avoiding situations involving litigation, torts, and conflict resolution. Explains general counsel services; outlines education,…

  2. Does comorbid chronic pain affect posttraumatic stress disorder diagnosis and treatment? Outcomes of posttraumatic stress disorder screening in Department of Veterans Affairs primary care.

    PubMed

    Outcalt, Samantha D; Hoen, Helena Maria; Yu, Zhangsheng; Franks, Tenesha Marie; Krebs, Erin E

    2016-01-01

    Because posttraumatic stress disorder (PTSD) is both prevalent and underrecognized, routine primary care-based screening for PTSD has been implemented across the Veterans Health Administration. PTSD is frequently complicated by the presence of comorbid chronic pain, and patients with both conditions have increased symptom severity and poorer prognosis. Our objective was to determine whether the presence of pain affects diagnosis and treatment of PTSD among Department of Veterans Affairs (VA) patients who have a positive PTSD screening test. This retrospective cohort study used clinical and administrative data from six Midwestern VA medical centers. We identified 4,244 VA primary care patients with a positive PTSD screen and compared outcomes for those with and without a coexisting pain diagnosis. Outcomes were three clinically appropriate responses to positive PTSD screening: (1) mental health visit, (2) PTSD diagnosis, and (3) new selective serotonin reuptake inhibitor (SSRI) prescription. We found that patients with coexisting pain had a lower rate of mental health visits than those without pain (hazard ratio: 0.889, 95% confidence interval: 0.821-0.962). There were no significant differences in the rate of PTSD diagnosis or new SSRI prescription between patients with and without coexisting pain.

  3. Expanded HIV Testing in the US Department of Veterans Affairs, 2009–2011

    PubMed Central

    Halloran, CNS, James; Pedati, Caitlin; Dursa, Erin K.; Durfee, Janet; Martinello, Richard; Davey, Victoria; Ross, David

    2013-01-01

    Objectives. We measured HIV testing and seropositivity among veterans in Veterans Affairs (VA) care for calendar years 2009 through 2011 and analyzed 2011 results by patient demographics. Methods. We performed a repeated-measures cross-sectional study using standardized electronic data extraction from the VA electronic health records for all veterans with at least 1 outpatient visit during 2009 through 2011. We analyzed testing rates and seropositivity by demographic characteristics for 2011. Results. Of veterans with an outpatient visit, 20.0% had an HIV test in 2011, compared with 9.2% in 2009. Documented HIV testing rates were highest in women and Blacks. Of confirmed positive test results, 67.0% were in outpatients older than 50 years. Seropositivity was highest among men aged 30 to 49 years, women aged 50 to 69 years, and Black outpatients of both genders. Implementation of an electronic clinical reminder was associated with higher testing rates. Conclusions. The significant effect of an electronic clinical reminder suggests that such decision support tools can substantially increase testing rates. The frequency of positive test results in older individuals suggests the need for additional work to define optimum approaches to HIV testing in this population. PMID:24134344

  4. Office of Indian Affairs 1984 Annual Report.

    ERIC Educational Resources Information Center

    New Mexico State Commission on Indian Affairs, Santa Fe.

    This report outlines the activities of the New Mexico Office of Indian Affairs (OIA) for 1984 in accordance with its directive to investigate, study, consider and act upon the entire subject of Indian conditions and relations within the State of New Mexico, including but not restricted to, problems of health, economy, education, legislation, and…

  5. The Feasibility of Using Large-Scale Text Mining to Detect Adverse Childhood Experiences in a VA-Treated Population.

    PubMed

    Hammond, Kenric W; Ben-Ari, Alon Y; Laundry, Ryan J; Boyko, Edward J; Samore, Matthew H

    2015-12-01

    Free text in electronic health records resists large-scale analysis. Text records facts of interest not found in encoded data, and text mining enables their retrieval and quantification. The U.S. Department of Veterans Affairs (VA) clinical data repository affords an opportunity to apply text-mining methodology to study clinical questions in large populations. To assess the feasibility of text mining, investigation of the relationship between exposure to adverse childhood experiences (ACEs) and recorded diagnoses was conducted among all VA-treated Gulf war veterans, utilizing all progress notes recorded from 2000-2011. Text processing extracted ACE exposures recorded among 44.7 million clinical notes belonging to 243,973 veterans. The relationship of ACE exposure to adult illnesses was analyzed using logistic regression. Bias considerations were assessed. ACE score was strongly associated with suicide attempts and serious mental disorders (ORs = 1.84 to 1.97), and less so with behaviorally mediated and somatic conditions (ORs = 1.02 to 1.36) per unit. Bias adjustments did not remove persistent associations between ACE score and most illnesses. Text mining to detect ACE exposure in a large population was feasible. Analysis of the relationship between ACE score and adult health conditions yielded patterns of association consistent with prior research. PMID:26579624

  6. 75 FR 78807 - Agency Information Collection (Notice to Department of Veterans Affairs of Veteran or Beneficiary...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... Incarcerated in Penal Institution) Activity Under OMB Review AGENCY: Veterans Benefits Administration... Veterans Affairs of Veteran or Beneficiary Incarcerated in Penal Institution, VA Form 21-4193. OMB Control... should be reduced or terminated when he or she is incarcerated in a penal institution in excess of...

  7. Report on the evaluation of the VA/Seattle below-knee prosthesis.

    PubMed

    Ellepola, W; Sheredos, S J

    1993-01-01

    The Department of Veterans Affairs (VA), Rehabilitation Research and Development (Rehab R&D) Service, Technology Transfer Section (TTS) with collaboration from the Prosthetic and Sensory Aids Service (PSAS) managed clinical trials to evaluate the VA/Seattle Below-Knee (BK) Prosthetic System. The clinical trials were held at the Prosthetic Treatment Center (PTC), VA Medical Center, Hines, Illinois. Five other VA medical centers participated in the outreach program of the trials as satellite stations, with PTC Hines as the central fabrication facility. The VA/Seattle BK system is the first complete prosthetic system designed and developed by the Department of Veterans Affairs. It consists of a socket designed and fabricated using computer-aided, automated technology, and off-the-shelf modular components: a lightweight pylon and an ankle unit, and a lightweight, energy-storing foot. The computer-based socket design software, the modular components, and the prosthetic foot were developed with funds from the VA Rehab R&D Service. The evaluation trials were conducted to determine the efficacy of the VA/Seattle prosthesis, its reliability, and acceptance by veterans. The clinical trials began in April 1991 and were completed in August 1992. Forty-six BK amputee veterans were fitted with the VA/Seattle prosthesis. Their progress with the prosthesis was followed for a period of 6 months and data were gathered at intervals of 2 weeks, 3 months, and 6 months. Forty sets of subject data instruments were collected. In order to maintain the accuracy of the results, TTS used the 22 sets that were complete for data analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Primary care satellite clinics and improved access to general and mental health services.

    PubMed Central

    Rosenheck, R

    2000-01-01

    OBJECTIVES: To evaluate the relationship between the implementation of community-based primary care clinics and improved access to general health care and/or mental health care, in both the general population and among people with disabling mental illness. STUDY SETTING: The 69 new community-based primary care clinics in underserved areas, established by the Department of Veterans Affairs (VA) between the last quarter of FY 1995 and the second quarter of FY 1998, including the 21 new clinics with a specialty mental health care component. DATA SOURCES: VA inpatient and outpatient workload files, 1990 U.S. Census data, and VA Compensation and Pension files were used to determine the proportion of all veterans, and the proportion of disabled veterans, living in each U.S. county who used VA general health care services and VA mental health services before and after these clinics began operation. DESIGN: Analysis of covariance was used to compare changes, from late FY 1995 through early FY 1998, in access to VA services in counties in which new primary care clinics were located, in counties in which clinics that included specialized mental health components were located, and for comparison, in other U.S. counties, adjusting for potentially confounding factors. KEY FINDINGS: Counties in which new clinics were located showed a significant increase from the FY 1995-FY 1998 study dates in the proportion of veterans who used general VA health care services. This increase was almost twice as large as that observed in comparison counties (4.2% vs. 2.5%: F = 12.6, df = 1,3118, p = .0004). However, the introduction of these clinics was not associated with a greater use of specialty VA mental health services in the general veteran population, or of either general health care services or mental health services among veterans who received VA compensation for psychiatric disorders. In contrast, in counties with new clinics that included a mental health component the proportion of

  9. More than Listening: A Casebook for Using Counseling Skills in Student Affairs Work

    ERIC Educational Resources Information Center

    Harper, Ruth; Wilson, Nona L.

    2010-01-01

    Helping skills are an essential component of today's student affairs practice. On a day-to-day basis, it is student affairs professionals who often work directly with students in need of mental health support and monitoring. "More Than Listening: A Casebook for Using Counseling Skills in Student Affairs Work" is written for those student affairs…

  10. Revolution in Detection Affairs

    SciTech Connect

    Stern W.

    2013-11-02

    The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovative application of anomaly detection algorithms.

  11. Public affairs committee actions

    NASA Astrophysics Data System (ADS)

    The AGU Public Affairs Committee will create an ad hoc committee to consider possible AGU position statements concerning the effects of nuclear war.The action was taken at the May 31, 1983, meeting of the Committee at the AGU Spring Meeting in Baltimore. Present were Carroll Ann Hodges, Chairman, and members Thomas J. Ahrens, David Cauffman, Jared Cohon, Stamatios Krimigis, Robert Murphy, Raymond Roble, and George Shaw. Also attending were the current Congressional Fellow Arthur Weissman and SPR—Cosmic Rays Section Secretary Miriam Forman.

  12. Public health assessment for US Defense General Supply Center, Richmond, Chesterfield County, Virginia, Region 3. CERCLIS No. VA3971520751. Final report

    SciTech Connect

    Not Available

    1993-04-21

    Defense General Supply Center (DGSC), south of Richmond, Virginia in Chesterfield County, is a military supply distribution center. The facility currently manages and furnishes military general supplies to the Armed Forces and several federal civilian agencies. Contaminants, primarily volatile organic chemicals, in groundwater and surface water have migrated to adjoining communities. A well survey was conducted in March 1987 by the Chesterfield County Health District, part of the Virginia Health Department. Some private wells were sampled at the time of the survey in the Rayon Park area, adjacent to the National Guard Area on DGSC, and the water contained contaminants at levels above regulatory limits. Because of those levels, 21 private wells in the community of Rayon Park were replaced with an alternate water supply in 1987. Because of infrequent exposure to low levels of VOCs in those wells, adverse health effects are not likely. Citizens have expressed concerns about contamination to installation officials and representatives of state and local health departments. They are also concerned about possible adverse health effects associated with past use of contaminated groundwater and on-going monitoring efforts being conducted by DGSC. Those concerns are evaluated in the Public Health Implications section of the public health assessment.

  13. US Department of Veterans Affairs disability policies for posttraumatic stress disorder: administrative trends and implications for treatment, rehabilitation, and research.

    PubMed

    Frueh, B Christopher; Grubaugh, Anouk L; Elhai, Jon D; Buckley, Todd C

    2007-12-01

    An accumulating body of empirical data suggests that current Department of Veterans Affairs (VA) psychiatric disability and rehabilitation policies for combat-related posttraumatic stress disorder (PTSD) are problematic. In combination, recent administrative trends and data from epidemiological and clinical studies suggest theses policies are countertherapeutic and hinder research efforts to advance our knowledge regarding PTSD. Current VA disability policies require fundamental reform to bring them into line with modern science and medicine, including current empirically supported concepts of resilience and psychiatric rehabilitation.

  14. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services...

  15. 38 CFR 17.120 - Payment or reimbursement for emergency treatment furnished by non-VA providers to certain...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment or reimbursement for emergency treatment furnished by non-VA providers to certain veterans with service-connected disabilities. 17.120 Section 17.120 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment and Reimbursement of...

  16. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services...

  17. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services...

  18. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services...

  19. 38 CFR 17.1000 - Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Payment or reimbursement for emergency services for nonservice-connected conditions in non-VA facilities. 17.1000 Section 17.1000 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Payment Or Reimbursement for Emergency Services...

  20. 76 FR 61150 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property at the VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ..., manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be... priority placement for homeless Veterans and Veterans at risk of homelessness; and provide a supportive... for applying the consideration under such a lease for the provision of medical care and services...

  1. Student Affairs Capitalism and Early-Career Student Affairs Professionals

    ERIC Educational Resources Information Center

    Lee, Jenny J.; Helm, Matthew

    2013-01-01

    This study explores student affairs capitalism as the alteration of professional practice towards the financial interests of institutions. Student affairs capitalism has the potential to create dynamics in which the interests of students become secondary to the institution's economic needs. This study examined this phenomenon from the…

  2. Oversight of Indian Program Budgets. Hearing Before the Select Committee on Indian Affairs. United States Senate, Ninety-Seventh Congress, First Session on Review of Budget Submissions of the Bureau of Indian Affairs, Department of the Interior; Indian Health Service, Department of Health and Human Services; Office of Indian Education, Department of Education; and Indian Housing, Department of Housing and Urban Development.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Select Committee on Indian Affairs.

    Testimony and prepared statements provide insight into the manner in which Indian affairs will be administered under the proposed 1982 fiscal year budget and compares the proposed innovations and the implementation of assistance to the Indian tribes with a general Federal policy to promote tribal self-determination. Probably because of the…

  3. Perceptions of other integrative health therapies by Veterans with pain who are receiving massage

    PubMed Central

    Fletcher, Carol Elizabeth; Mitchinson, Allison R.; Trumble, Erika L.; Hinshaw, Daniel B.; Dusek, Jeffery A.

    2016-01-01

    Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans’ perceptions of the VA’s efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants’ experience. Participants were asked about their experience in the VA and their opinions about which therapies would most benefit other Veterans. Participants reported that massage was well-received and resulted in decreased pain, increased mobility, and decreased opioid use. Major challenges were the high ratio of patients to CIH providers, the difficulty in receiving CIH from fee-based CIH providers outside of the VA, cost issues, and the role of administrative decisions in the uneven deployment of CIH across the VA. If the VA is to meet its goal of offering personalized, proactive, patient-centered care nationwide then it must receive support from Congress while considering Veterans’ goals and concerns to ensure that the expanded provision of CIH improves outcomes. PMID:27004453

  4. 30 CFR 57.22229 - Weekly testing (I-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Weekly testing (I-A, III, and V-A mines). 57.22229 Section 57.22229 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...-A, III, and V-A mines). (a) The mine atmosphere shall be tested for methane and carbon monoxide...

  5. 30 CFR 57.22229 - Weekly testing (I-A, III, and V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Weekly testing (I-A, III, and V-A mines). 57.22229 Section 57.22229 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...-A, III, and V-A mines). (a) The mine atmosphere shall be tested for methane and carbon monoxide...

  6. 30 CFR 57.22229 - Weekly testing (I-A, III, and V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Weekly testing (I-A, III, and V-A mines). 57.22229 Section 57.22229 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...-A, III, and V-A mines). (a) The mine atmosphere shall be tested for methane and carbon monoxide...

  7. VA and HRS Local Coordination of Florida's Home-Based Services to the Elderly.

    ERIC Educational Resources Information Center

    Bradham, Douglas D.; Chico, Innette Mary

    Florida's District 12 Veterans Administration (VA) wanted to deliver medical case-management services to veterans not receiving home-based services due to the geographic restrictions of the VA's Hospital-Based Home Care Program. The Florida Department of Health and Rehabilitative Services (HRS) desired to demonstrate the effectiveness of nurse…

  8. Military and VA General Dentistry Training: A National Resource.

    ERIC Educational Resources Information Center

    Atchison, Kathryn A.; Bachand, William; Buchanan, C. Richard; Lefever, Karen H.; Lin, Sylvia; Engelhardt, Rita

    2002-01-01

    Compared the program characteristics of the postgraduate general dentistry (PGD) training programs sponsored by the military and the Veterans Health Administration (VA). Gathered information on program infrastructure and emphasis, resident preparation prior to entering the program, and patients served and types of services provided. Programs…

  9. Risk of Smoking and Receipt of Cessation Services Among Veterans Affairs Patients With Mental Disorders

    PubMed Central

    Duffy, Sonia A.; Kilbourne, Amy M.; Austin, Karen L.; Dalack, Gregory W.; Woltmann, Emily M.; Waxmonsky, Jeanette A.; Noonan, Devon

    2012-01-01

    Objective The purpose of this study was to determine rates of smoking and receipt of provider recommendations to quit smoking among patients with mental disorders treated in U.S. Department of Veterans Affairs (VA) treatment settings. Methods The authors conducted a secondary analysis of the yearly, cross-sectional 2007 Veterans Health Administration Outpatient Survey of Healthcare Experiences of Patients (N=224,193). Logistic regression was used to determine the independent association of mental health diagnosis and the dependent variables of smoking and receipt of provider recommendations to quit smoking. Results Patients with mental disorders had greater odds of smoking, compared with those without mental disorders (p<.05). Those with various mental disorders reported similar rates of receiving services (more than 60% to 80% reported receiving selected services), compared with those without these disorders, except that those with schizophrenia had more than 30% lower odds of receiving advice to quit smoking from their physicians (p<.05). Moreover, those who had co-occurring posttraumatic stress disorder or substance use disorders had significantly greater odds of reporting that they received advice to quit, recommendations for medications, and physician discussions of quitting methods, compared with those without these disorders (p<.05). Older patients, male patients, members of ethnic minority groups, those who were unmarried, those who were disabled or unemployed, and those living in rural areas had lower odds of receiving selected services (p<.05). Conclusions The majority of patients with mental disorders served by the VA reported receiving cessation services, yet their smoking rates remained high, and selected groups were at risk for receiving fewer cessation services, suggesting the continued need to disseminate cessation services. PMID:22337005

  10. ESRD care within the US Department of Veterans Affairs: a forward-looking program with an illuminating past.

    PubMed

    Watnick, Suzanne; Crowley, Susan T

    2014-03-01

    The first governmental agency to provide maintenance hemodialysis to patients with end-stage renal disease (ESRD) was the Veterans Administration (VA; now the US Department of Veterans Affairs). Many historical VA policies and programs set the stage for the later care of both veteran and civilian patients with ESRD. More recent VA initiatives that target restructuring of care models based on quality management, system-wide payment policies to promote cost-effective dialysis, and innovation grants aim to improve contemporary care. The VA currently supports an expanded and diversified nationwide treatment program for patients with ESRD using an integrated patient-centered care paradigm. This narrative review of ESRD care by the VA explores not only the medical advances, but also the historical, socioeconomic, ethical, and political forces related to the care of veterans with ESRD.

