Vets ‘our challenge’

Secretary of Veterans Affairs Jim Nicholson said he will ask Congress today for a landmark $87 billion budget to meet the staggering needs of treating 1 million patients a week and tailoring health care for troops returning from the wars in Iraq and Afghanistan.

Among his challenges is to give the new breed of veterans treatment for brain, spinal and limb injuries while keeping veterans of past wars in concert with care for lingering combat stress disorders.

"That is our challenge, to make sure we are providing world class, state-of-the-art care to all veterans and especially those that are currently undergoing these injuries from war," he said after a national conference Wednesday in Las Vegas of VA and Defense health care providers.

Nicholson, a Vietnam War veteran, said he will tell a Senate appropriations subcommittee that the $87 billion, a 77 percent increase in VA spending since President Bush took office, is needed "to ensure that every seriously ill or injured man or woman returning from combat in Iraq or Afghanistan will receive the treatments and the benefits that they're entitled to and that they need in a timely way."

He plans to expand the VA's four traumatic brain injury centers to 21 "poly trauma sites" and hire 100 patient advocates to help the seriously wounded with getting fast care and items they need.

"The idea is they will have the power. They will have to portfolio to work the system, to cut through the red tape, to bypass bureaucratic obstacles and to elevate with timeliness the issues that are befalling these young people and their families," Nicholson said.

One of his goals for the fiscal year that begins Oct. 1 is to hire more claims adjudicators to shorten the average time for handling a claim, which is currently 177 days.

"If we get that, and I'm confident we will," he said about his budget request, "we will bring that down by 18 percent to 145 days.

"But I've also instructed our benefits people to give these returnees from the war a priority so that their file is considered first," Nicholson said. "It's the war we're in today, and they're the current combatants, and if they have a legitimate claim, start paying that claim just as soon as possible."

Bill Anton, Nevada adjutant for the Disabled American Veterans, said Nicholson's budget request with increasingly more veterans to care for "reflects the cost of medicine," especially when returning veterans suffer the physical and mental wounds the secretary described.

"The task is monumental compared to a normal hospital system," Anton said. "What we need is more claims adjudicators. We need 10,000 more. They're just swamped."

Nicholson's request will continue to fund construction of the $600 million VA hospital on the north side of the Las Vegas Valley, where foundation work is underway. The hospital is expected to be completed by 2011.

After his address at the Las Vegas Hilton to many of the 1,250 attendees at the "Evolving Paradigms" conference, Nicholson met for about 45 minutes with Rep. Jon Porter, R-Nev., to discuss among other things issues surrounding unshredded medical records that were found in trash bins behind the veterans health clinic on Rancho Drive in February.

"Mistakes were made regarding some old medical records, and we have taken very seriously this incident as we do all data security incidents," Nicholson said before meeting with Porter.

In addition to a pair of federal inquiries that were launched, Nicholson said local VA staff members and supervisors will be trained on records handling "to make sure they understand the importance of this."

According to Porter, Nicholson "said again they dropped the ball and reprimanded those involved." Porter didn't name the VA employees who were reprimanded for the records dumping incident but confirmed there were more than one.

In his speech, Nicholson talked about much-publicized criticism of the VA's "care received by some of our wounded troops returning from this war."

"There is no question that what we've seen in these reports is not the care that our veterans, especially these young combat veterans, or their families should need to expect," he said.

"As hard as we're trying, we haven't yet always gotten it perfect," he noted later.

Part of the problem with addressing the veterans' needs is the size of the health care system with 7.6 million patients enrolled compared to 800,000 in 1970 during the Vietnam War.

Asked about the recent deaths of five men at a Los Angeles VA facility and shelter, including 27-year-old Justin Bailey, the son of Las Vegas resident Tony Bailey, who was allowed to administer drugs to himself, Nicholson said an inspector general team and a group of medical investigators probing the matter will recommend corrective actions.

"We take each one of those seriously," he said. "If people were given sensitive and controlled substances that don't exhibit the self-discipline to administer, they shouldn't be given those. They should be administered to them on a custom basis. They should come in for them."