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What will it take to fix VA health care?

When President Obama was a candidate back in 2007, he pledged to remake the Department of Veterans Affairs (VA) for the 21st century. Seven years later, and six years into his presidency, it's still a goal that in many ways seems out of reach, especially with thousands more servicemembers returning home as wars overseas wind down.

The VA is roiled in scandal over allegations that numerous VA medical centers maintained secret waiting lists to conceal the number of patients who were not able to see doctors within the 14-day goal period.

It's hardly the first time the agency was accused of failing to give veterans timely access to care: the nonpartisan Government Accountability Office reported on evidence of VA wait time failures as far back as 2000, while the Office of the Inspector General at the VA (the agency's internal watchdog) looked at this problem in 2005, 2007, and again in 2012.

To see the original version as well as any other graphics or videos, drop by the link previously mentionedThe scandal has led to a raft of other accusations.

Play Video

CBS Evening News

Vets' widows say husbands died waiting for care

Three women say their husbands died while waiting for cancer care at a Phoenix VA hospital. None of the deaths in Phoenix have been formally link...

Mr. Obama spoke publicly about the issue for the first time in three weeks Wednesday, saying he "will not tolerate" mismanagement at the nation's VA hospitals. But what will it take?

The solution that most members of Congress and veterans groups are turning to is a major management overhaul, one that some believe should include the departure of VA Secretary Eric Shinseki.

The prevailing narrative from some, said Nick McCormick, a legislative associate for the Iraq and Afghanistan Veterans of America (IAVA), is that "there's a few bad apples but overall the VA has a spotless record...that's not really the case."

"The accusations we've heard in the last month or so, it's not the first time they've shown up," McCormick added.

Play Video

Face The Nation

American Legion head: Obama needs to step up on VA problems

Dan Dellinger, national commander of the American Legion, discusses reports of mismanagement at multiple VA medical facilities.

In an interview with CBS' "Face the Nation" last weekend, American Legion National Commander Daniel Dellinger called for a "cultural" change across the VA that starts with Shinseki. Roscoe Butler, the group's assistant director for health care, told CBS News that the agency needs far more accountability.

"The secretary, whoever that is, needs to be empowered so that when he's plagued with issues of people who are asleep...and are not telling him what's going on, then he needs to go and he needs to put somebody in there that is able to manage the system in such a way that its favorable for veterans," Butler said.

That was the aim of a bill that passed the House with an overwhelming bipartisan majority Wednesday that gives the VA secretary increased power to fire or demote senior officials in an attempt to reduce the red tape that leads to them staying in their jobs once they are deemed to be ineffective. The bill was authored by House Veterans Affairs Committee Jeff Miller, R-Fla.

Miller's Democratic counterpart, Rep. Mike Michaud, D-Maine, would have gone even further. His own bill would have covered the entire senior management system of the VA, instead of the few hundred managers identified in Miller's bill, and would have sought to introduce more accountability into the management system with performance objectives tied to organizational goals and veterans outcomes that were assessed during annual performance reviews.

Indeed, there are indications that a shortage of money is not the VA's problem.

While reports of long wait times for care and a huge backlog of disability claims goes back more than a decade, the VA saw its budget increase more than $20 billion during Mr. Obama's first two years in office, yet the problem persists.

"Every year VA submits a budget to Congress and Congress has given VA every dollar that they've requested, over and above that. So I don't think it's a matter of Congress giving them the money. If it's not enough they need to ask," Butler said.

The real problem, McCormick added, is that VA leaders haven't been honest in identifying and fixing their own weaknesses. "Members of Congress have a hard time getting straight, open, direct answers," he said. It's a problem that will only get worse as veterans of the Iraq and Afghanistan wars all return home and need care.

By and large, McCormick said that the longstanding bipartisan nature of veterans' care means that even in a time of budget-cutting, the agency will likely continue to enjoy deep pockets from Congress, though there may be political speed bumps along the way. For example, a $21 billion bill that would have greatly expanded to veterans - including VA health care - failed in the Senate earlier this year over partisan disputes that are symptomatic of the gridlock issues that have plagued the Senate recently.

There also doesn't appear to be a major quality problem among the agency's doctors and nurses either, even though it appears that not enough veterans can get through the door to see them. Veterans' advocates who appeared before Congress last week agreed that once veterans get access to care within the VA system, it is high-quality care. The problem is getting access to that care in the first place.