  11. Veterans' use of Department of Veterans Affairs care and perceptions of outsourcing inpatient care.

    PubMed

    Wakefield, Bonnie J; Tripp-Reimer, Toni; Rosenbaum, Marcy E; Rosenthal, Gary E

    2007-06-01

    The objective of the study was to examine veterans' perceptions of problems and benefits of outsourcing inpatient care from Veterans Affairs (VA) hospitals to private sector hospitals. Primary data were collected from a cross-section of 42 veterans who were VA users and nonusers using focus groups. Focus group discussion examined reasons patients use VA care, differences between VA and civilian care, positive and negative impacts of outsourcing, and special needs of veterans. Analyses revealed five domains related both to use of VA services and perceptions of outsourcing: costs, access, quality of care, contract (i.e., a covenant between veterans and the U.S. government), veteran milieu, and special needs. Participants identified a variety of potential positive and negative impacts. In general, veterans perceived more advantages than disadvantages to outsourcing VA care but still expressed significant concerns related to outsourcing. These issues should be considered in the development of future policy toward outsourcing VA care to the private sector. PMID:17615833

  12. Health hazard evaluation determination report number MHETA-82-006-9002, Sewell Coal Company, Number 1 Preparation Plant, Nettie, West Virginia, VA

    SciTech Connect

    Patil, A.; Corwell, R.J.

    1982-08-01

    The potential health effects of exposure to a coal antifreeze agent, Wendon-NF-40 were examined. The study was requested by the United Mine Workers of America and was conducted on March 8, 1982 at the Sewell Coal Company No. 1 Preparation Facility (SIC-1211), Nettie, West Virginia. The antifreeze agent was sprayed on the coal as it fell from a conveyer belt into a large hopper. The spraying operation was enclosed except at one side. The preliminary on site investigation was conducted after the facility had discontinued using the antifreeze agent. Therefore, only bulk samples were collected for qualitative analysis. Workers were interviewed by a NIOSH physician. The qualitative analysis revealed that the primary component of the antifreeze was diethylene-glycol (111466). Two of 10 workers interviewed complained of health problems they felt were related to exposure to Wendon-NF-40. Their symptoms included headache and skin irritation. Due to lack of environmental sampling, NIOSH was unable to determine that a hazard from overexposure to Wendon-NF-40 existed. The authors suggest that organic vapor respirators should be worn by workers when they are in area where inhalation of the mists or sprays is likely.

  13. 38 CFR 58.17 - VA Form 10-0144A-Statement of Assurance of Compliance with Equal Opportunity Laws.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0144A-Statement of Assurance of Compliance with Equal Opportunity Laws. 58.17 Section 58.17 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.17 VA Form 10-0144A—Statement of Assurance of Compliance with...

  14. 38 CFR 58.18 - VA Form 10-0460-Request for Prescription Drugs from an Eligible Veteran in a State Home.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-0460-Request for Prescription Drugs from an Eligible Veteran in a State Home. 58.18 Section 58.18 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) FORMS § 58.18 VA Form 10-0460—Request for Prescription Drugs from an...

  15. Minimally adequate mental health care and latent classes of PTSD symptoms in female Iraq and Afghanistan veterans.

    PubMed

    Hebenstreit, Claire L; Madden, Erin; Koo, Kelly H; Maguen, Shira

    2015-11-30

    Female veterans of Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) represent a growing segment of Department of Veterans Affairs (VA) health care users. A retrospective analysis used national VA medical records to identify factors associated with female OEF/OIF/OND veterans' completion of minimally adequate care (MAC) for PTSD, defined as the completion of at least nine mental health outpatient visits within a 15-week period or at least twelve consecutive weeks of medication use. The sample included female OEF/OIF/OND veterans with PTSD who initiated VA health care between 2007-2013, and were seen in outpatient mental health (N=2183). Multivariable logistic regression models examined factors associated with completing MAC for PTSD, including PTSD symptom expression (represented by latent class analysis), sociodemographic, military, clinical, and VA access factors. Within one year of initiating mental health care, 48.3% of female veterans completed MAC. Race/ethnicity, age, PTSD symptom class, additional psychiatric diagnoses, and VA primary care use were significantly associated with completion of MAC for PTSD. Results suggest that veterans presenting for PTSD treatment should be comprehensively evaluated to identify factors associated with inadequate completion of care. Treatments that are tailored to PTSD symptom class may help to address potential barriers.

  16. The Post-9/11 GI Bill: Insights from Veterans Using Department of Veterans Affairs Educational Benefits

    ERIC Educational Resources Information Center

    Bell, Geri L.; Boland, Elizabeth A.; Dudgeon, Brian; Johnson, Kurt

    2013-01-01

    Because the Post-9/11 GI Bill was implemented in August of 2009, increasing numbers of veterans returning from the Global War on Terror (GWT) have drawn on Department of Veterans Affairs (VA) educational benefits. Based on the findings of a mixed-methods study, quantitative and qualitative survey responses from veterans enrolled at a major…

  17. Technology and Student Affairs: Redux

    ERIC Educational Resources Information Center

    Moneta, Larry

    2005-01-01

    The author addresses two critical questions related to technology: How has students' use of technology influenced student affairs work? How do we best align our business practices with advances in information technology?

  18. Using Electronic Health Record Systems in Diabetes Care: Emerging Practices

    PubMed Central

    Veinot, Tiffany C.; Zheng, Kai; Lowery, Julie C.; Souden, Maria; Keith, Rosalind

    2013-01-01

    While there has been considerable attention devoted to the deployment of electronic health record (EHR) systems, there has been far less attention given to their appropriation for use in clinical encounters — particularly in the context of complex, chronic illness. The Department of Veterans’ Affairs (VA) has been at the forefront of EHR adoption and, as such, provides a unique opportunity to examine a mature EHR system in widespread use. Moreover, with a high prevalence of diabetes in its patient population, the VA provides a useful platform for examining EHR use in the context of chronic disease care. We conducted a sequential, exploratory qualitative study at two VA Medical Centers in the Midwest. First, we conducted observations of 64 clinical consultations with diabetes patients. These observations involved 31 different health care providers. Second, using insights from these observations, we conducted in-depth, semi-structured interviews with 39 health care providers focusing on their use of information in diabetes patient care. Field notes and interview transcripts were analyzed using a grounded theory approach. Our analysis generated several categories of EHR use in clinical encounters: priming, structuring, assessing, informing, and continuing. We also outline some mismatches between EHR system design and VA diabetes care practices. We conclude by discussing implications of these emergent system uses for improving the software design of EHRs to better support chronic disease care, as well as for our understanding of the integration of technologies in health care. PMID:25264545

  19. Increasing the ranks of academic researchers in mental health: a multisite approach to postdoctoral fellowship training.

    PubMed

    O'Hara, Ruth; Cassidy-Eagle, Erin L; Beaudreau, Sherry A; Eyler, Lisa T; Gray, Heather L; Giese-Davis, Janine; Hubbard, Jeffrey; Yesavage, Jerome A

    2010-01-01

    This report highlights the use of multisite training for psychiatry and psychology postdoctoral fellows developing careers in academic clinical research in the field of mental health. The objective is to describe a model of training for young investigators to establish independent academic clinical research careers, including (1) program structure and eligibility, (2) program goals and development of a multisite curriculum, (3) use of technology for implementing the program across multiple sites, and (4) advantages and challenges of this multisite approach. In 2000, in collaboration with the Veterans Affairs (VA) Mental Illness Research, Education and Clinical Centers (MIRECCs), the VA Office of Academic Affiliations launched the Special Fellowship Program in Advanced Psychiatry and Psychology. Each of the 10 currently participating VA sites across the United States is affiliated with a MIRECC and an academic medical institution. In the first five years of this fellowship program, 83 fellows (34 psychiatrists and 49 psychologists) have participated. The success of this multisite approach is evidenced by the 58 fellows who have already graduated from the program: 70% have entered academic clinical research positions, and over 25 have obtained independent extramural grant support from the VA or the National Institutes of Health. Multisite training results in a greater transfer of knowledge and capitalizes on the nationwide availability of experts, creating unique networking and learning opportunities for trainees. The VA's multisite fellowship program plays a valuable role in preparing substantial numbers of psychiatry and psychology trainees for a range of academic clinical research and leadership positions in the field of mental health.

  20. User and clinician perspectives on DEKA arm: results of VA study to optimize DEKA arm.

    PubMed

    Resnik, Linda; Klinger, Shana Lieberman; Etter, Katherine

    2014-01-01

    This article summarizes feedback from Department of Veterans Affairs (VA) subjects and clinicians gathered during the VA optimization study of the DEKA Arm. VA subjects and clinicians tested two DEKA Arm prototypes (second-generation [gen 2] and third-generation [gen 3]). Features of the prototypes in three configurations are described. DEKA used feedback from the VA optimization study and from their own subjects to refine the gen 2 prototype. Thirty-three unique subjects participated in the VA evaluation; 26 participated in the gen 2 evaluation (1 subject participated twice), 13 participated in the gen 3 evaluation, and 5 participated in both gen 2 and gen 3 evaluations. Subject data were gathered through structured and open-ended surveys, interviews, and audio- and videotaped sessions. Study prosthetists and therapists provided ongoing feedback and completed surveys at the end of each subject's protocol. Eleven categories of feedback were identified: weight, cosmesis, hand grips, wrist design, elbow design, end-point control, foot controls, batteries and chargers, visual notifications, tactor, and socket features. Final feedback on the gen 3 was generally positive, particularly regarding improvements in wrist design, visual notifications, foot controls, end-point control, and cosmesis. Additional refinements to make the device lighter in weight, eliminate external wires and cables, and eliminate the external battery may further enhance its perceived usability and acceptability.

  1. Academic Affiliations with the Department of Veterans Affairs: Characteristics of the Ohio State University Model.

    ERIC Educational Resources Information Center

    Newcomb, Robert D.; Hill, Richard M.

    1993-01-01

    The Ohio State University School of Optometry affiliation with four Veterans Administration (VA) health care facilities is characterized by a central governing committee, regular faculty appointments for all participating VA staff, substantial interaction with each site, strong orientation for rotating senior optometry students, and joint…

  2. You and me and the computer makes three: variations in exam room use of the electronic health record.

    PubMed

    Saleem, Jason J; Flanagan, Mindy E; Russ, Alissa L; McMullen, Carmit K; Elli, Leora; Russell, Scott A; Bennett, Katelyn J; Matthias, Marianne S; Rehman, Shakaib U; Schwartz, Mark D; Frankel, Richard M

    2014-02-01

    Challenges persist on how to effectively integrate the electronic health record (EHR) into patient visits and clinical workflow, while maintaining patient-centered care. Our goal was to identify variations in, barriers to, and facilitators of the use of the US Department of Veterans Affairs (VA) EHR in ambulatory care workflow in order better to understand how to integrate the EHR into clinical work. We observed and interviewed 20 ambulatory care providers across three geographically distinct VA medical centers. Analysis revealed several variations in, associated barriers to, and facilitators of EHR use corresponding to different units of analysis: computer interface, team coordination/workflow, and organizational. We discuss our findings in the context of different units of analysis and connect variations in EHR use to various barriers and facilitators. Findings from this study may help inform the design of the next generation of EHRs for the VA and other healthcare systems.

  3. You and me and the computer makes three: variations in exam room use of the electronic health record

    PubMed Central

    Saleem, Jason J; Flanagan, Mindy E; Russ, Alissa L; McMullen, Carmit K; Elli, Leora; Russell, Scott A; Bennett, Katelyn J; Matthias, Marianne S; Rehman, Shakaib U; Schwartz, Mark D; Frankel, Richard M

    2014-01-01

    Challenges persist on how to effectively integrate the electronic health record (EHR) into patient visits and clinical workflow, while maintaining patient-centered care. Our goal was to identify variations in, barriers to, and facilitators of the use of the US Department of Veterans Affairs (VA) EHR in ambulatory care workflow in order better to understand how to integrate the EHR into clinical work. We observed and interviewed 20 ambulatory care providers across three geographically distinct VA medical centers. Analysis revealed several variations in, associated barriers to, and facilitators of EHR use corresponding to different units of analysis: computer interface, team coordination/workflow, and organizational. We discuss our findings in the context of different units of analysis and connect variations in EHR use to various barriers and facilitators. Findings from this study may help inform the design of the next generation of EHRs for the VA and other healthcare systems. PMID:24001517

  4. Comparative Effectiveness Research Priorities at Federal Agencies: The View from the Department of Veterans Affairs, National Institute on Aging, and Agency for Healthcare Research and Quality

    PubMed Central

    O’Leary, Timothy J.; Slutsky, Jean R.; Bernard, Marie A.

    2010-01-01

    In the last year increased attention has been focused on translating federally sponsored health research into improved health for Americans. Since the passage of the American Recovery and Reinvestment Act (ARRA) on February 17, 2009, this focus has been accelerated by ARRA funds to support Comparative Effectiveness Research (CER). A high proportion of topical areas of interest in CER affect the older segment of the population. The Department of Veterans Affairs (VA), the National Institute on Aging (NIA), and the Agency for Healthcare Research and Quality (AHRQ) have supported robust research portfolios focused on aging populations that meet the varying definitions of CER. In this short paper we briefly describe the research missions of the AHRQ, NIA, and VA. We then review the various definitions of CER as put forward by the Congressional Budget Office, the Institute of Medicine, and the ARRA established Federal Coordinating Council; as well as important topics for which CER is particularly needed. Finally, we set forth approaches in which the three agencies support CER involving the aging population and outline opportunities for future CER research. PMID:20936736

  5. Overutilization of acute-care beds in Veterans Affairs hospitals.

    PubMed

    Smith, C B; Goldman, R L; Martin, D C; Williamson, J; Weir, C; Beauchamp, C; Ashcraft, M

    1996-01-01

    The authors tested the hypothesis that the Department of Veterans Affairs (VA) hospitals would have substantial overutilization of acute care beds and services because of policies that emphasize inpatient care over ambulatory care. Reviewers from 24 randomly selected VA hospitals applied the InterQual ISD* (Intensity, Severity, Discharge) criteria for appropriateness concurrently to a random sample of 2,432 admissions to acute medical, surgical, and psychiatry services. Reliability of hospital reviewers in applying the ISD* criteria was tested by comparing their reviews with those of a small group of expert reviewers. Validity of the ISD* criteria was tested by comparing the assessments of master reviewers with the implicit judgments of panels of nine physicians. The physician panels validated the ISD* admission criteria for medicine and surgery (74% agreement with master reviewers, kappa > 0.4), whereas the psychiatry criteria were not validated (66% agreement, kappa 0.29). Hospital reviewers reliably used all three criteria sets (> 83% agreement with master reviewers, kappa > 0.6). Rates of nonacute admissions to acute medical and surgical services were > 38% as determined by the hospital and master reviewers and by the physician panels. Nonacute rates of continued stay were > 32% for both medicine and surgery services. Similar rates of nonacute admissions and continued stay were found for all 24 hospitals. Reasons for nonacute admissions and continued stay included lack of an ambulatory care alternative, conservative physician practices, delays in discharge planning, and social factors such as homelessness and long travel distances to the hospital. Using criteria that the authors showed to be reliable and valid, substantial overutilization of acute medicine and surgical beds was found in a representative sample of VA hospitals. Correcting this situation will require changes in physician practice patterns, development of ambulatory care alternatives to inpatient

  6. Medical care collection or recovery--VA. Notice.

    PubMed

    1998-10-13

    In a companion document published in the "Proposed Rules" section of this issue of the Federal Register, we proposed to amend VA's medical regulations concerning collection or recovery by VA for medical care or services provided or furnished to a veteran: (i) For a non-service connected disability for which the veteran is entitled to care (or the payment of expenses of care) under a health-plan contract; (ii) For a non-service connected disability incurred incident to the veteran's employment and covered under a worker's compensation law or plan that provides reimbursement or indemnification for such care and services; or (iii) For a non-service connected disability incurred as a result of a motor vehicle accident in a State that requires automobile accident reparations insurance. The proposed rule includes methodology for establishing charges for VA medical care or services. Using this methodology, information for calculating proposed charge amounts at individual VA facilities for inpatient facility charges, skilled nursing facility/sub-acute inpatient facility charges, outpatient facility charges, and physician charges is set forth below. If this methodology were adopted subsequently as a final rule, the applicable data in this document, designed for the period August 1998 through September 1999, would be used for the period from the effective date of the final rule through September 1999. Accordingly, interested parties may wish to retain this document for future reference.

  7. KaVA ESTEMA project

    NASA Astrophysics Data System (ADS)

    Oyadomari, Miyako; Imai, Hiroshi; Cho, Se-Hyung; Asaki, Yoshiharu; Choi, Yoon-Kyong; Kim, Jaeheon; Yun, Youngjoo; Matsumoto, Naoko; Min, Cheul-Hong; Oyama, Tomoaki; Yoon, Sung-Chul; Yoon, Dong-Hwan; Kim, Dong-Jin; Dodson, Richard; Rioja, Maria; Burns, Ross; Orosz, Gabor; Nakagawa, Akiharu; Chibueze O, James; Nakashima, Jun-ichi; Sobolev, Andrey

    2016-07-01

    The ESTEMA (Expanded Study on Stellar Masers) project is one of three Large Programs of the KaVA (the combined array of the Korean VLBI Network and Japanese VLBI Exploration of Radio Astrometry), and conducted in 2015-2016. It aims to publish a database of the largest sample of VLBI images of circumstellar water (H2O) and silicon-monoxide (SiO) maser sources towards circumstellar envelopes (CSEs) of 80 evolved stars in late AGB to early post-AGB phase. Here we present the specifications of the ESTEMA observations and the planned scientific goals in order to share the basic information of the ESTEMA with astronomical community and encourage future collaborations with the ESTEMA and future follow-up observations for the targeted stars.

