Department of Veterans Affairs Claims Processing Dilemmas
Department of Veterans Affairs (VA) is a cabinet-level agency in the U.S. government. The mission of the VA is taken from Lincoln's second inaugural address and is to "care for him who shall have borne the battle, his widow and orphans." Pursuant to this fundamental mission, the VA administers the largest healthcare system in the country and has trained more than half of all of the physicians practicing in the U.S. today.
Agency Functions.
Today, the VA is the second-largest agency in the federal government and employs more than 220,000 people in three primary functions as follows:
The Veterans Benefits Administration (VBA); this division employs about 13,000 people in 57 regional benefit offices, and provides financial assistance to veterans through disability compensation and pension, education, and home loans;
B.
The Veterans Health Administration (VHA): this division employs around 200,000 people in 163 tertiary healthcare facilities (medical centers) and more…...
mlaReferences
Dyhouse, T. (2007, May). Overwhelmed VA claims system is strained to its limit. VFW
Magazine, 94(9), 10.
Hanson, S. (2006, March). Quality no longer 'job one' for VA claims processing. VFW Magazine,
93(6), 10.
HM and the Department of Veterans Affairs
Human esource Change Management Plan Approach Paper for Department of Veterans Affairs Objective E.1 from the FY 2003-2008 Strategic Plan
Like every other organization in the world today, employees are the foundation of the Department of Veterans Affairs and the key to its success. In spite of the enormous contribution made by VA to the country in caring for its veterans and their families, the department has experienced some negative publicity as a result of various failures in patient care and administration that have adversely affected employee morale across the board (Veterans' Hospital under Investigation, 2003). Therefore, the purpose of this initiative is to ensure that VA has the workforce it needs to serve veterans and their families, today and in the future. The 21st century presents VA with an unprecedented set of human capital challenges -- an aging workforce, a shifting and expanding mission,…...
mlaReferences
Batt, R., Colvin, A.J.S. & Keefe, J. (July 2002). Emplyee voice, human resource practices, and quit rates: Evidence from the telecommunications industry. Industrial & Labor
Relations Review, 55(4), 573. Retrieved January 25, 2005 from EBSCOhost.
Dubois, D. & Rothwell, W. (April 2004). Competency-Based or a Traditional Approach to Training? T+D, 58(4), 46-58. Retrieved January 26, 2005 from EBSCOhost.
Find War Heroes Online. (July/August 2004). Information Management Journal, 38(4), 7.
Organizational Development Contracting Process at the Department of Veterans Affairs
Organizational development (OD) consultation is a complex enterprise, and the contracting process that is used to define and manage the work can also be a challenge in both the public and private sectors (Vogelsang & Townsend, 2013). When it comes to addressing the problems that are being experienced by an organizational behemoth such as the U.S. Department of Veterans Affairs (VA), though, the challenges can be immense and seemingly insurmountable. Fortunately, there are some proven steps available to OD consultants that can help them work through the miasma of bureaucratic complexity to hone in on the real problems that are adversely affecting their clients. To this end, this paper provides a review of the related literature concerning the OD contracting process as applied to the recent problems being experienced by the VA with respect to patient scheduling and the provision…...
mlaReferences
Dyhouse, T. (2014, August). VA in crisis. VFW Magazine, 101(10), 16-17.
Hawkins, P. & Smith, N. (2006). Coaching, mentoring and organizational consultancy: Supervision and development. Maidenhead, England: Open University Press.
Massarik, F. & Pel-Carpenter, M. (2009). Organization development and consulting: Perspectives and foundations. San Francisco: Jossey-Bass/Pfeiffer.
Vogelsang, J. & Townsend, M. (2013). Handbook for strategic HR: Best practices in organizational development from the OD network. New York: American Management Association.
Ethical Dilemma in a Department of Veterans Affairs Tertiary Healthcare Facility
Selection of the environment.
Selected environment. The environment for the proposed study will be a Department of Veterans Affairs (VA) medical center (hereinafter alternatively "VAMC") that provides the full complement of tertiary healthcare services. The pseudonym for the selected facility will be "Lincolnville VAMC" (because the VA's motto is derived from Lincoln's second inaugural address).
Description of environment and rationale for selection. The Lincolnville VAMC provides tertiary healthcare services for veterans living in a 25-county area in a midwestern state. Besides its operations in the main facility, the Lincolnville VAMC also operates two community-based outpatient clinics. Some of the primary services offered by the Lincolnville VAMC include:
Behavioral Health Service: This service provides consultation, evaluation, and treatment for a variety of issues that can impact emotional well-being.
2) Pharmacy: This service processes more than 80,000 prescriptions each month.