The American Customer Satisfaction Index (ACSI), the nation's only cross-industry measure of customer satisfaction, ranks VA customer satisfaction among the best in the nation -- equal to or better than ratings for private sector hospitals. When asked if they would use a VA medical center the next time they need inpatient or outpatient care, veterans in the 2013 ACSI survey overwhelmingly indicated that they would (96 and 95 percent, respectively).

"When I see [my health care provider], they offer me top-notch care," said Ryan Gallucci of the Veterans of Foreign Wars of the United States.

There are smaller changes that would be easier to achieve than a massive management overhaul. Butler said a modernized, online scheduling system is key, as is higher pay caps that will make it easier to recruit physicians, especially in rural areas.

But it all seems to come back to leadership, no matter what the person's partisan leanings.

"Right now we have got to hold people accountable for not taking the kind of actions that should be done," Senate Veteran Affairs Committee Chairman Bernie Sanders, I-Vt., said on MSNBC Wednesday.

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08 Jun 2014
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Business Software Available To Save Time And Money

Many computer programs are available to assist business owners with shortcuts and tax information. These programs help to manage small and medium companies of all types. A Business software program you purchase is set up to fit the exact needs of your company.

Rental agencies for apartments, cars or watercraft can accelerate their record keeping. Medical clinics are always on a rushed time schedule and they will save valuable time. Any business owner will agree, saving time is like saving money.

All legally required tax records will be organized and stored for the required number of years. Records are accurate and productivity is increased. Satisfactory employees can be noted as such. Those who are absent more than an average number of days can have that noted on their records. These lists will make evaluations easier to conduct.

There are applications that require interaction and these can be modified for each business owner who purchases the software. They are available for purchase online or in retail stores. They may be installed on a server or multiple desktop computers used by any number of employees.

Mid-size companies that can benefit by using such a program are accounting offices, loan companies and franchise owners. Lists of inventory are kept. Reminders of when to order additional supplies are sent out.

An owner can list whatever functions he wants and buy a program that will do those things. Records are easy to keep. Excel sheets are incorporated to measure sales and tax records as well as vacation schedules.

Problem employees, those who miss work frequently and those who may be harassing fellow workers will be tracked. An evaluation is relatively easy with all this information available. Promotions are given to the most likely candidates Turnstiles and those who complain are passed over.

Lists of prospective customers will be recorded and updated. These computer software programs make excellent robotic employees. They do not require annual vacations or health benefits.

The company grounds will be monitored using surveillance equipment. This compares favorably to the system of using a security guard to make rounds. Even if that guard sits in front of monitors that show all areas, he or she cannot see all areas at all times as a camera can.

If any illegal activity takes place there will be a video showing what was done and who did it. This is a convenience for police officers and insurance adjusters. An intruder cannot reach cameras to break or obstruct them if they are mounted high on the walls. Security is automatically improved.
06 Jun 2014
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Protect Your Domestic Rights With Family Law Specialists

The topic of family law is broad and it includes relationship between children and their parents, between domestic partners and relationship between spouses. It is this law that demarcates the boundaries and spells out parameters what safe personal relationships is all about. Likewise, if situation so demands, it offers suitable legal respite.

Cases such as divorce, separation, violence and adoption have legal complications. Therefore, it is better they are resolved via family law advice and this is where role of family law specialists come into the picture.

These specialists can assist you in a number of ways. For instance, they possess the requisite know-how to handle such cases and are well aware of the sensitive nature of these cases. Strained personal relationships affect a person both financially as well as personally. The mounting frustration and stress add to their dilemma. These specialists are good at Knoxville Personal Injury Lawyer mending matters with their expert family law advice

They deal each case with utmost compassion and sensitivity to give due importance to grandparent right, father right, paternity issues, guardian-ships, visitation rights and much more. Family law issues are emotionally charged and very stressful. A specialist is the one who is well aware of small issues involved in handling such cases. That explains why you should hire them. It is only an encouraging and strong lawyer who is capable of assuring you a competent legal representation. They also become a source to garner best emotional support.

Such shared parenting orks wonders in treating cases involving divorces or a palpable rift between the spouses so that an amicable solution can be found.

With their rationalism and logic they try to solve the issue and sit down for consultation with the victim. Hiring these specialists is one way to finding solutions without putting the family dispute under public scanner. To arrive at some logical decisions, they collect information and investigate the same. It is based on findings of the investigation that the specialist solves matters for their client.

To see the original article as well as any extra graphics or online video, navigate to the link previously mentioned

22 May 2014
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15 May 2014
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