  8. An Evaluation of Current CCTV Usage To Support Patient Health Education Activities at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Brecksville Division.

    ERIC Educational Resources Information Center

    Kromke, Diane

    Closed-circuit television (CCTV) is a promising technology used by many medical centers to support health education activities for patients and their families. It may provide one method of reaching multiple patients at various times and locations, providing consistent, easily repeated information in a low stress manner, but it is unclear how much…

  9. Evaluating the Efficacy of a Short Aging Simulation Workshop for an Interdisciplinary Group of Health-Care Employees at a Veterans Affairs Medical Center

    ERIC Educational Resources Information Center

    Halpin, Sean N.

    2015-01-01

    Several interventions aimed at increasing positive attitudes towards older adults among health-care professionals have been introduced. These interventions tend to focus on a small subset of clinical employees, ignoring other clinical and nonclinical hospital staff. The objective of this study was to evaluate the efficacy of a short aging…

  10. The VA-Medical School Partnership: The Medical School Perspective.

    ERIC Educational Resources Information Center

    Petersdorf, Robert G.

    1987-01-01

    Issues in the relationship between the Veterans' Administration (VA) and medical schools are discussed, including VA faculty recruitment and retention, ambulatory care in VA teaching hospitals, governance and growth of research within VA medical centers, and effects of cost containment and competition on teaching and training in VA hospitals. (MSE)

  11. NIOSH testimony on Kuwait before the subcommittee on hospitals and health care, committee on veterans' affairs by J. S. Andrews, September 16, 1992

    SciTech Connect

    Not Available

    1992-09-16

    The testimony summarizes potential adverse health effects related to service in the Persian Gulf as presented by the Department of Health and Human Services. An estimated 9,000 workers from 43 different countries battled the burning oil wells in Kuwait from February 1991 through early November 1991 when the last was capped. Exposures and health effects in US military personnel, Kuwaiti citizens, and fire fighters were described. The hazards to the soldiers were largely dependent on the concentration of the pollutants in the air near the camps. Fortunately, the plume from the fires rose up to 10,000 and 12,000 feet, mixed with the air and then dispersed for several thousand miles downwind over a period of several weeks. The particles and gases contained in the plume were diluted as the plume travelled. Even so, some minor respiratory problems were present among the soldiers. Some of the hydrocarbons measured at low concentrations have been shown to produce cancer in laboratory animals only when present at higher levels of exposure. Based on the exposure information gathered, the author concludes that there will not likely be a detectable increase in lung cancer in Gulf War Veterans as a result of the oil well fires.

  12. Lean Six Sigma in health care and the challenge of implementation of Six Sigma methodologies at a Veterans Affairs Medical Center.

    PubMed

    Pocha, Christine

    2010-01-01

    Six Sigma and Lean Thinking are quality initiatives initially deployed in industry to improve operational efficiency leading to better quality and subsequent cost savings. The financial rationale for embarking on this quality journey is clear; applying it to today's health care remains challenging. The cost of medical care is increasing at an alarming rate; most of these cost increases are attributed to an aging population and technological advances; therefore, largely beyond control. Furthermore, health care cost increases are caused by unnecessary operational inefficiency associated with the direct medical service delivery process. This article describes the challenging journey of implementing Six Sigma methodology at a tertiary care medical center. Many lessons were learned; however, of utmost importance were team approach, "buy in" of the stakeholders, and the willingness of team members to change daily practice and to adapt new and innovative ways how health care can be delivered. Six Sigma incorporated as part of the "company's or hospital's culture" would be most desirable but the learning curve will be steep.

  13. Delivery of gender-sensitive comprehensive primary care to women veterans: implications for VA Patient Aligned Care Teams.

    PubMed

    Yano, Elizabeth M; Haskell, Sally; Hayes, Patricia

    2014-07-01

    The Veterans Health Administration (VA) has undertaken a major initiative to transform primary care delivery through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home concept, PACTs aim to improve access, continuity, coordination, and comprehensiveness using team-based care that is patient driven and patient centered. However, how PACT principles should be applied to meet the needs of special populations, including women veterans, is not entirely clear. While historical differences in military participation meant women veterans were rarely seen in VA healthcare settings, they now represent the fastest growing segment of new VA users. They also have complex healthcare needs, adding gender-specific services and other needs to the spectrum of services that the VA must deliver. These trends are changing the VA landscape, introducing challenges to how VA care is organized, how VA providers need to be trained, and how VA considers implementation of new initiatives, such as PACT. We briefly describe the evolution of VA primary care delivery for women veterans, review VA policy for delivering gender-sensitive comprehensive primary care for women, and discuss the challenges that women veterans' needs pose in the context of PACT implementation. We conclude with recommendations for addressing some of these challenges moving forward.

  14. Indigenous Affairs = Asuntos Indigenas, 1996.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1996

    1996-01-01

    This document contains the four 1996 English-language issues of Indigenous Affairs and the four corresponding issues in Spanish. These newsletters provide a resource on the history, current conditions, and struggles for self-determination and human rights of indigenous peoples around the world. Articles on the United States and Canada (1) discuss…

  15. Indigenous Affairs = Asuntos Indigenas, 1997.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1997

    1997-01-01

    This document contains the three 1997 English-language issues of Indigenous Affairs and the three corresponding issues in Spanish. (The last two quarterly issues were combined.) These periodicals provide a resource on the history, current conditions, and struggles for self-determination and human rights of indigenous peoples around the world.…

  16. Indigenous Affairs = Asuntos Indigenas, 2000.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 2000

    2000-01-01

    This document contains the four English-language issues of Indigenous Affairs published in 2000 and four corresponding issues in Spanish. The Spanish issues contain all or some of the articles contained in the English issues plus additional articles on Latin America. These periodicals provide a resource on the history, current conditions, and…

  17. Indigenous Affairs = Asuntos Indigenas, 1998.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1998

    1998-01-01

    This document contains the four 1998 English-language issues of Indigenous Affairs and the four corresponding issues in Spanish. These periodicals provide a resource on the history, current conditions, and struggles for self-determination and human rights of indigenous peoples around the world. The first issue is a theme issue on the indigenous…

  18. Employment Practices in Student Affairs.

    ERIC Educational Resources Information Center

    McIntire, David A.; Carpenter, D. Stanley

    1981-01-01

    Investigated job search and hiring practices in student affairs work. Questionnaires sent to member institutions of the National Association of Student Personnel Administrators indicated the extensive use of newspapers to advertise positions. Institutions placed a high level of importance on effective resumes and reference letters. (RC)

  19. Sustainability, Student Affairs, and Students

    ERIC Educational Resources Information Center

    Kerr, Kathleen G.; Hart-Steffes, Jeanne S.

    2012-01-01

    Colleges and universities are developing both the next generation of leaders as well as state-of-the-art technology that allow climate reduction aspirations and triple bottom-line outcomes to become realities. Divisions of student affairs play a crucial role in the sustainability movement in colleges and universities. The technology-savvy,…

  20. Employee Development in Student Affairs.

    ERIC Educational Resources Information Center

    Jones, Susan Holtzer

    A survey was undertaken of staff in Student Affairs of the University of California at Davis in December 1979. Data gathered in that survey and relating to professional development activities of the staff are presented. The objective is to provide information on development opportunities for those employees, staff participation in them, and need…

  1. Online Education in Public Affairs

    ERIC Educational Resources Information Center

    Ginn, Martha H.; Hammond, Augustine

    2012-01-01

    This exploratory study provides an overview of the current landscape of online education in the fields of Master of Public Administration and Master of Public Policy (MPA/MPP) utilizing a dataset compiled from content analysis of MPA/MPP programs' websites and survey of 96 National Association of Schools of Public Affairs and Administration…

  2. Minority Affairs Department Resource Guide.

    ERIC Educational Resources Information Center

    American Chemical Society, Washington, DC.

    The American Chemical Society (ACS), founded in 1876, is a not-for-profit organization that is recognized as a world leader in fostering scientific education and research and promoting public understanding of science. The ACS Committee on Minority Affairs has a mission to develop and implement programs to support minority involvement in the…

  3. Vital status ascertainment through the files of the Department of Veterans Affairs and the Social Security Administration.

    PubMed

    Page, W F; Mahan, C M; Kang, H K

    1996-03-01

    Veterans of US military service are a valuable resource for epidemiologic studies, and the Department of Veterans Affairs (VA) files provide an effective way to gather mortality information on veterans, so long as these files provide reasonably complete death reporting. To determine the completeness of VA death reporting, we assembled an independent sample of known veteran deaths among males born between 1936 and 1955 and assessed the performance of VA death reporting in this sample. We also compared VA death ascertainment to Social Security Administration (SSA) ascertainment. Based on the more than 4300 deaths in our study, we found VA death reporting to be approximately 90% complete by itself and 96% complete when used in conjunction with SSA death reporting. In addition, we found no evidence that VA death reporting changed substantially after passage of the Omnibus Budget Reconciliation Act of 1981, which limited eligibility for VA death benefits. Because veterans make up a large segment of the US population, our findings have particular relevance for studies in which mortality is a primary end point. PMID:10068251

  4. A bill to amend title 38, United States Code, to expand and enhance eligibility for health care and services through the Department of Veterans Affairs, and for other purposes.

    THOMAS, 113th Congress

    Sen. Sanders, Bernard [I-VT

    2013-10-29

    11/19/2013 Committee on Veterans' Affairs. Ordered to be reported with an amendment in the nature of a substitute favorably. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  5. 30 CFR 57.22229 - Weekly testing (I-A, III, and V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Weekly testing (I-A, III, and V-A mines). 57.22229 Section 57.22229 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal...

  6. 30 CFR 57.22229 - Weekly testing (I-A, III, and V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Weekly testing (I-A, III, and V-A mines). 57.22229 Section 57.22229 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal...

  7. A formalized teaching, practice, and research partnership with the Veterans Affairs North Texas Health Care System: a model for advancing academic partnerships.

    PubMed

    Hall, Ronald G; Foslein-Nash, Cynthia; Singh, Dilpreet K; Zeiss, Robert A; Sanders, Karen M; Patry, Roland; Leff, Richard

    2009-12-17

    In 1999, the Texas Tech University Health Sciences Center School of Pharmacy expanded its Dallas/Fort Worth presence by creating a regional campus for pharmacy students in their third and fourth years (P3 and P4 years) of the program. This expansion was driven by the need for additional practice sites. The VANTHCS was an obvious choice for the school due to the similarity of missions for clinical practice, education, and research. The VANTHCS and pharmacy school renovated a 4,000 square foot building, which includes classrooms, conference rooms, a student lounge, and faculty offices (expanded to 8,000 square feet in 2003). To date, the school has invested $1 million in the building. From a practice perspective, VANTHCS purchases faculty professional services from the school to augment its clinical specialist staff. These professional practice contracts provide VANTHCS with 12 additional clinical pharmacy specialists serving 50% of their time in multiple specialty areas. The collaboration has also allowed for expansion of clinical teaching, benefitting both institutions. In addition to the pharmacy student interns on P3 and P4 practice experiences, the collaboration allows for 8 to 10 postgraduate pharmacy residents to train with VANTHCS clinical specialists and school faculty members each year. The VANTHCS/pharmacy school collaboration has clearly enhanced the ability of both institutions to exceed their teaching, research, and practice goals in a cost-effective manner. PMID:20221334

  8. Suicide Mortality Among Individuals Receiving Treatment for Depression in the Veterans Affairs Health System: Associations with Patient and Treatment Setting Characteristics

    PubMed Central

    Zivin, Kara; Kim, H. Myra; McCarthy, John F.; Austin, Karen L.; Hoggatt, Katherine J.; Walters, Heather; Valenstein, Marcia

    2007-01-01

    Objectives. We sought to report clinical and demographic factors associated with suicide among depressed veterans in an attempt to determine what characteristics identified depressed veterans at high risk for suicide. Methods. We used longitudinal, nationally representative data (1999–2004) to determine suicide rates among depressed veterans, estimating time until suicide using Cox proportional hazards regression models. Results. Of 807694 veterans meeting study criteria, 1683 (0.21%) committed suicide during follow-up. Increased suicide risks were observed among male, younger, and non-Hispanic White patients. Veterans without service-connected disabilities, with inpatient psychiatric hospitalizations in the year prior to their qualifying depression diagnosis, with comorbid substance use, and living in the southern or western United States were also at higher risk. Posttraumatic stress disorder (PTSD) with comorbid depression was associated with lower suicide rates, and younger depressed veterans with PTSD had a higher suicide rate than did older depressed veterans with PTSD. Conclusions. Unlike the general population, older and younger veterans are more prone to suicide than are middle-aged veterans. Future research should examine the relationship between depression, PTSD, health service use, and suicide risks among veterans. PMID:17971541

  9. Tribal Veterans Representative (TVR) training program: the effect of community outreach workers on American Indian and Alaska Native Veterans access to and utilization of the Veterans Health Administration.

    PubMed

    Kaufmann, L Jeanne; Buck Richardson, W J; Floyd, James; Shore, Jay

    2014-10-01

    American Indians and Alaska Natives serve at the highest rate of any US race or ethnic group, yet are the most underserved population of Veterans and do not take advantage of the Department of Veterans Affairs (VA) benefits and services. Barriers to seeking care include stigma, especially for mental health issues; distance to care; and lack of awareness of benefits and services they are entitled to receive. In response to this underutilization of the VA, an innovative program--the Tribal Veterans Representative (TVR) program--was developed within the VA to work with American Indians and Alaska Natives in rural and remote areas. The TVR goes through extensive training every year; is a volunteer, a Veteran and tribal community member who seeks out unenrolled Native Veterans, provides them with information on VA health care services and benefits, and assists them with enrollment paperwork. Being from the community they serve, these outreach workers are able to develop relationships and build rapport and trust with fellow Veterans. In place for over a decade in Montana, this program has enrolled a countless number of Veterans, benefiting not only the individual, but their family and the community as well. Also resulting from this program, are the implementation of Telemental Health Clinics treating Veterans with PTSD, a transportation program helping Veterans get to and from distant VA facilities, a Veteran Resource Center, and a Veteran Tribal Clinic. This program has successfully trained over 800 TVRs, expanded to other parts of the country and into remote areas of Alaska.

  10. Lipid Management Guidelines from the Departments of Veteran Affairs and Defense: A Critique.

    PubMed

    Bennet, Catherine S; Dahagam, Chanukya R; Virani, Salim S; Martin, Seth S; Blumenthal, Roger S; Michos, Erin D; McEvoy, John W

    2016-09-01

    In December 2014, the US Department of Veterans Affairs and Department of Defense (VA/DoD) published an independent clinical practice guideline for the management of dyslipidemia and cardiovascular disease risk, adding to the myriad of recently published guidelines on this topic. The VA/DoD guidelines differ from major US guidelines published by the American College of Cardiology/American Heart Association in 2013 in the following ways: recommending moderate-intensity statins for the majority of patients with statin indications regardless of atherosclerotic cardiovascular disease risk; advocating for limited on-treatment lipid monitoring; and deemphasizing ancillary data, such as coronary artery calcium testing, to improve atherosclerotic cardiovascular disease risk estimation. In the context of manifold treatment recommendations from numerous guideline committees, the VA/DoD recommendations may generate further confusion and mixed messages among healthcare providers about the optimal treatment of dyslipidemia. In this review, we critically appraise the VA/DoD recommendations with a focus on the evidence base for each area where the VA/DoD guidelines differ from the American College of Cardiology/American Heart Association guidelines. We also call for harmonization of lipid treatment guidelines to ensure high-quality and consistent care for patients with, and at risk for, atherosclerotic cardiovascular disease. PMID:27154781

  11. Veterans' Group Life Insurance (VGLI) no-health period extension. Final rule.

    PubMed

    2012-11-01

    The Department of Veterans Affairs (VA) is issuing this final rule that amends the regulations governing eligibility for Veterans' Group Life Insurance (VGLI) to extend to 240 days the current 120-day "no-health" period during which veterans can apply for VGLI without proving that they are in good health for insurance purposes. The purpose of this rule is to increase the opportunities for disabled veterans to enroll in VGLI, some of whom would not qualify for VGLI coverage under existing provisions. This document adopts as a final rule, without change, the proposed rule published in the Federal Register on June 25, 2012.

  12. Chair Report for the Committee on Research and Graduate Affairs.

    ERIC Educational Resources Information Center

    Broom, Arthur D.

    1988-01-01

    The report of the American Association of Colleges of Pharmacy's Committee on Research and Graduate Affairs addresses: graduate program evaluation, women's status in the pharmaceutical sciences, graduate student membership in the association, research needs and funding, animal use in research, a national health policy project, and clinical faculty…

  13. Who Knows? Selected Information Resources on International Social Affairs.

    ERIC Educational Resources Information Center

    Feulner, John A., Comp.

    These two annotated listings cite organizations, groups, and programs that provide information on international social affairs. The entries were selected from the data base of the National Referral Center of the Library of Congress. Listings are organized under the following headings: volunteer agencies; food; law; health; population; rural…

  14. Information Communication Technology (ICT) Shaping Student Affairs.

    ERIC Educational Resources Information Center

    Broughton, Elizabeth

    This paper opens with the following questions: "How prepared are you as a student affairs professional for information communication technology (ICT)? Do you understand such concepts as portals, e-business, Napster, computer use policies, and wireless communication? Will student affairs be shaped by ICT or will student affairs help shape ICT on…

  15. A GUIDE TO UNDERSTANDING WORLD AFFAIRS.

    ERIC Educational Resources Information Center

    ROGERS, WILLIAM C.