3) Primary Care: This service offers…...
mlaReferences
Gomulka, G.T. (2010). Saving military families. Military Review, 90(1), 111-112.
Hendin, H. & Foley, K. (2008). Physician-assisted suicide in Oregon: a medical perspective.
Issues in Law & Medicine, 24(2), 121-122.
Lighthall, A. (2010, November/December). The rules of engagement. Psychotherapy Networker,
This "complex bureaucracy" may at least partially explain the controversy that surrounds many Veterans Hospitals after accusations of poor conditions and health care have tarnished the VA's image during the past year. Two Washington Post reporters write, "Stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the system" (Hull and Priest, 2007, p. A01). The arguments against these problems has steadily grown, and as they have grown, new problems have been uncovered. With so many returning veterans, the VA is finding it difficult to cope with the sheer numbers of veterans involved. The Post reporters continue, "Nearly 4,000 outpatients are currently in the military's Medical Holding or Medical Holdover companies, which oversee the wounded. Soldiers and veterans report bureaucratic disarray [...] indifferent, untrained staff; lost paperwork; medical appointments that drop from the computers; and long waits for consultations"…...
mlaReferences
Editors. (2007). Facts about the Department of Veterans Affairs. Retrieved 13 March 2008 from the VA.gov Web site: http://www1.va.gov/opa/fact/docs/vafacts.doc.1-7.
Hull, a, and Priest, D. (5 March 2007). 'It is just not Walter Reed': Soldiers share troubling stories of military health care across U.S. Washington Post. A01.
Manske, J.E. (2006). Social work in the Department of Veterans Affairs: Lessons learned. Health and Social Work, 31(3), 233+.
The management of large organizations is a very crucial issue, whether they are government-related or not (Argyris, 1993; Argyris & Schon, 1978; Broom, Jackson, Harris, & Vogelsang-Coombs, n.d.; Brown & Brudney, 2003; Hatry, 1999; Haynes, 1999). Often, however, the government does not seem to realize that it must manage itself in the same way that a business would in certain aspects if it is to succeed and therefore it does not market itself to the public.
The spending that has been involved with the Department of Homeland Security is also crucial, because it has changed over time to reflect the needs and the realization of what it takes to make the Department work (Eggen & Mintz, 2003). This spending is important to discuss, because it indicates how much of the government's money - and by extension how much of the tax dollars of Americans - is going toward funding this…...
mlaWorks Cited
Argyris, C., (1993). Knowledge for action: A guide to overcoming barriers to organizational change. San Francisco: Jossey-Bass.
Argyris, C. & Schon, D.A. (1978). Organizational learning, a theory of action perspective. Boston, MA: Addison-Wesley.
Broom, C., Jackson, M., Harris, J., & Vogelsang-Coombs, V. (n.d.). Performance measurement: Concepts and techniques (3rd ed.), workbook. Washington, DC: American Society for Public administration.
Brown, M.M., & Brudney, J.L. (2003). Learning organizations in the public sector? A study of police agencies employing information and technology to advance knowledge. Public Administration Review. 63(1), 30-43.
The War on Terror has led to an extended war in the Middle East that started with a U.S. intervention in Afghanistan, spread to Iraq, and has steadily engulfed other states as well. Returning veterans from Afghanistan and Iraq have suffered from post traumatic stress disorder (PTSD), which has impacted the work and family life of these veterans (Vogt et al., 2017). 1.3 million veterans of the Afghanistan and Iraq interventions are at risk for suicide (Kang et al., 2015). Hundreds of thousands of this same population suffer from identity adjustment as the return to civilian life and attempt to make the transition from military norms to civilian living (Orazem et al., 2017). This paper will discuss this specific population, its needs, policies and laws that impact this population, barriers to resource utilization, and how the nursing profession can promote change to improve healthcare outcomes for this veteran population.
The Population
2.8…...
veterans leaving the military. Specifically, it will attempt to solve some of the problems veterans being discharged from the military are facing. Veterans returning from the war in Iraq face a variety of problems and issues, and many of them are not being addressed by the military. Health care is one vital problem, many veterans coming home find that if they need health care, the Veterans Administration (VA) hospitals are so crowded they cannot receive treatment for weeks or even months. However, probably the biggest problem facing returning vets is readjusting to civilian life, and all that entails, from dealing with family and friends to the stresses of their jobs. Many returning vets will not admit they may need mental health counseling, and if they do admit it, they may not be able to find it. The problems of returning veterans are many, and until we learn how to…...
mlaReferences
Anonymous. 23 Nov. 2004. Nightmare #1. Retrieved from the Veterans for Common Sense Web site: 24 Nov. 2004.http://www.veteransforcommonsense.org/NewsArticle.cfm?ID=2432
Author not Available. (2 Oct. 2002). Readjustment, reconnecting after deployment. Retrieved from the United States Military Academy Web site: 24 Nov. 2004.http://www.usma.edu/publicaffairs/PV/021004/Deployment.htm
Editors (23 Oct. 2003). Coping with traumatic stress reactions. Retrieved from the National Center for Post-Traumatic Stress Disorder Web site: 24. Nov. 2004.http://www.ncptsd.org//war/fs_coping.html?printable=yes
Most advocacy groups can help the families of veterans also understand their legal entitlements to support services.