    WRITTEN IN EVERYDAY ENGLISH, THIS READING BOOK PRESENTS MANY FACTS AND IDEAS ABOUT WORLD AFFAIRS. CHAPTERS COVER INTERNATIONAL LIFE, POWER IN WORLD AFFAIRS, WAR AS INTERNATIONAL CONFLICT, THE MEANS AND VARIETIES OF ARMED CONFLICT, INTERNATIONAL CONFLICT SHORT OF WAR, THE ACCOMMODATION OF CONFLICT IN WORLD AFFAIRS, AND PEACE--WHAT IT IS AND HOW TO…

  16. The Digital Identity of Student Affairs Professionals

    ERIC Educational Resources Information Center

    Ahlquist, Josie

    2016-01-01

    This chapter highlights opportunities in the digital space for student affairs professionals. A blended approach, grounded in the new technology competency recently added in the ACPA and NASPA student affairs professional competencies, is proposed for student affairs professionals' digital identity development. It includes the awareness of one's…

  17. Clinician Documentation on Receipt of Trauma-Focused Evidence-Based Psychotherapies in a VA PTSD Clinic.

    PubMed

    Lu, Mary W; Plagge, Jane M; Marsiglio, Mary C; Dobscha, Steven K

    2016-01-01

    The U.S. Department of Veterans Affairs (VA) is implementing two trauma-focused, evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD): cognitive processing therapy and prolonged exposure therapy (PE). Veterans with PTSD often do not receive these treatments, and little is known about the reasons veterans may not receive TF-EBPs. The aim of this qualitative study was to summarize clinician-reported reasons in medical records for nonreceipt of TF-EBPs. All veterans (N = 63) identified through PTSD screening who were newly engaged in mental health care and received individual evaluations in a PTSD specialty clinic in fiscal year 2008 were included in the sample. Content analysis of electronic medical records revealed multiple potential reasons for nonreceipt of TF-EBPs including referral to other PTSD treatments, other clinical priorities, poor engagement in care, practical barriers, negative beliefs, and receipt of care in other settings. Eight veterans (13%) initiated TF-EBPs. Further interventions to promote engagement in PTSD treatment are warranted.

  18. Prevalence and correlates of smoking status among veterans affairs primary care patients with probable major depressive disorder.

    PubMed

    Lombardero, Anayansi; Campbell, Duncan G; Harris, Kari J; Chaney, Edmund F; Lanto, Andrew B; Rubenstein, Lisa V

    2014-03-01

    In an attempt to guide planning and optimize outcomes for population-specific smoking cessation efforts, the present study examined smoking prevalence and the demographic, clinical and psychosocial characteristics associated with smoking among a sample of Veterans Affairs primary care patients with probable major depression. Survey data were collected between 2003 and 2004 from 761 patients with probable major depression who attended one of 10 geographically dispersed VA primary care clinics. Current smoking prevalence was 39.8%. Relative to nonsmokers with probable major depression, bivariate comparisons revealed that current smokers had higher depression severity, drank more heavily, and were more likely to have comorbid PTSD. Smokers with probable major depression were also more likely than nonsmokers with probable major depression to have missed a health care appointment and to have missed medication doses in the previous 5months. Smokers were more amenable than non-smokers to depression treatment and diagnosis, and they reported more frequent visits to a mental health specialist and less social support. Alcohol abuse and low levels of social support were significant concurrent predictors of smoking status in controlled multivariable logistic regression. In conclusion, smoking prevalence was high among primary care patients with probable major depression, and these smokers reported a range of psychiatric and psychosocial characteristics with potential to complicate systems-level smoking cessation interventions.

  19. Military to civilian questionnaire: a measure of postdeployment community reintegration difficulty among veterans using Department of Veterans Affairs medical care.

    PubMed

    Sayer, Nina A; Frazier, Patricia; Orazem, Robert J; Murdoch, Maureen; Gravely, Amy; Carlson, Kathleen F; Hintz, Samuel; Noorbaloochi, Siamak

    2011-12-01

    The primary objective of this study was to describe the development, reliability, and construct validity of scores on the Military to Civilian Questionnaire (M2C-Q), a 16-item self-report measure of postdeployment community reintegration difficulty. We surveyed a national, stratified sample of 1,226 Iraq and Afghanistan veterans who used U.S. Department of Veterans Affairs (VA) medical care; 745 completed the M2C-Q and validated mental health screening measures. All analyses were based on weighted estimates. The internal consistency of the M2C-Q was .95 in this sample. Factor analyses indicated a single total score was the best-fitting model. Total scores were associated with measures theoretically related to reintegration difficulties including perception of overall difficulty readjusting back into civilian life (R(2) = .49), probable PTSD (d = 1.07), probable problem drug or alcohol use (d = 0.34), and overall mental health (r = -.83). Subgroup analyses revealed a similar pattern of findings in those who screened negative for PTSD. Nonwhite and unemployed veterans reported greater community reintegration difficulty (d = 0.20 and 0.45, respectively). Findings offer preliminary support for the reliability and construct validity of M2C-Q scores.

  20. Providers' Note-Writing Practices for Post-traumatic Stress Disorder at Five United States Veterans Affairs Facilities.

    PubMed

    Tuepker, Anaïs; Zickmund, Susan L; Nicolajski, Cara E; Hahm, Bridget; Butler, Jorie; Weir, Charlene; Post, Lori; Hickam, David H

    2016-07-01

    The capacity of electronic health records (EHRs) to capture desired information depends on the practices of health care providers. These practices have not been well studied in relation to post-traumatic stress disorder (PTSD). This qualitative study investigated how providers write EHR notes on PTSD through 38 interviews with providers working at five Veterans Affairs (VA) hospitals across the United States of America. Two overarching themes were prominent in the results. Providers used progress notes primarily to remember and access details for direct patient care, but only rarely for care coordination. Providers infrequently recorded information not judged to directly contribute to improved care, sometimes deliberately omitting information perceived to jeopardize patients' access to, or quality of, care. Omitted information frequently included sexual or non-military trauma. Understanding providers' thought processes can help clinicians be aware of the limitations of EHR notes as a tool for learning the histories of new patients. Similarly, researchers relying on EHR data for PTSD research should be aware of likely areas of missing data.

  1. Acquired Immune Deficiency Syndrome (AIDS) and the Veterans' Administration. Hearing before the Subcommittee on Hospitals and Health Care of the Committee on Veterans' Affairs. House of Representatives, One Hundredth Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Veterans' Affairs.

    This document presents witness testimony and prepared statements from the Congressional hearing called to examine the issue of acquired immune deficiency syndrome (AIDS) and the role of the Veterans' Administration (VA) in combating AIDS. Opening statements are included from Representatives G. V. Montgomery, J. Roy Rowland, Joseph P. Kennedy, II,…

  2. VA Construction Assistance Act of 2014

    THOMAS, 113th Congress

    Rep. Coffman, Mike [R-CO-6

    2013-11-21

    09/17/2014 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  3. Indian Health Service Oversight and Reauthorization of Indian Health Care Improvement Act. Hearing before the Select Committee on Indian Affairs, United States Senate, Ninety-Sixth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Select Committee on Indian Affairs.

    The transcript of the March 28, 1980, Senate hearing on the Indian Health Service (IHS) and reauthorization of the Indian Health Care Improvement Act (Public Law 94-437) held in Billings, Montana, is presented with testimony from the Three Affiliated Tribes of North Dakota, Montana United Indian Association, Montana Indian Health Board, Fort Peck…

  4. Do Older Rural and Urban Veterans Experience Different Rates of Unplanned Readmission to VA and Non-VA Hospitals?

    ERIC Educational Resources Information Center

    Weeks, William B.; Lee, Richard E.; Wallace, Amy E.; West, Alan N.; Bagian, James P.

    2009-01-01

    Context: Unplanned readmission within 30 days of discharge is an indicator of hospital quality. Purpose: We wanted to determine whether older rural veterans who were enrolled in the VA had different rates of unplanned readmission to VA or non-VA hospitals than their urban counterparts. Methods: We used the combined VA/Medicare dataset to examine…

  5. Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital.

    PubMed

    Kind, Amy J H; Brenny-Fitzpatrick, Maria; Leahy-Gross, Kris; Mirr, Jacquelyn; Chapman, Elizabeth; Frey, Brooke; Houlahan, Beth

    2016-02-01

    The Department of Veterans Affairs (VA) Coordinated-Transitional Care (C-TraC) program is a low-cost transitional care program that uses hospital-based nurse case managers, inpatient team integration, and in-depth posthospital telephone contacts to support high-risk patients and their caregivers as they transition from hospital to community. The low-cost, primarily telephone-based C-TraC program reduced 30-day rehospitalizations by one-third, leading to significant cost savings at one VA hospital. Non-VA hospitals have expressed interest in launching C-TraC, but non-VA hospitals differ in important ways from VA hospitals, particularly in terms of context, culture, and resources. The objective of this project was to adapt C-TraC to the specific context of one non-VA setting using a modified Replicating Effective Programs (REP) implementation theory model and to test the feasibility of this protocolized implementation approach. The modified REP model uses a mentored phased-based implementation with intensive preimplementation activities and harnesses key local stakeholders to adapt processes and goals to local context. Using this protocolized implementation approach, an adapted C-TraC protocol was created and launched at the non-VA hospital in July 2013. In its first 16 months, C-TraC successfully enrolled 1,247 individuals with 3.2 full-time nurse case managers, achieving good fidelity for core protocol steps. C-TraC participants experienced a 30-day rehospitalization rate of 10.8%, compared with 16.6% for a contemporary comparison group of similar individuals for whom C-TraC was not available (n = 1,307) (P < .001). The new C-TraC program continues in operation. Use of a modified REP model to guide protocolized adaptation to local context resulted in a C-TraC program that was feasible and sustained in a real-world non-VA setting. A modified REP implementation framework may be an appropriate foundational step for other clinical programs seeking to harness

  6. Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital.

    PubMed

    Kind, Amy J H; Brenny-Fitzpatrick, Maria; Leahy-Gross, Kris; Mirr, Jacquelyn; Chapman, Elizabeth; Frey, Brooke; Houlahan, Beth

    2016-02-01

    The Department of Veterans Affairs (VA) Coordinated-Transitional Care (C-TraC) program is a low-cost transitional care program that uses hospital-based nurse case managers, inpatient team integration, and in-depth posthospital telephone contacts to support high-risk patients and their caregivers as they transition from hospital to community. The low-cost, primarily telephone-based C-TraC program reduced 30-day rehospitalizations by one-third, leading to significant cost savings at one VA hospital. Non-VA hospitals have expressed interest in launching C-TraC, but non-VA hospitals differ in important ways from VA hospitals, particularly in terms of context, culture, and resources. The objective of this project was to adapt C-TraC to the specific context of one non-VA setting using a modified Replicating Effective Programs (REP) implementation theory model and to test the feasibility of this protocolized implementation approach. The modified REP model uses a mentored phased-based implementation with intensive preimplementation activities and harnesses key local stakeholders to adapt processes and goals to local context. Using this protocolized implementation approach, an adapted C-TraC protocol was created and launched at the non-VA hospital in July 2013. In its first 16 months, C-TraC successfully enrolled 1,247 individuals with 3.2 full-time nurse case managers, achieving good fidelity for core protocol steps. C-TraC participants experienced a 30-day rehospitalization rate of 10.8%, compared with 16.6% for a contemporary comparison group of similar individuals for whom C-TraC was not available (n = 1,307) (P < .001). The new C-TraC program continues in operation. Use of a modified REP model to guide protocolized adaptation to local context resulted in a C-TraC program that was feasible and sustained in a real-world non-VA setting. A modified REP implementation framework may be an appropriate foundational step for other clinical programs seeking to harness

  7. Revolution in nuclear detection affairs

    SciTech Connect

    Stern, Warren M.

    2014-05-09

    The detection of nuclear or radioactive materials for homeland or national security purposes is inherently difficult. This is one reason detection efforts must be seen as just one part of an overall nuclear defense strategy which includes, inter alia, material security, detection, interdiction, consequence management and recovery. Nevertheless, one could argue that there has been a revolution in detection affairs in the past several decades as the innovative application of new technology has changed the character and conduct of detection operations. This revolution will likely be most effectively reinforced in the coming decades with the networking of detectors and innovative application of anomaly detection algorithms.

  8. 76 FR 75509 - Autopsies at VA Expense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-02

    ... that amendment, VA promulgated 38 CFR 17.38, on October 6, 1999, 64 FR 54212. Section 17.38, inter alia... spouse or, in a proper case, the next of kin, unless the patient or domiciled person was abandoned by the... next preceding his death, he or she shall be deemed to have been abandoned. (b) If there is no...

  9. 78 FR 32126 - VA Dental Insurance Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ...) Resin-based composite restorations. (iv) Endodontic services. (A) Pulp capping. (B) Pulpotomy and... in the Federal Register (77 FR 12517) a proposed rule to amend VA regulations to establish VADIP, a... coverage capabilities as determined during the Federal contracting process. See 77 FR 12518. Although...

  10. 75 FR 24757 - Virginia Disaster #VA-00029

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-05

    ... ADMINISTRATION Virginia Disaster VA-00029 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the... of Disaster Assistance, U.S. Small Business Administration, 409 3rd Street, SW., Suite...

  11. 76 FR 70804 - Virginia Disaster #VA-00037

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... ADMINISTRATION Virginia Disaster VA-00037 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for the Commonwealth of Virginia... INFORMATION CONTACT: A. Escobar, Office of Disaster Assistance, U.S. Small Business Administration, 409...

  12. 76 FR 72994 - Virginia Disaster #VA-00041

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... ADMINISTRATION Virginia Disaster VA-00041 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a Notice of the Presidential declaration of a major disaster for Public Assistance Only for the... Disaster Assistance, U.S. Small Business Administration, 409 3rd Street SW., Suite 6050, Washington,...

  13. 76 FR 56861 - Virginia Disaster #VA-00038

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-14

    ... ADMINISTRATION Virginia Disaster VA-00038 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... Commonwealth of Virginia (FEMA-4024-DR), dated 09/03/2011. Incident: Hurricane Irene. Incident Period: 08/26..., Southampton, Suffolk City, Sussex, Virginia Beach City, Westmoreland, Williamsburg City, York. The...

  14. 77 FR 73510 - Virginia Disaster #VA-00052

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-10

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00052 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... State of Virginia (FEMA- 4092-DR), dated 11/26/2012. Incident: Hurricane Sandy Incident Period:...

  15. 75 FR 9006 - Virginia Disaster #VA-00028

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-26

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00028 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... Commonwealth of Virginia (FEMA-1874-DR), dated 02/16/2010. Incident: Severe Winter Storm and...

  16. 76 FR 40766 - Virginia Disaster #VA-00032

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... ADMINISTRATION Virginia Disaster VA-00032 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated... determined to be adversely affected by the disaster: Primary Counties: Pulaski. Contiguous Counties:...

  17. 76 FR 72020 - Virginia Disaster #VA-00039

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... ADMINISTRATION Virginia Disaster VA-00039 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated... adversely affected by the disaster: Primary Counties: Fairfax, Prince William. Contiguous Counties:...

  18. 76 FR 59765 - Virginia Disaster # VA-00036

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... ADMINISTRATION Virginia Disaster VA-00036 AGENCY: U.S. Small Business Administration. ACTION: Notice SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated...: Virginia: Charles City, Chesterfield, Colonial Heights City, Dinwiddie, Hanover, Henrico, James City,...

  19. 76 FR 72022 - Virginia Disaster #VA-00040

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster VA-00040 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY... State of Virginia (FEMA- 4042-DR), dated 11/10/2011. Incident: Earthquake. Incident Period:...

  20. 76 FR 40765 - Virginia Disaster #VA-00034

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-11

    ... ADMINISTRATION Virginia Disaster VA-00034 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated...: Virginia: Bristol City, Grayson, Russell, Scott, Smyth. Tennessee: Johnson, Sullivan. The Interest...

  1. 77 FR 74908 - Virginia Disaster #VA-00051

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... ADMINISTRATION Virginia Disaster VA-00051 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the Commonwealth of Virginia dated... adversely affected by the disaster: Primary Counties: Accomack. Contiguous Counties: Virginia:...

  2. The VA advantage: the gold standard in clinical informatics.

    PubMed

    Morgan, Matthew W

    2005-01-01

    How does a healthcare organization undergo such transformation as described in the lead paper in eight short years? Just imagine being part of an organization that achieved the following transformations: (1) reduction in hospital and long-term-care beds from 92,000 to 53,000 and an increase in outpatient clinics from 200 to 850 (2) a 75% increase in the number of patients treated on an annual basis (from 2.8 million to 4.9 million) with only a 32% cumulative increase in budget (from $19 billion to $25 billion) (3) clinicians who have access to complete medical records for almost all patient visits and all care settings (4) clinicians who willingly enter medication orders 94% of the time (5) patients who are increasingly satisfied with their care, ranking the service consistently higher than the competition (6) improved patient outcomes, achieved at costs 25% less than the competition. Such transformation is impossible to achieve without vision, leadership, talent, teamwork and tools. I will restrict my comments to a discussion of the tools, specifically the VA's clinical information system (VistA, HealtheVet, My HealtheVet. However, it is important to note that the results described in this paper would not be possible without the VA's transformational leadership and dedicated teams of professionals capable of executing the vision.

  3. Collaborative Academic Training of Psychiatrists and Psychologists in VA and Medical School Settings

    ERIC Educational Resources Information Center

    Scaturo, Douglas J.; Huszonek, John J.

    2009-01-01

    Objective: The authors review the background and contemporary strengths of Dean's Committee Veterans Affairs Medical Centers in the collaborative academic training of psychiatrists and psychologists. Methods: The authors discuss the problems and prospects of the current health care environment as it impacts the behavioral health treatment of…

  4. Indigenous Affairs = Asuntos Indigenas, 1994-1995.

    ERIC Educational Resources Information Center

    Indigenous Affairs, 1995

    1995-01-01

    This document consists of the eight issues of the IWGIA newsletter "Indigenous Affairs" published during 1994-95. Each issue is published in separate English and Spanish versions. The newsletter is published by the International Work Group for Indigenous Affairs (IWGIA), an organization that supports indigenous peoples in their efforts to gain…

  5. Challenges of Assessment in Student Affairs

    ERIC Educational Resources Information Center

    Blimling, Gregory S.