Congressional representatives can occasionally come to the aid of their constituents who are veterans. Lawmakers listening to the concerns of their constituents can bring special cases to the attention of their fellow congressmen and women in Washington to help advocate on behalf of veterans and veterans affairs. Some congressional representatives may be willing to serve on special committees that advocate for veterans affairs in Washington.
Social workers have an obligation to learn about the large-scale organizations that serve the needs of veterans as well as smaller scale community organizations. Even social workers that do not specialize in veterans affairs should become familiar with the unique legal situation of their clients. For example, social workers should familiarize themselves with the specific medical, social, occupational, and psychiatric needs that veterans have, especially the veterans that live…...
careers, many social workers will encounter individuals who are veterans of active duty military service. Like other client populations, veterans may experience issues with their day-to-day living requirements that require assistance, but these individuals may also experience a wide range of problems that are unique to service in the armed forces. This paper reviews the relevant literature to determine how current social work policies in the United States address issues of inequality, oppression or social justice for military veterans, the social work staff's ability to provide quality social work services, and ethical issues that affect social work values and practice in this area. An analysis concerning alternative approaches that social work and others could advocate or organize on behalf of veterans is followed by an assessment of which models of advocacy (Jannson or Hayes & Mickelson) are currently being used with this client population. Finally, a summary of the…...
mlaReferences
Adams, C. (2013, March 13). Millions went to war in Iraq, Afghanistan, leaving many with lifelong scars. McClatchy Newspapers. Retrieved from http://www.mcclatchydc.com/
2013/03/14/185880/millions-went-to-war-in-iraq-afghanistan.html#storylink=cpy.
Franklin, E. (2009, August). The emerging needs of veterans: A call to action for the social work profession. Health and Social Work, 34(3), 163-169.
Haynes, K.S. & Mickelson, J.S. (2000). The debate. In Affecting social change: Social workers in the political arena (pp. 23 -- 39). Boston: Allyn & Bacon.
Problems in Local Government: Ending Veteran Homelessness in Tulsa, OklahomaOnce widely known as the Oil Capital of the World, Tulsa is still a cosmopolitan city that is famous for its historic art deco that eschews the cow town image that characterizes many cities in Oklahoma, including most especially its capital, Oklahoma City. With a population of just over 400,000 people, Tulsa also has a sizeable veteran population, but far too many of these national heroes become homeless and stay that way after their discharge from the U.S. armed forces. Although precise figures are unavailable, what is known for certain at present is that many homeless veterans also suffer from various substance abuse and mental health disorders that complicates their treatment by the VA and the social services that are tasked with helping them (Smelson et al., 2022). Against this backdrop, it is clear that identifying opportunities to reduce the prevalence…...
mlaReferencesAbout Us. (2022). Veterans Community Project. Retrieved from communityproject.org/about.Evans, E. J. (2022). U.S. Department of Housing and Urban Development-Veterans Affairs Supportive Housing Program: Bring All Homeless Veterans Home. Health & Social Work, 47(3), 161–164.Guy, M. E. & Ely, T. L. (2018). Essentials of Public Service: An Introduction to Contemporary Public Administration. Irvine, CA: Melvin & Leigh, Publishers.Homelessness in America: Overview of Data and Causes. (2019). National Law Center. Retrieved from https://homelesslaw.org/wp-content/uploads/2018/10/Homeless_ Stats_Fact_Sheet.pdf.Schaeffer, N. (2020, January 20). VA participates in homeless census in Tulsa. VAntage Point. Retrieved from https://blogs.va.gov/VAntage/70897/va-participates-homeless-census-tulsa/ .Smelson, D. A., Yakovchenko, V., Byrne, T., McCullough, M. B., Smith, J. L., Bruzios, K. E., & Gabrielian, S. (2022). Testing implementation facilitation for uptake of an evidence-based psychosocial intervention in VA homeless programs: A hybrid type III trial. PLoS ONE, 17(3), 1–16.The law and homelessness. (2022). Law Library Guide. Retrieved from https://law-hawaii. libguides.com/c.php?g=421172&p=2875672.VA Homeless Programs. (2022). U.S. Department of Veterans Affairs. Retrieved from https://www.va.gov/homeless/ .https://www.veterans
H..1247 -- Improving Veterans Access to Quality Care Act of 2015
The Improving Veterans Access to Care Act (H..1247) sponsored by epresentatives Sam Graves (-MO) and Jan Schakowsky (D-IL) (hereinafter alternatively "the Act"), is intended to reduce existing delays in healthcare delivery being experienced by the Veterans Health Administration (VHA) (Smith, 2015). The provisions of the Act would extend full practice authority to certain advanced practice registered nurses (APNs), including nurse midwives, clinical nurse specialists, nurse practitioners, and certified registered nurse anesthetists in Department of Veterans Affairs (VA) health care facilities regardless of the state in which they are located. To date, the American Association of Nurse Anesthetists (AANA), the Association of Veterans Affairs Nurse Anesthetists (AVANA), more than 50 nursing organizations, as well as veterans service organizations, the Military Officers Association of America, the Air Force Sergeants Association, the American Association of etired Persons (AAP) together with more than 75…...
mlaReferences
APRN roles recognized. (2016). National Council of State Boards of Nursing. Retrieved from https://www.ncsbn.org/5399.htm .
ANA urges support for bill to increase veterans' access to APRNs' services. (2015, March/April). American Nurse, 47(2), 16.
From the trenches. (2015, July 25). Medical Economics, 92(14), 11-13.
GovTrack H.R. 1247. (2016). Govtrack. Retrieved from bills/114/hr1247.https://www.govtrack.us/congress/
Current Policy
The Obama Administration had pledged to end veteran homelessness, an interesting pledge given the myriad of complex reasons why people become homeless. But they were able to make progress towards that objective. The White House announced in 2016 that it had be able to cut veteran homelessness by 47% as of 2016 (Zoroya, 2016). The number living on the street was reduced 56% during the 2010-2016 time period. This was the result of a number of different approaches, which highlight the way that policy is addressed in this area.
The project to end veteran homelessness was the result of a coordinated effort by two departments, the Bureau of Veteran Affairs (VA) and Housing & Urban Development. The VA cites three components of its plan: conducting outreach to seek out veterans in need; connecting homeless and at-risk veterans with housing solutions; and collaborating with various government agencies, employers, housing providers and…...
Incidents of Suicide Among African American Veterans1.) ackgroundAfrican American Male veterans are reported to be twice as likely to commit suicide compared to the civilians on the streets. So far, most of the information regarding suicide among veterans is derived from the ones accessing healthcare from the VA Department. However, figures show that 75% of veterans do access healthcare via VA. The study shows that African American veterans are 58% more likely to commit suicide by using a firearm. The research also shows that the number of veterans with limitations on daily life activity is high. Such limitations contribute to their tendency to commit suicide. It suggests that there is a need for community interventions. Clinicians have also been urged to detect any signs of the likelihood of a veteran to commit suicide, and to review their access to guns.[footnoteRef:1] [1: Mark Kaplan S., Nathalie Huguet, entson H. McFarland, and…...
mlaBibliography Kaplan, Mark S., Nathalie Huguet, Bentson H. McFarland, and Jason T. Newsom. \\\\\\\\\\\\\\\"Suicide among male veterans: a prospective population-based study.\\\\\\\\\\\\\\\" Journal of Epidemiology & Community Health 61, no. 7 (2007): 619-624.\\\\\\\\\\\\\\\"Qualitative and Quantitative Research - Data Analysis.\\\\\\\\\\\\\\\" Atlas.ti. Accessed April 12, 2018. Robert M., Cynthia A. Claassen, and Kerry L. Knox. \\\\\\\\\\\\\\\"Evaluating Evidence of Risk for Suicide Among Veterans.\\\\\\\\\\\\\\\" Military Medicine 175, no. 10 (October 2010): 703. Koven, Steven G. \\\\\\\\\\\\\\\"PTSD and Suicides Among Veterans—Recent Findings.\\\\\\\\\\\\\\\" Public Integrity 19, no. 5 (September 2017): 500. Miller, Matthew, et al. \\\\\\\\\\\\\\\"Veterans and Suicide: A Reexamination of the National Death Index-Linked National Health Interview Survey.\\\\\\\\\\\\\\\" American Journal of Public Health 102, no. S1 (March 2, 2012): S154-S159. McCarthy, John F., et al. \\\\\\\\\\\\\\\"Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs.\\\\\\\\\\\\\\\" American Journal of Public Health 105, no. 9 (September 2015): 1935-1942. Katz, Ira. \\\\\\\\\\\\\\\"Lessons Learned from Mental Health Enhancement and Suicide Prevention Activities in the Veterans Health Administration.\\\\\\\\\\\\\\\" American Journal of Public Health, March 02, 2012., S14-S16Substance Abuse and Mental Health Services Administration, (DHHS/PHS), and (DHHS/PHS) Office of the Surgeon General. \\\\\\\\\\\\\\\"2012 National Strategy for Suicide Prevention: Goals and Objectives for Action. A Report of the U.S. Surgeon General and of the National Action Alliance for Suicide Prevention.