    2013-01-01

    This chapter focuses on how the climate of accountability in higher education is compelling student affairs organizations to develop comprehensive assessment programs, the challenges faced in creating those programs, and ways student affairs professionals can meet those challenges. For the purpose of this chapter, the author has defined assessment…

  6. A Legal Guide for Student Affairs Professionals.

    ERIC Educational Resources Information Center

    Kaplin, William A.; Lee, Barbara A.

    Today's college campuses offer student affairs divisions a multitude of challenges. Ways in which student affairs professionals can develop the capacities they need to successfully meet a myriad of legal concerns are covered in this text. The book is divided into 12 chapters and covers approximately 200 topics. It organizes and conceptualizes the…

  7. Enhanced T-lymphocyte blastogenic response to tuberculin (PPD) in children of northeast (NE) Thailand supplemented with vitamin A (VA) and zinc (Zn)

    SciTech Connect

    Kramer, T.R.; Udomkesmalee, E.; Dhanamitta, S.; Sirisinha, S.; Charoenkiatkul, S.; Tantipopipat, S.; Banjong, O.; Rojroongwasinkul, N.; Smith, J.C. Jr. Mahidol Univ., Nakhon Pathom )

    1991-03-15

    Beneficial effects of Va and/or Zn supplementation of children in NE Thailand are described in a companion abstract. In the same study, blastogenic response (BR) of T-lymphocytes to concanavalin-A (ConA) and PPD were assayed in cultures containing mononuclear cells (MNC) or whole blood (WB). Methods were previously described. Children were previously vaccinated with BCG. BR to ConA of MNC or WB from children supplemented with VA, Zn, VA + Zn or placebo were similar. BR to PPD of MNC was higher in children receiving VA + Zn than placebo, but not in children supplemented with VA or Zn alone. Data indicate that children with suboptimal VA and Zn nutriture supplemented with < 2 times RDA of these nutrients showed enhanced cellular immunity to PPD. This observation is relevant to BCG immunization program and thus may benefit public health.

  8. Using the Veterans Health Administration inpatient care database: trends in the use of antireflux surgery.

    PubMed

    Finalyson, Samuel R G; Stroupe, Kevin T; Joseph, George J; Fisher, Elliott S

    2002-01-01

    Context. In the private sector, the use of surgery to treat gastroesophageal reflux disease has increased substantially since the development of minimally invasive laparoscopic techniques. However, trends in the use of antireflux surgery in the Veterans Affairs (VA) health care system have not been explored. Objective. To compare secular trends in the use of antireflux surgery in VA hospitals and the private sector. Data Sources. VA data are from the 1991-1999 medical SAS datasets for inpatient care (commonly known as patient treatment files); private sector data are from the 1991-1997 Nationwide Inpatient Sample and the U.S. census. Calculations. We compared secular trends in the use of antireflux surgery in the VA and private sector with each group's baseline rate in 1991. For the VA, we calculated annual rates of antireflux surgery among active users of the VA health care system by dividing the number of procedures (based on the appropriate procedure codes from the International Classification of Diseases, ninth revision, clinical modification) by the number of veterans who had at least two hospital or clinic visits in a given year. For the private sector, we calculated true population rates by dividing procedure counts by the total U.S. population. Results. From 1991 to 1995, the annual rate of antireflux surgery among active users of VA hospitals increased by 64%, then decreased over the next 4 years to almost baseline rates. In contrast, rates of antireflux surgery in the private sector increased 185% from 1991 to 1995, then appeared to reach a plateau thereafter. Among patients undergoing antireflux surgery, those in the VA were less likely than those in the private sector to undergo laparoscopic surgery (29% vs. 65%, respectively, in 1997). Conclusions. With the development of laparoscopic surgery, rates of antireflux surgery in VA hospitals increased only modestly compared with the private sector and have decreased in recent years. Both patient and

  9. 48 CFR 819.7109 - VA review of application.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false VA review of application... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS VA Mentor-Protégé Program 819.7109 VA review of application. (a... that the information that is in VAAR 819.7108 is included. If the application relates to a...

  10. 38 CFR 18a.1 - Delegations of responsibility between the Secretary of Veterans Affairs and the Secretary...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Delegations of responsibility between the Secretary of Veterans Affairs and the Secretary, Department of Health and Human Services, and the Secretary, Department of Education. 18a.1 Section 18a.1 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  11. Conceptualizing and Categorizing Race and Ethnicity in Health Services Research

    PubMed Central

    Ford, Marvella E; Kelly, P Adam

    2005-01-01

    Objectives Veterans Affairs (VA) patient populations are becoming increasingly diverse in race and ethnicity. The purpose of this paper is to (1) document the importance of using consistent standards of conceptualizing and categorizing race and ethnicity in health services research, (2) provide an overview of different methods currently used to assess race and ethnicity in health services research, and (3) suggest assessment methods that could be incorporated into health services research to ensure accurate assessment of disease prevalence and incidence, as well as accounts of appropriate health services use, in patients with different racial and ethnic backgrounds. Design A critical review of published literature was used. Principal Findings Race is a complex, multidimensional construct. For some individuals, institutionalized racism and internalized racism are intertwined in the effects of race on health outcomes and health services use. Ethnicity is most commonly used as a social–political construct and includes shared origin, shared language, and shared cultural traditions. Acculturation appears to affect the strength of the relationships among ethnicity, health outcomes, and health services use. Conclusions Improved and consistent methods of data collection need to be developed for use by VA researchers across the country. VA research sites with patients representing specific population groups could use a core set of demographic items in addition to expanded modules designed to assess the ethnic diversity within these population groups. Improved and consistent methods of data collection could result in the collection of higher-quality data, which could lead to the identification of race- and ethnic-specific health services needs. These investigations could in turn lead to the development of interventions designed to reduce or eliminate these disparities. PMID:16179001

  12. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  13. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  14. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  15. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  16. 30 CFR 57.22101 - Smoking (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Smoking (I-A, II-A, III, and V-A mines). 57.22101 Section 57.22101 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Smoking (I-A, II-A, III, and V-A mines). Persons shall not smoke or carry smoking materials, matches,...

  17. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... agency may apply to the Under Secretary for Health for approval. If the VA decides to participate in the... Health, Regional Director, medical facility Director, or their designees, have access to confidential...

  18. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... agency may apply to the Under Secretary for Health for approval. If the VA decides to participate in the... Health, Regional Director, medical facility Director, or their designees, have access to confidential...

  19. 38 CFR 17.509 - Authorized disclosure: Non-Department of Veterans Affairs requests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the facility in possession of the records or documents for response. The procedures outlined in 38 CFR... agency may apply to the Under Secretary for Health for approval. If the VA decides to participate in the... Health, Regional Director, medical facility Director, or their designees, have access to confidential...

  20. 30 CFR 57.22314 - Flow-control devices (V-A and V-B mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Flow-control devices (V-A and V-B mines). 57.22314 Section 57.22314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND...

  1. 30 CFR 57.22314 - Flow-control devices (V-A and V-B mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Flow-control devices (V-A and V-B mines). 57.22314 Section 57.22314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND...

  2. Schedule for rating disabilities--mental disorders and definition of psychosis for certain VA purposes. Interim final rule.

    PubMed

    2014-08-01

    The Department of Veterans Affairs (VA) is amending the portion of its Schedule for Rating Disabilities (VASRD) dealing with mental disorders and its adjudication regulations that define the term ``psychosis.'' The VASRD refers to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and VA's adjudication regulations refer to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR). DSM-IV and DSM-IV-TR were recently updated by issuance of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). This rulemaking will remove outdated DSM references by deleting references to DSM-IV and DSM-IV-TR and replacing them with references to DSM-5. Additionally, this rulemaking will update the nomenclature used to refer to certain mental disorders to conform to DSM-5.

  3. Serratia marcescens in human affairs.

    PubMed

    Greenberg, L

    1978-11-01

    Serratia marcescens, a ubiquitous, essentially saprophytic bacterium with a predilection for starches, has played a significant role in human affairs. Its notoriety has been occasioned by a blood-red pigment liberated by the organism during its metabolic activities that has been mistaken for fresh blood. In early Greek and Roman history, such "bloody" episodes were viewed as manifestations of divine destiny; by the Middle Ages in Europe they coincided with the development of church doctrine regarding the holy sacraments and had a far more sinister effect. In numerous instances between 1300 and 1500 A.D. host wafers developed a "bloody" appearance and led to the mass slaughter of Jews, who were accused of destructive attempts against the Eucharist. In our time, Serratia marcescens has been shown to possess significant endotoxic activity and can no longer be regarded as a harmless nuisance. It has been implicated in a wide range of human infections, particularly hospital-associated infections, of varying degrees of severity and including fatal antibiotic-resistant septicemias.

  4. Polygraph. Council on Scientific Affairs.

    PubMed

    1986-09-01

    The American Medical Association (AMA) Council on Scientific Affairs has reviewed the data on the validity and accuracy of polygraphy testing as it is applied today. The use of the control question technique in criminal cases is time honored and has seen much scientific study. It is established that classification of guilty can be made with 75% to 97% accuracy, but the rate of false-positives is often sufficiently high to preclude use of this test as the sole arbiter of guilt or innocence. This does not preclude using the polygraph test in criminal investigations as evidence or as another source of information to guide the investigation with full appreciation of the limitations in its use. Application of the polygraph in personnel screening, although gaining in popularity, has not been adequately validated. The few limited studies that have been performed suggest no greater accuracy for the types of testing done for this purpose than for the control question polygraph testing used in criminal cases. The effect of polygraph testing to deter theft and fraud associated with employment has never been measured, nor has its impact on employee morale and productivity been determined. Much more serious research needs to be done before the polygraph should be generally accepted for this purpose.

  5. Intentional anticipatory mourning, caregiver and bereavement support program for terminally ill veterans, their families & caregivers in the VA Contract Home Hospice Program.

    PubMed

    Flanagan-Kaminsky, Donnamarie

    2013-01-01

    As a response to the increasing numbers of Veterans utilizing the Veterans Affairs (VA) Contract Home Hospice Program, and with growing awareness of the increased stress at end-of-life, the social work leadership of the Louis Stokes Cleveland VA Medical Center implemented a unique approach to support Veterans and their families. The role of a grief/bereavement counselor was added to enhance the VA Contract Home Hospice Program, to assess the needs of the Veterans and family caregivers, and to create a program in response to these findings. A three-prong module evolved encompassing: Anticipatory Mourning Support for both the Veteran and caregiver/ family; Caregiver Support; and Bereavement Support. The components of this module are described along with findings in each module.

  6. Intentional anticipatory mourning, caregiver and bereavement support program for terminally ill veterans, their families & caregivers in the VA Contract Home Hospice Program.

    PubMed

    Flanagan-Kaminsky, Donnamarie

    2013-01-01

    As a response to the increasing numbers of Veterans utilizing the Veterans Affairs (VA) Contract Home Hospice Program, and with growing awareness of the increased stress at end-of-life, the social work leadership of the Louis Stokes Cleveland VA Medical Center implemented a unique approach to support Veterans and their families. The role of a grief/bereavement counselor was added to enhance the VA Contract Home Hospice Program, to assess the needs of the Veterans and family caregivers, and to create a program in response to these findings. A three-prong module evolved encompassing: Anticipatory Mourning Support for both the Veteran and caregiver/ family; Caregiver Support; and Bereavement Support. The components of this module are described along with findings in each module. PMID:23977781

  7. 38 CFR 1.9 - Description, use, and display of VA seal and flag.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... stationery. (B) Official VA identification cards and security credentials. (C) Business cards for VA employees. (D) Official VA signs. (E) Official publications or graphics issued by and attributed to VA,...

  8. 38 CFR 1.9 - Description, use, and display of VA seal and flag.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... stationery. (B) Official VA identification cards and security credentials. (C) Business cards for VA employees. (D) Official VA signs. (E) Official publications or graphics issued by and attributed to VA,...

  9. How Do Healthcare Employees Rate the Ethics of Their Organization? An Analysis Based on VA IntegratedEthics@ Staff Survey Data.

    PubMed

    Cohen, Jennifer H; Foglia, Mary Beth; Kwong, Katherine; Pearlman, Robert; Fox, Ellen

    2015-01-01

    Healthcare organizations with an ethical culture experience higher levels of employee productivity, less staff turnover, better levels of patient safety, resource and cost savings, and higher levels of patient satisfaction. Employees' perceptions of the ethics of their organization are considered a good indicator of the ethics culture. How employees rate the ethics of their organization is not well understood. Previous research has identified a number of attributes that are salient to employees' perceptions in this area. However, little is known about how employees synthesize their perceptions of these attributes to rate the ethics of their organization. Without this knowledge, managers have little specific information to act on to improve practices that would in turn improve employees' perceptions of their organization's ethics. For this study, we used data from Department of Veterans Affairs' (VA) 2014 IntegratedEthics@ Staff Survey administered to Veterans Health Administration (VHA) staff. We used multivariate regression analyses to investigate how VHA employees weigh their perceptions of eight attributes of an ethical organization to inform an overall rating of the ethics of their organization. We found that employee perceptions of fairness, clarity of expectations, accountability, and leadership's prioritization of ethics had the strongest associations with the overall rating. In addition, employees disproportionately weighed their positive perceptions in determining their overall rating. Therefore, a strategy to improve employees' perceptions of these attributes could potentially have the greatest marginal return on investment with respect to improving employees' perceptions of the ethics of an organization.

  10. How Do Healthcare Employees Rate the Ethics of Their Organization? An Analysis Based on VA IntegratedEthics@ Staff Survey Data.

    PubMed

    Cohen, Jennifer H; Foglia, Mary Beth; Kwong, Katherine; Pearlman, Robert; Fox, Ellen

    2015-01-01

    Healthcare organizations with an ethical culture experience higher levels of employee productivity, less staff turnover, better levels of patient safety, resource and cost savings, and higher levels of patient satisfaction. Employees' perceptions of the ethics of their organization are considered a good indicator of the ethics culture. How employees rate the ethics of their organization is not well understood. Previous research has identified a number of attributes that are salient to employees' perceptions in this area. However, little is known about how employees synthesize their perceptions of these attributes to rate the ethics of their organization. Without this knowledge, managers have little specific information to act on to improve practices that would in turn improve employees' perceptions of their organization's ethics. For this study, we used data from Department of Veterans Affairs' (VA) 2014 IntegratedEthics@ Staff Survey administered to Veterans Health Administration (VHA) staff. We used multivariate regression analyses to investigate how VHA employees weigh their perceptions of eight attributes of an ethical organization to inform an overall rating of the ethics of their organization. We found that employee perceptions of fairness, clarity of expectations, accountability, and leadership's prioritization of ethics had the strongest associations with the overall rating. In addition, employees disproportionately weighed their positive perceptions in determining their overall rating. Therefore, a strategy to improve employees' perceptions of these attributes could potentially have the greatest marginal return on investment with respect to improving employees' perceptions of the ethics of an organization. PMID:26554261

  11. InterVA versus Spectrum: how comparable are they in estimating AIDS mortality patterns in Nairobi's informal settlements?

    PubMed Central

    Oti, Samuel Oji; Wamukoya, Marilyn; Mahy, Mary; Kyobutungi, Catherine

    2013-01-01

    Background The Spectrum computer package is used to generate national AIDS mortality estimates in settings where vital registration systems are lacking. Similarly, InterVA-4 (the latest version of the InterVA programme) is used to estimate cause-of-mortality data in countries where cause-specific mortality data are not available. Objective This study aims to compare trends in adult AIDS-related mortality estimated by Spectrum with trends from the InterVA-4 programme applied to data from a Health and Demographic Surveillance System (HDSS) in Nairobi, Kenya. Design A Spectrum model was generated for the city of Nairobi based on HIV prevalence data for Nairobi and national antiretroviral therapy coverage, underlying mortality, and migration assumptions. We then used data, generated through verbal autopsies, on 1,799 deaths that occurred in the HDSS area from 2003 to 2010 among adults aged 15–59. These data were then entered into InterVA-4 to estimate causes of death using probabilistic modelling. Estimates of AIDS-related mortality rates and all-cause mortality rates from Spectrum and InterVA-4 were compared and presented as annualised trends. Results Spectrum estimated that HIV prevalence in Nairobi was 7%, while the HDSS site measured 12% in 2010. Despite this difference, Spectrum estimated higher levels of AIDS-related mortality. Between 2003 and 2010, the proportion of AIDS-related mortality in Nairobi decreased from 63 to 40% according to Spectrum and from 25 to 16% according to InterVA. The net AIDS-related mortality in Spectrum was closer to the combined mortality rates when AIDS and tuberculosis (TB) deaths were included for InterVA-4. Conclusion Overall trends in AIDS-related deaths from both methods were similar, although the values were closer when TB deaths were included in InterVA. InterVA-4 might not accurately differentiate between TB and AIDS deaths. PMID:24160914

  12. Implementation outcomes of evidence-based quality improvement for depression in VA community based outpatient clinics

    PubMed Central

    2012-01-01

    Background Collaborative-care management is an evidence-based practice for improving depression outcomes in primary care. The Department of Veterans Affairs (VA) has mandated the implementation of collaborative-care management in its satellite clinics, known as Community Based Outpatient Clinics (CBOCs). However, the organizational characteristics of CBOCs present added challenges to implementation. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI) as a strategy to facilitate the adoption of collaborative-care management in CBOCs. Methods This nonrandomized, small-scale, multisite evaluation of EBQI was conducted at three VA Medical Centers and 11 of their affiliated CBOCs. The Plan phase of the EBQI process involved the localized tailoring of the collaborative-care management program to each CBOC. Researchers ensured that the adaptations were evidence based. Clinical and administrative staff were responsible for adapting the collaborative-care management program for local needs, priorities, preferences and resources. Plan-Do-Study-Act cycles were used to refine the program over time. The evaluation was based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework and used data from multiple sources: administrative records, web-based decision-support systems, surveys, and key-informant interviews. Results Adoption: 69.0% (58/84) of primary care providers referred patients to the program. Reach: 9.0% (298/3,296) of primary care patients diagnosed with depression who were not already receiving specialty care were enrolled in the program. Fidelity: During baseline care manager encounters, education/activation was provided to 100% (298/298) of patients, barriers were assessed and addressed for 100% (298/298) of patients, and depression severity was monitored for 100% (298/298) of patients. Less than half (42.5%, 681/1603) of follow-up encounters during the acute stage were completed

  13. A multicenter two by two factorial trial of cognitive behavioral therapy and aerobic exercise for Gulf War veterans' illnesses: design of a veterans affairs cooperative study (CSP #470).

    PubMed

    Guarino, P; Peduzzi, P; Donta, S T; Engel, C C; Clauw, D J; Williams, D A; Skinner, J S; Barkhuizen, A; Kazis, L E; Feussner, J R

    2001-06-01

    The Department of Veterans Affairs (VA) Cooperative Studies Program (CSP) Study #470 is a 2 x 2 factorial trial designed to evaluate the hypothesis that both cognitive behavioral therapy (CBT) and aerobic exercise will significantly improve physical function in participants with Gulf War veterans' illnesses (GWVI), and that adding CBT to aerobic exercise will provide further incremental benefit. One thousand three hundred fifty-six veterans will be randomized to one of four treatment arms: CBT plus aerobic exercise plus usual and customary care, aerobic exercise plus usual and customary care, CBT plus usual and customary care, or usual and customary care alone. The study duration is 2.5 years with 1.5 years of intake and 1 year of follow-up. The primary outcome measure is the proportion of veterans improved more than seven units on the physical component summary (PCS) scale of the Short Form Health Survey for Veterans (SF-36V) measured 12 months after randomization. This generic quality-of-life measure was chosen because there is no disease-specific measure for GWVI and the symptoms of GWVI span a wide range of physical manifestations that are related to the domains covered by the PCS scale. Sample size was determined to detect all six pairwise comparisons between the four treatment arms with 90% power and a Bonferroni adjustment for an overall type I error of 0.05 or 0.05/6 = 0.0083. CSP #470 was initiated in May 1999 in 18 VA and two Department of Defense medical centers. To date this represents the largest randomized trial designed to evaluate treatments for individuals with unexplained physical symptoms. This paper will focus on the rationale and unique features of the study design. Control Clin Trials 2001;22:310-332

  14. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  15. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  16. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  17. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  18. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used...

  19. Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center.

    PubMed

    Tsan, Grace L; Hoban, Keely L; Jun, Weon; Riedel, Kevin J; Pedersen, Amy L; Hayes, John

    2015-01-01

    We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy.

  20. The past, present, and future of comparative effectiveness research in the US Department of Veterans Affairs.

    PubMed

    Kupersmith, Joel; Ommaya, Alexander K

    2010-12-01

    A particular challenge for the healthcare provider and the patient is to choose among competing therapeutic approaches for a particular condition. Often, the relative benefits and risks of potential therapies are not uniformly available from the existing scientific information. Many have pointed to the need for more comparative effectiveness research (CER) to aide in these decisions. The US Department of Veterans Affairs (VA) has a long history of conducting CER. The success of the VA CER program has been facilitated by several important aspects of scientific infrastructure related to (1) research question refinement, (2) study design, planning and coordination, (3) evidence synthesis, and (4) implementation research. In publications that had VA coauthors in 2 major medical journals, 25% of the published studies were classified as CER. The most frequent categories of study were pharmaceutical and behavioral interventions. In the future, the CER enterprise will move toward increased input from clinicians in research topic choice and enhanced consideration of other methodologies besides the randomized controlled trial.

  1. Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

    ERIC Educational Resources Information Center

    Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea

    2012-01-01

    The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…

  2. Frequency of HIV Screening in the Veterans Health Administration: Implications for Early Diagnosis of HIV Infection

    ERIC Educational Resources Information Center

    Valdiserri, Ronald O.; Rodriguez, Fred; Holodniy, Mark

    2008-01-01

    We evaluated the frequency of HIV testing across the Department of Veterans Affairs (VA), the largest provider of HIV care in the United States. An electronic survey was used to determine the volume and location of HIV screening, confirmatory testing, rapid testing and laboratory consent policies in VA medical centers between October 1, 2005, and…

  3. The reality of virtual learning for nurses in the largest integrated health care system in the nation.

    PubMed

    Rick, Cathy; Kearns, Martha A; Thompson, Nancy A

    2003-01-01

    The health care network and hospital system within the Department of Veterans Affairs (VA), the Veterans Health Administration (VHA), provides employment to more than 56,000 nursing personnel and serves as clinical education site to countless other nursing and health professional students. Nurse administrators and educators are posed with the challenge of providing an environment in which each nurse is able to gain needed knowledge, learn new skills, and share and communicate this knowledge with other colleagues. The education of nurses improves the health status of veterans while also realizing individual professional enhancement. Regional and cultural diversity of the system present challenges to education, in both delivery and content. VHA's learning organizations, the Employee Education System and the Office of Special Projects, have maximized new technologies and information systems to provide innovative, virtual education opportunities, capitalizing on the benefits of informal and formal learning, thus moving VHA to the forefront in knowledge sharing and dissemination. The Virtual Learning Center, VA Knowledge Network, Learning Catalog, and VA Learning Online provide VHA's nurses with interactive, desktop virtual learning opportunities.

  4. Student Affairs as Formal Educators: When Rhetoric Meets Reality

    ERIC Educational Resources Information Center

    Virkus, Annie J.

    2013-01-01

    The Student Affairs literature contains numerous approaches and strategies for bridging the gap between Student and Academic Affairs on college campuses. The use of student affairs professionals as instructors of credit-bearing courses is one example of such collaborative efforts. The student affairs literature identifies student affairs…

  5. Enhancing Student Learning with Academic and Student Affairs Collaboration

    ERIC Educational Resources Information Center

    Frost, Robert A.; Strom, Stephen L.; Downey, JoAnna; Schultz, Deanna D.; Holland, Teresa A.

    2010-01-01

    As the student affairs profession developed, expanded, and specialized over the last century, a disconnect occurred between student affairs professionals and academics. Despite that separation, the literature on student affairs in higher education supports the need for movement towards collaboration and integration of academic affairs and student…

  6. Student Affairs and Service Learning: Promoting Student Engagement

    ERIC Educational Resources Information Center

    Caruso, Robert; Bowen, Glenn; Adams-Dunford, Jane

    2006-01-01

    Why should service learning be placed within student affairs? What special skills can student affairs professionals bring to service-learning program implementation? How can administrators use this program to promote strong student affairs-academic affairs collaboration? This article discusses a "best practices" model that is working well at a…

  7. 38 CFR 17.251 - The Subcommittee on Academic Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Academic Affairs. 17.251 Section 17.251 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.251 The Subcommittee on Academic Affairs. There is... Subcommittee on Academic Affairs, and the Subcommittee shall advise the Secretary, through the Under...

  8. 38 CFR 17.251 - The Subcommittee on Academic Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Academic Affairs. 17.251 Section 17.251 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.251 The Subcommittee on Academic Affairs. There is... Subcommittee on Academic Affairs, and the Subcommittee shall advise the Secretary, through the Under...

  9. Effectiveness of a social robot, "Paro," in a VA long-term care setting.

    PubMed

    Lane, Geoffrey W; Noronha, Delilah; Rivera, Alexandra; Craig, Kathy; Yee, Christina; Mills, Brent; Villanueva, Eimee

    2016-08-01

    Interest in animal assisted interventions (AAI) has grown over the years, but acceptance of AAI by the clinical and research community has been hampered by safety, hygiene, and logistical concerns. Advances in the field of social robotics have provided a promising route to deliver AAI while avoiding these aforementioned obstacles. Although there has been promising initial research on social robotics in older adults, to date there has been no such research conducted with a veteran population. The present pilot study followed 23 veteran residents of a Veterans Affairs (VA) geropsychiatric long-term care facility over the span of approximately a year and a half. It was found that use of Paro, a social robot, resulted in increased observed positive affective and behavioral indicators, with concomitant decreases observed in negative affective and behavioral indicators. The authors concluded that Paro is likely an effective nonpharmacological approach for managing dementia-related mood and behavior problems with veterans in VA long term care facilities. They additionally observed that Paro is best presented to residents who are relatively calm and approachable, as opposed to actively exhibiting behavior or mood problems. Future research directions are discussed in light of both the positive results noted and the inherent limitations of our pilot study. (PsycINFO Database Record PMID:27195530

  10. Effectiveness of a social robot, "Paro," in a VA long-term care setting.

    PubMed

    Lane, Geoffrey W; Noronha, Delilah; Rivera, Alexandra; Craig, Kathy; Yee, Christina; Mills, Brent; Villanueva, Eimee

    2016-08-01

    Interest in animal assisted interventions (AAI) has grown over the years, but acceptance of AAI by the clinical and research community has been hampered by safety, hygiene, and logistical concerns. Advances in the field of social robotics have provided a promising route to deliver AAI while avoiding these aforementioned obstacles. Although there has been promising initial research on social robotics in older adults, to date there has been no such research conducted with a veteran population. The present pilot study followed 23 veteran residents of a Veterans Affairs (VA) geropsychiatric long-term care facility over the span of approximately a year and a half. It was found that use of Paro, a social robot, resulted in increased observed positive affective and behavioral indicators, with concomitant decreases observed in negative affective and behavioral indicators. The authors concluded that Paro is likely an effective nonpharmacological approach for managing dementia-related mood and behavior problems with veterans in VA long term care facilities. They additionally observed that Paro is best presented to residents who are relatively calm and approachable, as opposed to actively exhibiting behavior or mood problems. Future research directions are discussed in light of both the positive results noted and the inherent limitations of our pilot study. (PsycINFO Database Record

  11. Nurse Workforce Characteristics and Infection Risk in VA Community Living Centers: A Longitudinal Analysis

    PubMed Central

    Uchida-Nakakoji, Mayuko; Stone, Patricia W.; Schmitt, Susan K.; Phibbs, Ciaran S.

    2015-01-01

    Objective To examine effects of workforce characteristics on resident infections in Veterans Affairs (VA) Community Living Centers (CLCs). Data Sources A six-year panel of monthly, unit-specific data included workforce characteristics (from the VA Decision Support System and Payroll data) and characteristics of residents and outcome measures (from the Minimum Data Set). Study Design A resident infection composite was the dependent variable. Workforce characteristics of registered nurses (RN), licensed practical nurses (LPN), nurse aides (NA), and contract nurses included: staffing levels, skill mix and tenure. Descriptive statistics and unit-level fixed effects regressions were conducted. Robustness checks varying workforce and outcome parameters were examined. Principal Findings Average nursing hours per resident day was 4.59 hours (sd = 1.21). RN tenure averaged 4.7 years (sd = 1.64) and 4.2 years for both LPN (sd= 1.84) and NA (sd= 1.72). In multivariate analyses RN and LPN tenure were associated with decreased infections by 3.8% (IRR= 0.962 p<0.01) and 2% (IRR=0.98 p<0.01) respectively. Robustness checks consistently found RN and LPN tenure to be associated with decreased infections. Conclusions Increasing RN and LPN tenure are likely to reduce CLC resident infections. Administrators and policymakers need to focus on recruiting and retaining a skilled nursing workforce. PMID:25634087

  12. The process of implementing a rural VA wound care program for diabetic foot ulcer patients.

    PubMed

    Reiber, Gayle E; Raugi, Gregory J; Rowberg, Donald

    2007-10-01

    Delivering and documenting evidence-based treatment to all Department of Veterans Affairs (VA) foot ulcer patients has wide appeal. However, primary and secondary care medical centers where 52% of these patients receive care are at a disadvantage given the frequent absence of trained specialists to manage diabetic foot ulcers. A retrospective review of diabetic foot ulcer patient records and a provider survey were conducted to document the foot ulcer problem and to assess practitioner needs. Results showed of the 125 persons with foot ulcers identified through administrative data, only, 21% of diabetic foot patients were correctly coded. Chronic Care and Microsystem models were used to prepare a tailored intervention in a VA primary care medical center. The site Principal Investigators, a multidisciplinary site wound care team, and study investigators jointly implemented a diabetic foot ulcer program. Intervention components include wound care team education and training, standardized good wound care practices based on strong scientific evidence, and a wound care template embedded in the electronic medical record to facilitate data collection, clinical decision making, patient ordering, and coding. A strategy for delivering offloading pressure devices, regular case management support, and 24/7 emergency assistance also was developed. It took 9 months to implement the model. Patients were enrolled and followed for 1 year. Process and outcome evaluations are on-going.

  13. [Social change and Pharmaceutical Affairs Law (PAL)].

    PubMed

    Masuyama, Koichi; Isobe, Soichiro

    2010-01-01

    Former Japanese pharmaceutical laws, originally based on the Pharmaceutical Marketing and Handling Regulations enacted in 1874 were in operation for many years before World War II. However, in order to address several drug issues, such as poor drug quality and insufficiences regarding the role of pharmacists during the War, the laws needed to be unified and revised. In this paper, we analyzed the record of discussions held by the Imperial Diet on the bill for the Pharmaceutical Affairs Law (PAL) in 1943. This is also regarded as the origin of the current PAL (LawNo.145 in 1960). Through this analysis, we tried to clarify the relationship between the social change and the role of PAL in society. During the War, the bill was discussed, aiming at the improvement of both human resources who treated drugs, and the quality of drug materials. Diet members discussed three main points, namely, "the duty of pharmacists", "the mission of the Japan Pharmaceutical Association" and "the quality control of pharmaceutical products". Notably, the bill pharmacists are required not only to dispense drugs, a role they had previously, but also to manage drug and food hygiene through the quality control of pharmaceutical products and the inspection of food and drink, in order to improve the public health in Japan. Originally, the law was passed to deal with the extraordinary circumstances during the War, but through our analysis, we found that they proactively improved the role of the law to comply with various drug issues raised during the War, the rapid change of the pharmaceutical hygiene concept and the social transformation. PMID:21032892

  14. Student Affairs and Academic Affairs Collaborations in the Community College Setting

    ERIC Educational Resources Information Center

    Gulley, Needham Yancey; Mullendore, Richard H.

    2014-01-01

    The relationship between academic affairs and student affairs units in higher education settings has traditionally and historically been troubled by the divergent understandings of each other's institutional role and the systematic division of labor between the two. However, for a variety of reasons, not the least of which is a desire to…

  15. Preparing for Fiscal Leadership in Student Affairs: The Senior Student Affairs Officer Voice

    ERIC Educational Resources Information Center

    Stewart, Stephanie C.; Williams, Terry E.

    2010-01-01

    Success within today's challenging economic environment mandates that senior student affairs officers in higher education possess a sophisticated financial and budgetary skill set. Limited research addresses avenues through which professionals might best acquire the financial acumen needed. To address this gap, 19 senior student affairs officers…

  16. 78 FR 24469 - Proposed Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... AFFAIRS Proposed Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA), Department of Veterans Affairs (VA), is announcing...

  17. 75 FR 9490 - Proposed Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-02

    ... AFFAIRS Proposed Information Collection (Ethics Consultation Feedback Tool (ECFT)) Activity: Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA), Department of Veterans Affairs (VA), is announcing...

  18. Stable extramarital affairs are breaking the heart.

    PubMed

    Fisher, A D; Bandini, E; Corona, G; Monami, M; Cameron Smith, M; Melani, C; Balzi, D; Forti, G; Mannucci, E; Maggi, M

    2012-02-01

    The relationship between extramarital affairs and cardiovascular risk is still not completely clarified. The aim of this study was to investigate whether extramarital affairs have a protective effect on cardiovascular risk or, conversely, a deleterious one. Among patients studied, 91.8% of the whole sample reported no or occasional extramarital affairs, while 8.2% declared a stable secondary relationship. During a median follow-up of 4 [0-8] years, 95 major adverse cardiovascular events (MACE), eight of which were fatal, were observed. Cox analysis, after adjustment for confounding factors, showed that presence of stable extramarital affair was associated with a higher incidence of MACE (HR = 2.13 [1.12; 4.07], p = 0.023). The introduction in the Cox model of patient perceived partner's hypoactive sexual desire (PPPHSD) attenuates the association (HR 1.86 [0.93; 3.70], p = 0.078). The sample was therefore divided according to PPPHSD. We observed that unadjusted incidence of MACE was significantly associated with presence of extramarital affairs only in men reporting a primal partner without PPPHSD. This association was also confirmed in a Cox regression model, after adjusting for confounders (HR = 2.87 [1.81; 6.98], p = 0.020). We can conclude that to be unfaithful represents an independent risk factor for MACE. Therefore, infidelity induces not only heart trouble in the betrayed partners, but seems to be also able to increase the betrayer's heart-related events.

  19. 76 FR 65133 - Sharing Information Between the Department of Veterans Affairs and the Department of Defense

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... Military Justice.'' This restriction is narrower than the statutory restriction, and it impedes VA's... their care and treatment. Our need to share this information is critical to the health and well-being of... initiative, a strategic initiative that will ensure timely access to key electronic information on...

  20. Automated quality measurement in Department of the Veterans Affairs discharge instructions for patients with congestive heart failure.

    PubMed

    Garvin, Jennifer H; Elkin, Peter L; Shen, Shuying; Brown, Steven; Trusko, Brett; Wang, Enlai; Hoke, Linda; Quiaoit, Ylenia; Lajoie, Joan; Weiner, Mark G; Graham, Pauline; Speroff, Theodore

    2013-01-01

    Quality measurement is an important issue for the United States Department of Veterans Affairs (VA). In this study, we piloted the use of an informatics tool, the Multithreaded Clinical Vocabulary Server (MCVS), which extracted automatically whether the VA Office of Quality and Performance measures of quality of care were met for the completion of discharge instructions for inpatients with congestive heart failure. We used a single document, the discharge instructions, from one section of the medical records for 152 patients and developed a reference standard using two independent reviewers to assess performance. When evaluated against the reference standard, MCVS achieved a sensitivity of 0.87, a specificity of 0.86, and a positive predictive value of 0.90. The automated process using the discharge instruction document worked effectively. The use of the MCVS tool for concept-based indexing resulted in mostly accurate data capture regarding quality measurement, but improvements are needed to further increase the accuracy of data extraction.