\\\\\\\\\\\\\\\" (September 1, 2012): ERIC.Galfalvy, Hanga C., Maria A. Oquendo, and J. John Mann. \\\\\\\\\\\\\\\"Evaluation of clinical prognostic models for suicide attempts after a major depressive episode.\\\\\\\\\\\\\\\" Acta Psychiatrica Scandinavica 117, no. 4 (2008): 244-252.Tiet, Quyen Q., Mark A. Ilgen, Hilary F. Byrnes, and Rudolf H. Moos. \\\\\\\\\\\\\\\"Suicide attempts among substance use disorder patients: an initial step toward a decision tree for suicide management.\\\\\\\\\\\\\\\" Alcoholism: Clinical and Experimental Research 30, no. 6 (2006): 998-1005.Kessler, Ronald C., Christopher H. Warner, Christopher Ivany, Maria V. Petukhova, Sherri Rose, Evelyn J. Bromet, Millard Brown et al. \\\\\\\\\\\\\\\"Predicting suicides after psychiatric hospitalization in US Army soldiers: the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).\\\\\\\\\\\\\\\" JAMA psychiatry 72, no. 1 (2015): 49-57.Tran, Truyen, Wei Luo, Dinh Phung, Richard Harvey, Michael Berk, Richard Lee Kennedy, and Svetha Venkatesh. \\\\\\\\\\\\\\\"Risk stratification using data from electronic medical records better predicts suicide risks than clinician assessments.\\\\\\\\\\\\\\\" BMC psychiatry 14, no. 1 (2014): 76.Hunter, Sarah B., Bing Han, Mary E. Slaughter, Susan H. Godley, and Bryan R. Garner. \\\\\\\\\\\\\\\"Associations between implementation characteristics and evidence-based practice sustainment: a study of the Adolescent Community Reinforcement Approach.\\\\\\\\\\\\\\\" Implementation Science 10, no. 1 (2015): 173.http://atlasti.com/quantitative-vs-qualitative-research/.Bossarte,
Speaking Truth to Health Policy: Helping Veterans eadjust
Every day, at least 20 combat veterans commit suicide in the United States, or one veteran every 65 seconds (Shane & Kime, 2016). This alarming trend is attributable in large part to the symptoms that many people suffer from after experiencing traumatic episodes in their lives. Drawing on the sources of power enumerated by Mason, Gardner, Hopkins Outlaw and O'Grady (2016).This paper provides a current description concerning the health policy adopted by the Department of Veterans Affairs (VA) in response to this nation-wide problem to determine how the situation could benefit from having nurses speak truth to power. Finally, a summary of the research and important findings concerning this issue are presented in the conclusion.
The condition currently known as posttraumatic stress disorder is certainly not a new construct. In World War I, the condition was termed "shell shock" and in World War II…...
mlaReferences
Bare, S. (2015, June 2). The truth about 22 veterans suicides a day. Task & Purpose. Retrieved from http://taskandpurpose.com/truth-22-veteran-suicides-day/ .
List of nursing organizations. (2016). Nurse.org. Retrieved from http://nurse.org/orgs.shtml .
Miller, J. (2013, May-June). Veterans on trial: The coming court battles over PTSD. Military Review, 93(3), 92-94.
Shane, L. & Kime, P. (2016, July 7). New VA study finds 20 veterans commit suicide each day. Military Times. Retrieved from va-suicide-20-daily-research/86788332/.http://www.militarytimes.com/story/veterans/2016/07/07/
I. Introduction
II. Body
1. Statistics show that veterans are at a higher risk of suicide compared to the general population, sparking the need for urgent action.
2. The mental health struggles faced by many veterans often go unnoticed and untreated, leading to devastating consequences.
3. The stigma surrounding mental health in the military can prevent veterans from seeking help and exacerbate their risk of suicide.
4. Lack of access to adequate mental health resources for veterans contributes to the high rate of suicides within this community.
5. Addressing the root causes of veterans suicides....
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