  1. Strategic plan for geriatrics and extended care in the veterans health administration: background, plan, and progress to date.

    PubMed

    Shay, Kenneth; Hyduke, Barbara; Burris, James F

    2013-04-01

    The leaders of Geriatrics and Extended Care (GEC) in the Veterans Health Administration (VHA) undertook a strategic planning process that led to approval in 2009 of a multidisciplinary, evidence-guided strategic plan. This article reviews the four goals contained in that plan and describes VHA's progress in addressing them. The goals included transforming the healthcare system to a veteran-centric approach, achieving universal access to a panel of services, ensuring that the Veterans Affair's (VA) healthcare workforce was adequately prepared to manage the needs of the growing elderly veteran population, and integrating continuous improvement into all care enhancements. There has been substantial progress in addressing all four goals. All VHA health care has undergone an extensive transformation to patient-centered care, has enriched the services it can offer caregivers of dependent veterans, and has instituted models to better integrate VA and non-VA cares and services. A range of successful models of geriatric care described in the professional literature has been adapted to VA environments to gauge suitability for broader implementation. An executive-level task force developed a three-pronged approach for enhancing the VA's geriatric workforce. The VHA's performance measurement approaches increasingly include incentives to enhance the quality of management of vulnerable elderly adults in primary care. The GEC strategic plan was intended to serve as a road map for keeping VHA aligned with an ambitious but important long-term vision for GEC services. Although no discrete set of resources was appropriated for fulfillment of the plan's recommendations, this initial report reflects substantial progress in addressing most of its goals.

  2. 78 FR 13897 - Bureau of International Labor Affairs; Office of Trade and Labor Affairs; Labor Affairs Council...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... Affairs Council of the United States-Korea Free Trade Agreement; Notice of Public Session Meeting AGENCY.... ADDRESSES: The LAC will meet at the U.S. Department of Labor, 200 Constitution Avenue NW., Washington, DC... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR......

  3. 76 FR 72047 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... of a Parking Structure, Professional Medical Office Structure, a Hotel and General Use Retail Space... building, a hotel, and general use retail space. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office...

  4. 76 FR 71439 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... services program that guides resident Veterans toward attaining long-term independence and self- sufficiency. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management...

  5. 76 FR 60965 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... priority placement for homeless Veterans and Veterans at risk of homelessness and their families; and...-sufficiency. FOR FURTHER INFORMATION CONTACT: Edward Bradley, Office of Asset Enterprise Management (044... toll-free number). SUPPLEMENTARY INFORMATION: Title 38 U.S.C. 8161 et seq. states that the...

  6. 76 FR 71441 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to construct, renovate, operate, and maintain permanent housing facilities; provide preference and...

  7. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... of a Skilled and Intermediate Nursing Home Care Facility in Mather, CA AGENCY: Department of Veterans... permanent long-term care facility (skilled nursing home and assisted living services); provide...

  8. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., maintain and operate the EUL development. As consideration for the lease, the lessee will be required to... homeless and at-risk Veterans and their families; and provide a supportive services program. FOR FURTHER... for applying the consideration under such a lease for the provision of medical care and services...

  9. 76 FR 67022 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... Northampton, Massachusetts. The selected lessee will finance, design, develop, construct, manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be required to...

  10. 76 FR 67021 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ..., Newington campus in Newington, Connecticut. The selected lessee will finance, design, develop, construct... required to construct, renovate, operate and maintain an assisted living facility; provide preference...

  11. 76 FR 67022 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... Pineville, Louisiana. The selected lessee will finance, design, develop, construct, renovate, manage... construct, renovate, operate, and maintain a transitional housing facility; provide preference and...

  12. 76 FR 71442 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... System in Minnesota. The selected lessee will finance, design, develop, construct, manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be required to...

  13. 76 FR 67023 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ...--Kerrville campus in Kerrville, Texas. The selected lessee will finance, design, develop, construct, manage... construct, renovate, operate and maintain a senior housing facility; provide preference and...

  14. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... in Brockton, Massachusetts. The selected lessee will finance, design, develop, construct, renovate... required to construct, renovate, operate, and maintain a permanent housing facility, provide preference...

  15. 76 FR 71440 - Enhanced-Use Lease (EUL) of Department of Veterans Affairs (VA) Real Property for the Development...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ..., Illinois. The selected lessee will finance, design, develop, construct, manage, maintain and operate the EUL development. As consideration for the lease, the lessee will be required to construct,...

  16. Review of VA/DOD Clinical Practice Guideline on management of acute stress and interventions to prevent posttraumatic stress disorder.

    PubMed

    Nash, William P; Watson, Patricia J

    2012-01-01

    This article summarizes the recommendations of the Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress that pertain to acute stress and the prevention of posttraumatic stress disorder, including screening and early interventions for acute stress states in various settings. Recommended interventions during the first 4 days after a potentially traumatic event include attending to safety and basic needs and providing access to physical, emotional, and social resources. Psychological first aid is recommended for management of acute stress, while psychological debriefing is discouraged. Further medical and psychiatric assessment and provision of brief, trauma-focused cognitive-behavioral therapy are warranted if clinically significant distress or functional impairment persists or worsens after 2 days or if the criteria for a diagnosis of acute stress disorder are met. Follow-up monitoring and rescreening are endorsed for at least 6 months for everyone who experiences significant acute posttraumatic stress. Four interventions that illustrate early intervention principles contained in the VA/DOD Clinical Practice Guideline are described.

  17. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  18. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  19. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  20. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  1. 38 CFR 1.203 - Information to be reported to VA Police.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reported to VA Police. 1.203 Section 1.203 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... be reported to VA Police. Information about actual or possible violations of criminal laws related to... occurs on VA premises, will be reported by VA management officials to the VA police component...

  2. 77 FR 67063 - VA Directive 0005 on Scientific Integrity

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... April 9, 2012 (77 FR 21158). FOR FURTHER INFORMATION CONTACT: Billy E. Jones, M.D., Senior Advisor to... http://www1.va.gov/vapubs/ . Directive 0005 establishes VA policies that: Foster a culture of... technological information from political or commercial influence; Prohibit suppression or alteration...

  3. FACILITIES FOR EDUCATION IN VA HOSPITALS. FINAL REPORT.

    ERIC Educational Resources Information Center

    GREEN, ALAN C.; AND OTHERS

    THIS STUDY WAS AUTHORIZED BY THE VA DEPARTMENT OF MEDICINE AND SURGERY FOR THE PURPOSE OF IDENTIFYING AND DETERMINING THE FACILITIES NEEDED TO PROPERLY HOUSE AND SUPPORT EDUCATION ACTIVITIES IN EXISTING AND FUTURE VA HOSPITALS AND TO PRODUCE ARCHITECTURAL GUIDANCE IN THE DESIGN OF THE FACILITIES. CURRENT PRACTICES AND SIGNIFICANT TRENDS IN MEDICAL…

  4. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA....

  5. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA....

  6. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA....

  7. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA....

  8. 33 CFR 80.510 - Chesapeake Bay Entrance, VA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Chesapeake Bay Entrance, VA. 80.510 Section 80.510 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.510 Chesapeake Bay Entrance, VA....

  9. Building Partnerships With Rural Arkansas Faith Communities to Promote Veterans’ Mental Health: Lessons Learned

    PubMed Central

    Sullivan, Greer; Hunt, Justin; Haynes, Tiffany F.; Bryant, Keneshia; Cheney, Ann M.; Pyne, Jeffrey M.; Reaves, Christina; Sullivan, Steve; Lewis, Caleb; Barnes, Bonita; Barnes, Michael; Hudson, Cliff; Jegley, Susan; Larkin, Bridgette; Russell, Shane; White, Penny; Gilmore, LaNissa; Claypoole, Sterling; Smith, Rev. Johnny; Richison, Ruth

    2014-01-01

    Background The Mental Health–Clergy Partnership Program established partnerships between institutional (Department of Veterans’ Affairs [VA] chaplains, mental health providers) and community (local clergy, parishioners) groups to develop programs to assist rural veterans with mental health needs. Objectives Describe the development, challenges, and lessons learned from the Mental Health–Clergy Partnership Program in three Arkansas towns between 2009 and 2012. Methods Researchers identified three rural Arkansas sites, established local advisory boards, and obtained quantitative ratings of the extent to which partnerships were participatory. Results Partnerships seemed to become more participatory over time. Each site developed distinctive programs with variation in fidelity to original program goals. Challenges included developing trust and maintaining racial diversity in local program leadership. Conclusions Academics can partner with local faith communities to create unique programs that benefit the mental health of returning veterans. Research is needed to determine the effectiveness of community based programs, especially relative to typical “top-down” outreach approaches. PMID:24859098

  10. Orienting Mid-Level Student Affairs Professionals

    ERIC Educational Resources Information Center

    Mather, Peter C.; Bryan, Stephen P.; Faulkner, William O.

    2009-01-01

    Mid-level managers comprise a large proportion of student affairs organizations. They are often the most overlooked when it comes to professional orientation and institutional introduction when entering new positions. Accordingly, information is presented from the professional literature that speaks to the characteristics and unique needs of this…

  11. Undergraduate Consumer Affairs Program Needs: Employers' Perspectives

    ERIC Educational Resources Information Center

    Morrison, Kathryn; Saboe-Wounded Head, Lorna; Cho, Soo Hyun

    2012-01-01

    Forty-six Consumer Affairs (CA) internship supervisors were surveyed to identify critical knowledge and skills demonstrated by interns and to examine the importance of knowledge and skills needed in the workplace from the supervisors' perspectives.The knowledge and skills measured were identified through program goals. Results revealed that CA…

  12. Education for America's Role in World Affairs.

    ERIC Educational Resources Information Center

    Fonte, John, Ed.; Ryerson, Andre, Ed.

    This collection of essays by leading policy analysts and educators investigate the often contradictory claims of global, peace, multicultural and citizenship education and examines what U.S. students should know about world affairs in the post-cold war era. The essays suggest methods of change based on a strong academic core of history,…

  13. Student Employee Development in Student Affairs

    ERIC Educational Resources Information Center

    Athas, Christina; Oaks, D'Arcy John; Kennedy-Phillips, Lance

    2013-01-01

    Employment within student affairs divisions offers environments in which students can apply the knowledge they have gained, as well as acquire new competencies, helping them to build solid foundations for their futures. Researchers used an online survey to assess the outcomes associated with part-time student employment within the student affairs…

  14. The Digital Age of Student Affairs

    ERIC Educational Resources Information Center

    Cabellon, Edmund T.; Junco, Reynol

    2015-01-01

    This chapter describes the student affairs profession in the digital age. The authors explore new challenges educators and professionals face as new areas are added and expanded, how social networks and digital technology tools continue to evolve, and what skills are needed to engage with students in person and online.

  15. Student Affairs and Services Stream: College Quarterly

    ERIC Educational Resources Information Center

    Buddel, Neil

    2015-01-01

    "College Quarterly" recently introduced a stream for academic and scholar-practitioner dialogue concerning student affairs and services. To contribute to the growth and enhancement of the field, scholars and scholar-practitioners are invited to contribute original pieces that advance scholarship and/or practice around facilitating…

  16. Office of Indian Affairs 1985 Annual Report.

    ERIC Educational Resources Information Center

    New Mexico State Commission on Indian Affairs, Santa Fe.

    The major goals of the New Mexico Office of Indian Affairs (OIA) in 1985 were to enhance Indian education concerns, aid tribes in economic development, and effectuate a smooth working relationship between state, local, and tribal governments in the spirit of and through the use of the Joint Powers Act. Advancement is reflected in all these areas.…

  17. Excellence in Community College Student Affairs

    ERIC Educational Resources Information Center

    Knight, Ashley

    2014-01-01

    Student success, accountability, and educational outcomes have been strongly emphasized in U.S. community colleges in recent years. For those individuals serving in community college student affairs, intentional commitment to standards and competencies in professional practice is essential in order to achieve institutional expectations and to meet…

  18. Foreign Affairs News and the Broadcast Journalist.

    ERIC Educational Resources Information Center

    Batscha, Robert M.

    Discussion of the role of the broadcast journalist in foreign affairs news is divided into four parts in this volume: (1) "The Correspondent" deals with the group characteristics of foreign correspondents and their role conceptions, (2) "Gathering the News" examines the correspondent;s view of the mechanical constraints and structural…

  19. TQM: Finding a Place in Student Affairs.

    ERIC Educational Resources Information Center

    Holmes, Tyrone A.

    1996-01-01

    Critically examines Total Quality Management (TQM). Analyzes the concepts and practices of TQM and its failure to live up to expectations in higher education. Emphasizes the problems inherent with TQM initiatives in an educational environment and outlines ways that student affairs officials can proactively apply TQM to support universities'…

  20. 76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... AFFAIRS Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA) is announcing an opportunity for public comment on...

  1. Health Insurance: Comparison of Coverage for Federal and Private Sector Employees. Briefing Report to the Chairman, Subcommittee on Civil Service, Post Office, and General Services, Committee on Governmental Affairs, U.S. Senate.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Div. of Human Resources.

    This briefing report was developed to provide a Senate subcommittee with information concerning certain benefit features of the Federal Employees Health Benefits Program (FEHBP). It compares coverage for selected health benefits in the federal and private sectors for a 6-year period (1980-1985). A description of methodology states that information…

  2. The Indian Health Promotion and Disease Prevention Act of 1985. Hearing before the Select Committee on Indian Affairs. United States Senate, Ninety-Ninth Congress, First Session on S. 400. (Gallup, NM, June 1, 1985).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Select Committee on Indian Affairs.

    The document contains transcripts of a Congressional hearing on providing health promotion and disease prevention services to American Indians. The bill under consideration would add the following programs to the Indian Health Care Improvement Act (25, U.S.C. 1603): reduction of drug, alcohol, and tobacco use; improvement of nutrition and physical…

  3. Female genital mutilation. Council on Scientific Affairs, American Medical Association.

    PubMed

    1995-12-01

    Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia. PMID:7474278

  4. 30 CFR 57.22314 - Flow-control devices (V-A and V-B mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Flow-control devices (V-A and V-B mines). 57.22314 Section 57.22314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Safety Standards for Methane in Metal...

  5. The Establishment of Minority Affairs Offices in Schools of Dentistry: Pros and Cons.

    ERIC Educational Resources Information Center

    Ballard, Billy R.

    2003-01-01

    Discusses the establishment of Minority Affairs Offices in dental schools, which follow the American Association of Medical Colleges' model as one method of addressing the declining enrollment and compounding oral health disparities of underrepresented minorities--African Americans, Hispanics, and Native Americans. (EV)

  6. The Violence Against Women Act on Trial: A Student Affairs Professional's Guide to the Issues.

    ERIC Educational Resources Information Center

    Goree, Cathryn T.; Holford, Elyzabeth J.

    1997-01-01

    Reviews legal issues surrounding the constitutionality of the Violence Against Women Act, which is currently being tested in federal courts. Provides background information for judicial officers, policymakers, health educators, women's advocates, and student affairs professionals who work regularly with women students. (Author/MKA)

  7. The Veterans Affairs National Quality Scholars program: a model for interprofessional education in quality and safety.

    PubMed

    Patrician, Patricia A; Dolansky, Mary A; Pair, Vincent; Bates, Mekeshia; Moore, Shirley M; Splaine, Mark; Gilman, Stuart C

    2013-01-01

    The Quality and Safety Education for Nurses (QSEN) project is enhancing the emphasis on quality care and patient safety content in nursing schools. A partnership between QSEN and the Veterans Affairs National Quality Scholars program resulted in a unique experiential, interdisciplinary fellowship for both nurses and physicians. This article introduces the Veterans Affairs National Quality Scholars program and provides examples of learning activities and fellows' accomplishments. Interprofessional quality and safety education at the doctoral and postdoctoral levels is germane to improving the quality of health care.

  8. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Main fan operation and inspection (I-A, II-A, III, and V-A mines). 57.22204 Section 57.22204 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... Main fan operation and inspection (I-A, II-A, III, and V-A mines). Main fans shall be— (a)...

  9. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Main fan operation and inspection (I-A, II-A, III, and V-A mines). 57.22204 Section 57.22204 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... Main fan operation and inspection (I-A, II-A, III, and V-A mines). Main fans shall be— (a)...

  10. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Main fan operation and inspection (I-A, II-A, III, and V-A mines). 57.22204 Section 57.22204 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... Main fan operation and inspection (I-A, II-A, III, and V-A mines). Main fans shall be— (a)...

  11. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Main fan operation and inspection (I-A, II-A, III, and V-A mines). 57.22204 Section 57.22204 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... Main fan operation and inspection (I-A, II-A, III, and V-A mines). Main fans shall be— (a)...

  12. 30 CFR 57.22204 - Main fan operation and inspection (I-A, II-A, III, and V-A mines).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Main fan operation and inspection (I-A, II-A, III, and V-A mines). 57.22204 Section 57.22204 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION... Main fan operation and inspection (I-A, II-A, III, and V-A mines). Main fans shall be— (a)...

  13. Student Affairs as Perceived Through Abraham Maslow's Hierarchy of Needs.

    ERIC Educational Resources Information Center

    Nowacki, Steven

    The needs of human behavior are explored and correlated to the various departments within Student Affairs in an effort to show how Student Affairs can satisfy those needs. Maslow's Hierarchy of needs is briefly explained and related to the following Student Affairs departments: Financial Aid, Student Management, Career Development and Placement,…

  14. Student Affairs Practice in Higher Education. Second Edition.

    ERIC Educational Resources Information Center

    Rentz, Audrey L.; And Others

    This book describes significant issues and trends in the evolution of student affairs and reviews current methods and models of practice. The chapters are: (1) "The Philosophical Heritage of Student Affairs," by Stan Carpenter, reviewing the relationship between educational philosophy and student services; (2) "A History of Student Affairs," by…

  15. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 1 2014-01-01 2014-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  16. 16 CFR 0.20 - Office of International Affairs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 1 2013-01-01 2013-01-01 false Office of International Affairs. 0.20... ORGANIZATION § 0.20 Office of International Affairs. The Office of International Affairs (OIA) comprises international antitrust, international consumer protection, and international technical assistance. OIA...

  17. MMPI-2 Symptom Validity (FBS) Scale: psychometric characteristics and limitations in a Veterans Affairs neuropsychological setting.

    PubMed

    Gass, Carlton S; Odland, Anthony P

    2014-01-01

    The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Symptom Validity (Fake Bad Scale [FBS]) Scale is widely used to assist in determining noncredible symptom reporting, despite a paucity of detailed research regarding its itemmetric characteristics. Originally designed for use in civil litigation, the FBS is often used in a variety of clinical settings. The present study explored its fundamental psychometric characteristics in a sample of 303 patients who were consecutively referred for a comprehensive examination in a Veterans Affairs (VA) neuropsychology clinic. FBS internal consistency (reliability) was .77. Its underlying factor structure consisted of three unitary dimensions (Tiredness/Distractibility, Stomach/Head Discomfort, and Claimed Virtue of Self/Others) accounting for 28.5% of the total variance. The FBS's internal structure showed factoral discordance, as Claimed Virtue was negatively related to most of the FBS and to its somatic complaint components. Scores on this 12-item FBS component reflected a denial of socially undesirable attitudes and behaviors (Antisocial Practices Scale) that is commonly expressed by the 1,138 males in the MMPI-2 normative sample. These 12 items significantly reduced FBS reliability, introducing systematic error variance. In this VA neuropsychological referral setting, scores on the FBS have ambiguous meaning because of its structural discordance. PMID:24826489

  18. Evaluation of an Implementation Model: A National Investigation of VA Residential Programs

    PubMed Central

    Dinnen, Stephanie; Coyne, James C.; Thompson, Richard; Simiola, Vanessa; Ruzek, Josef; Schnurr, Paula P.

    2014-01-01

    This national investigation utilizes qualitative data to evaluate an implementation model regarding factors influencing provider use of two evidence-based treatments for posttraumatic stress disorder (PTSD). Semi-structured qualitative interviews with 198 mental health providers from 38 Department of Veterans Affairs’ (VA) residential treatment programs were used to explore these issues regarding prolonged exposure (PE) and cognitive processing therapy (CPT) in VA residential PTSD programs. Several unique and some overlapping predictors emerged. Leadership was viewed as an influence on implementation for both CPT and PE, while a lack of dedicated time and resources was viewed as a deterrent for both. Compatibility of CPT with providers’ existing practices and beliefs, the ability to observe noticeable patient improvement, a perceived relative advantage of CPT over alternative treatments, and the presence of a supportive peer network emerged as influential on CPT implementation. Leadership was associated with PE implementation. Implications for the design and improvement of training and implementation efforts are discussed. PMID:24817625

  19. Exploration Day at Busch Gardens, Williamsburg, Va. - Aug. 5, 2011

    NASA Video Gallery

    Friday, August 8, was NASA Days at Busch Gardens Williamsburg, Va. NASA exhibits and educational specialists worked to inspire young and old, and NASA astronaut Susan Kilrain -- a veteran of two Sp...

  20. 75 FR 35511 - Virginia Disaster Number VA-00028

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... From the Federal Register Online via the Government Publishing Office SMALL BUSINESS ADMINISTRATION Virginia Disaster Number VA-00028 AGENCY: Small Business Administration. ACTION: Amendment 3... Federal Domestic Assistance Numbers 59002 and 59008) Roger B. Garland, Acting Associate Administrator...

  1. Preparation and physicochemical characterization of a solid dispersion of (3, 5, 6-trimethylpyrazin-2-yl) methyl 3-methoxy-4-[(3, 5, 6-trimethylpyrazin-2-yl) methoxy] benzoate (VA-T) and polyvinylpyrrolidone.

    PubMed

    Cao, Sa-Li; Hou, Peng; Li, Bin; Fu, Jing; Yin, Xing-Bin; Dang, Xiao-Fang; Yang, Chun-Jing; Zhang, Jin; Zhang, Hui; Lei, Hai-Min; Ni, Jian

    2015-11-01

    Ischemic brain injury is a major disease which threatens human health and safety. (3, 5, 6-trimethylpyrazin-2-yl) methyl 3-methoxy-4-[(3, 5, 6-trimethylpyrazin-2-yl) methoxy] benzoate (VA-T), a newly discovered lead compound, is effective for the treatment of ischemic brain injury and its sequelae. But the poor solubility of VA-T leads to poor dissolution and limited clinical application. In order to improve the dissolution of VA-T, the pharmaceutical technology of solid dispersions was used in the present study. VA-T/polyvinylpyrrolidone (PVP) solid dispersion was prepared by the solvent method. The dissolution studies were carried out and solid state characterization was evaluated by differential scanning calorimetry (DSC), infrared spectroscopy (IR), x-ray diffraction (XRD) and scanning electron microscopy (SEM). The dissolution rate of VA-T was significantly improved by solid dispersion compared to that of the pure drug and physical mixture. The results of DSC and XRD indicated that the VA-T solid dispersion was amorphous. The IR spectra showed the possible interaction between VA-T and PVP was the formulation of hydrogen bonding. The SEM analysis demonstrated that there was no VA-T crystal observed in the solid dispersions. The ideal drug-to-PVP ratio was 1:5. In conclusion, the solid dispersion technique can be successfully used for the improvement of the dissolution profile of VA-T.

  2. A model for improving the quality and timeliness of compensation and pension examinations in VA facilities.

    PubMed

    Weeks, William Brinson; Mills, Peter Donald; Waldron, Julia; Brown, Steven Holloway; Speroff, Theodore; Coulson, Lewis R

    2003-01-01

    In response to external and internal customer dissatisfaction and in anticipation of markedly higher volumes of examination requests, the Department of Veterans Affairs (VA) produced an eight-month facilitated quality-improvement project designed to improve the quality and timeliness of compensation examination processing. To determine whether participation in the project was associated with better outcomes and to identify team characteristics that were associated with high performance, we obtained centrally collected facility-level performance measures on quality and timeliness of the examinations. To determine factors associated with team success, we compared measures of leadership support reported by teams with high and low performance outcomes. Thirty teams representing 34 VA medical centers and 22 Veterans Benefits Administration's regional offices participated in the project. Monthly volumes were significantly higher for participating teams, and volumes increased significantly over time for both groups. At the beginning of the project, examination timeliness was substantially worse for participating teams (34.1 versus 29.9 days, p = .03); by the end, participants had better performance (28.5 versus 30.3 days, p = .00). Quality measures were maintained. By the end of the project, high performers reported improved leadership, frontline support, resource availability, alignment with strategic goals, and leadership mandate when compared to performance at the beginning of the project; low performers reported the opposite. These results suggest that the principles of clinical improvement can be applied successfully to teach teams how to achieve process improvements within a large healthcare organization. Visible, ongoing support by leadership and alignment of project objectives with strategic goals are associated with improved project outcomes.

  3. Childhood cause-specific mortality in rural Western Kenya: application of the InterVA-4 model

    PubMed Central

    Amek, Nyaguara O.; Odhiambo, Frank O.; Khagayi, Sammy; Moige, Hellen; Orwa, Gordon; Hamel, Mary J.; Van Eijk, Annemieke; Vulule, John; Slutsker, Laurence; Laserson, Kayla F.

    2014-01-01

    Background Assessing the progress in achieving the United Nation's Millennium Development Goals in terms of population health requires consistent and reliable information on cause-specific mortality, which is often rare in resource-constrained countries. Health and demographic surveillance systems (HDSS) have largely used medical personnel to review and assign likely causes of death based on the information gathered from standardized verbal autopsy (VA) forms. However, this approach is expensive and time consuming, and it may lead to biased results based on the knowledge and experience of individual clinicians. We assessed the cause-specific mortality for children under 5 years old (under-5 deaths) in Siaya County, obtained from a computer-based probabilistic model (InterVA-4). Design Successfully completed VA interviews for under-5 deaths conducted between January 2003 and December 2010 in the Kenya Medical Research Institute/US Centers for Disease Control and Prevention HDSS were extracted from the VA database and processed using the InterVA-4 (version 4.02) model for interpretation. Cause-specific mortality fractions were then generated from the causes of death produced by the model. Results A total of 84.33% (6,621) childhood deaths had completed VA data during the study period. Children aged 1–4 years constituted 48.53% of all cases, and 42.50% were from infants. A single cause of death was assigned to 89.18% (5,940) of cases, 8.35% (556) of cases were assigned two causes, and 2.10% (140) were assigned ‘indeterminate’ as cause of death by the InterVA-4 model. Overall, malaria (28.20%) was the leading cause of death, followed by acute respiratory infection including pneumonia (25.10%), in under-5 children over the study period. But in the first 5 years of the study period, acute respiratory infection including pneumonia was the main cause of death, followed by malaria. Similar trends were also reported in infants (29 days–11 months) and children aged 1

  4. Public affairs events at Fall Meeting

    NASA Astrophysics Data System (ADS)

    Uhlenbrock, Kristan

    2012-02-01

    AGU's Public Affairs team presented two workshop luncheons and hosted 17 oral and poster sessions at the 2011 Fall Meeting. Topics ranged from defining the importance of the geosciences, to climate change science for communities and institutions. The workshop luncheon "How to Be a Congressional Science Fellow or Mass Media Fellow" was a well-attended event with more than 115 participants. The luncheon provided the opportunity for audience members to ask fellow scientists about their experiences working either in Congress or as a reporter for a news organization. For scientists looking to expand their expertise outside the academic environment, these AGU fellowships are fantastic opportunities.

  5. Insomnia treatment experience and preferences among veterans affairs primary care patients.

    PubMed

    Shepardson, Robyn L; Funderburk, Jennifer S; Pigeon, Wilfred R; Maisto, Stephen A

    2014-10-01

    Insomnia is common, but undertreated, among primary care patients. Within the Veterans Health Administration (VA), increasing attention has been given to the treatment of insomnia within primary care settings, but little research has examined Veterans' treatment preferences. We examined preferences for sleep treatment among VA primary care patients. Participants (N = 126: 98% male, 89% white; M age = 60 years) completed a brief survey. On the basis of Insomnia Severity Index scores, 22% reported subthreshold and 13% moderate insomnia. Fifty percent reported having issues with sleep (falling asleep, staying asleep, or sleeping too much) in the past 12 months; among these, only 44% reported any discussion of medication (34%) or other strategies (32%) to improve sleep with medical providers. The most preferred treatment approach was to work it out on one's own, followed by consulting the primary care provider (PCP). The most preferred modality was a one-on-one meeting with the PCP, followed by a one-on-one meeting with the behavioral health provider. In conclusion, VA primary care patients preferred handling sleep problems on their own, but if seeking help, they preferred working with PCPs over behavioral health providers. The majority of Veterans preferred individual treatment and strategies other than medication.

  6. VA Accountability First and Appeals Modernization Act of 2016

    THOMAS, 113th Congress

    Rep. Miller, Jeff [R-FL-1

    2016-07-05

    09/15/2016 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  7. 75 FR 3540 - Agency Information Collection (Health Eligibility Center (HEC) New Enrollee Survey) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-21

    ... collected on VA Form 10-0479 will be used to improve customer service processes for Veterans applying for health care benefits. VA will use this information to determine the quality of customer service given...

  8. Student Affairs Case Management: Merging Social Work Theory with Student Affairs Practice

    ERIC Educational Resources Information Center

    Adams, Sharrika D.; Hazelwood, Sherry; Hayden, Bruce

    2014-01-01

    Case management is a functional area in higher education and student affairs that emerged after the mass shootings at Virginia Tech in 2007. Although new to higher education, case management emerged from established social work practice. This article compares social work theory and case management standards with a new case management model for…

  9. Designing Student Affairs Organizational Structures: Perceptions of Senior Student Affairs Officers

    ERIC Educational Resources Information Center

    Kuk, Linda; Banning, James H.

    2009-01-01

    Student affairs organizations have become complex entities and serve as a critical link to student success and the quality of the overall educational experience in collegiate institutions. Over time, new programs and services have been added to the array of existing programs and services with little attention focused on how these organizations…

  10. Excellence within Student Affairs: Understanding the Practice of Integrating Academic and Student Affairs

    ERIC Educational Resources Information Center

    Ozaki, C. Casey; Hornak, Anne M.

    2014-01-01

    In this final chapter, the authors synthesize and draw from chapters across this volume to provide concluding remarks and recommendations. The authors suggest that core to the discussion of excellence of student affairs in community colleges are the concepts of integration and collaboration. As professionals tasked with supporting the student…

  11. "To care for him who shall have borne the battle and for his widow and his orphan" (Abraham Lincoln): the Department of Veterans Affairs polytrauma system of care.

    PubMed

    Sigford, Barbara J

    2008-01-01

    The initiation of combat in Iraq and Afghanistan has resulted in a new cohort of active-duty service members and veterans seeking rehabilitation care through the U.S. Department of Veterans Affairs (VA). Service members injured in combat most often sustain multiple injuries (polytrauma) and require a unique service delivery model to meet their needs. The VA recognized this need and responded with the development of the Polytrauma System of Care (PSC). This national system of care balances access and expertise to provide specialized life-long care to the combat injured. The PSC is comprised of: 4 specialized regional rehabilitation centers that are accredited in brain injury by the Commission on Accreditation of Rehabilitation Facilities; 21 specialized outpatient and subacute rehabilitation programs; designated polytrauma teams at smaller, more remote VA facilities; and a point of contact at all other VA facilities. In addition, the PSC has developed a proactive case-management model, a specialized telehealth network, guidelines for long-term follow-up, and services for those individuals who are unable to return home. The following commentary and articles provide additional detail on this new and unique system of care.

  12. 75 FR 61859 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... FFPS); A Computer Generated Funding Fee Receipt) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits...

  13. 78 FR 59771 - Proposed Information Collection (Create Payment Request for the VA Funding Fee Payment System (VA...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS... FFPS); a Computer Generated Funding Fee Receipt) Activity: Comment Request AGENCY: Veterans Benefits Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Benefits...

  14. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... assisting the Administrator and other officials on matters relating to agency legislative and media affairs...) Drafting and administering policy guidelines on press contacts, photography, audiovisual...

  15. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... assisting the Administrator and other officials on matters relating to agency legislative and media affairs...) Drafting and administering policy guidelines on press contacts, photography, audiovisual...

  16. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... assisting the Administrator and other officials on matters relating to agency legislative and media affairs...) Drafting and administering policy guidelines on press contacts, photography, audiovisual...

  17. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... assisting the Administrator and other officials on matters relating to agency legislative and media affairs...) Drafting and administering policy guidelines on press contacts, photography, audiovisual...

  18. 7 CFR 371.10 - Legislative and Public Affairs.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... assisting the Administrator and other officials on matters relating to agency legislative and media affairs...) Drafting and administering policy guidelines on press contacts, photography, audiovisual...

  19. Changes in implementation of two evidence-based psychotherapies for PTSD in VA residential treatment programs: a national investigation.

    PubMed

    Cook, Joan M; Dinnen, Stephanie; Thompson, Richard; Simiola, Vanessa; Schnurr, Paula P

    2014-04-01

    There has been little investigation of the natural course of evidence-based treatments (EBTs) over time following the draw-down of initial implementation efforts. Thus, we undertook qualitative interviews with the providers at 38 U.S. Department of Veterans Affairs' residential treatment programs for posttraumatic stress disorder (PTSD) to understand implementation and adaptation of 2 EBTs, prolonged exposure (PE), and cognitive processing therapy (CPT), at 2 time points over a 4-year period. The number of providers trained in the therapies and level of training improved over time. At baseline, of the 179 providers eligible per VA training requirements, 65 (36.4%) had received VA training in PE and 111 (62.0%) in CPT with 17 (9.5%) completing case consultation or becoming national trainers in both PE and CPT. By follow-up, of the increased number of 190 eligible providers, 87 (45.8%) had received VA training in PE and 135 (71.1%) in CPT, with 69 (36.3%) and 81 (42.6%) achieving certification, respectively. Twenty-two programs (57.9%) reported no change in PE use between baseline and follow-up, whereas 16 (42.1%) reported an increase. Twenty-four (63.2%) programs reported no change in their use of CPT between baseline and follow-up, 12 (31.6%) programs experienced an increase, and 2 (5.2%) programs experienced a decrease in use. A significant number of providers indicated that they made modifications to the manuals (e.g., tailoring, lengthening). Reasons for adaptations are discussed. The need to dedicate time and resources toward the implementation of EBTs is noted.

  20. Mental health utilization of new-to-care Iraq and Afghanistan Veterans following suicidal ideation assessment.

    PubMed

    Denneson, Lauren M; Corson, Kathryn; Helmer, Drew A; Bair, Matthew J; Dobscha, Steven K

    2014-07-30

    We evaluated the impact of brief structured suicidal ideation (SI) assessments on mental health care among new-to-care Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) veterans. National datasets provided military, demographic, and clinical information. For all new-to-care OEF/OIF veterans administered depression screens (PHQ-2: Patient Health Questionnaire-2) and structured SI assessments in primary care or ambulatory mental health settings of three Veterans Affairs (VA) Medical Centers between April 2008 and September 2009 (N=465), generalized estimating equations were used to examine associations between SI and number of subsequent-year specialty mental health visits and antidepressant prescriptions. Approximately one-third of the veterans reported SI. In multivariate models, PTSD and anxiety diagnoses, severe depression symptoms, being married, and SI assessment by a mental health clinician were associated with more mental health visits in the subsequent year. Depression, PTSD, and anxiety diagnoses, and SI assessment by a mental health clinician were associated with receiving antidepressants. Presence of SI did not significantly affect subsequent year mental health utilization when adjusting for diagnostic and clinician variables, but inaugural visits involving mental health clinicians were consistently associated with subsequent mental health care. PMID:24726814