A new video produced by VA’s Prosthetic and Sensory Aids Service discusses how service dogs might be a good option for some veterans living with disabilities.

VA also provides a Q&A on Guide and Service Dogs that explains eligibility and other info.

For anyone interested in this benefit, it may be a solid starting point in your journey to acquiring your very own service dog.

VetsFirst has actively advocated for greater availability of service dogs for veterans who need them. For many, these animals are critical to greater quality of life and independence. They are beneficial to veterans living with a variety of disabilities, including hearing loss, traumatic brain injury, seizures, and mobility issues.

VetsFirst NSO Stephen Fricano taking in the sights
at the Grand Canyon.

When I first enrolled in the VA healthcare system, it was the fall of 2009, and I was fresh out of the U.S. Air Force. With the assistance of the excellent people of my local VA Medical Center––as well as that of United Spinal Association, the company for which I now have the pleasure of working for––my claims for service-connected disability were investigated, evaluated and in due time, approved.

After this came my move to Buffalo, and my enrollment in the Buffalo VA Medical Center. It was there at the Buffalo VAMC that a doctor would find something that would truly change the way I see, literally!

“Mr. Fricano, I’m going to need another look at that eye,” the doctor said.

The simplicity of the statement threw me off balance, given what has transpired since it was uttered. It was only six short months ago, but what my VA optometrist saw through her technical equipment that day will have a lasting effect on the rest of my life.

As it turns out, I had two very small tears in the retina of my left eye, and she was the first person to observe this and bring it to my attention. I was informed that she would start making all the necessary calls and hopefully get me in to Ophthalmology as soon as possible.

I sat in the eye doctor’s chair, waiting to hear when my next appointment would be, and what this means for my sight, when I was informed that the ophthalmologist would actually be ready to see me within the hour. Soon, I was in another chair, in another office, talking to another doctor. As we started to talk specifics, the doctor told me that, while the two tears in my retina were relatively minor, they were closer enough together that, with time, they could become one larger tear. This posed a serious threat to become retinal detachment. We discussed the options in my case: wait and see, or corrective surgery. After doing a bit of research on my own, at home, I opted for the retinal surgery.

It was a fine, brisk morning in western NY, when I found myself back in the same office at the Buffalo VAMC. Per the doctor’s orders, I had worn my glasses, and kept taking them off to polish at the lenses nervously. The doctor brought in two medical students who were enrolled at the local SUNY Buffalo state university; they were there as part of a partnership between the Buffalo VAMC and the college, to observe and study in their chosen field.

After the preliminary tests and confirmation of the diagnosis by all parties, I was instructed to head to the operating room. As our small group passed into the designated room, I immediately spotted the equipment that would correct my problem. It was an optical laser interface machine, designed, through the use of special lenses and controls, to let a technician or doctor aim and use a powerful green laser to literally scar the eye around the tears. This would prevent the tears from ever becoming larger.

As I was coached on what I’d be experiencing, I had my eyes prepped for surgery, the doctor joked with me to keep the tension down. The experience of actually getting the surgery is a bit of a blur, with instructions to keep looking straight, praise that I was doing great, and continual statements that we were almost done. If I had to compare it to something else, I’d say it was a lot like watching an extremely bright laser show with your eyes closed. I’d get glimpses of the green laser out of my peripheral vision, but since the doctor had a steady hand, and apparently I kept my eyes relatively straight and motionless, the surgery went off without a hitch.

Many people speak of light-affected migraines; my main symptom of the healing process from the surgery was something similar. After a few days, though, the majority of the pain and discomfort had passed. In a few weeks, I was back in the Buffalo VAMC for my follow-up. The doctor informed me that the small ring of burns created by the laser to contain the tears had been very successful. Barring the creation of new tears, which are normally created by minor blunt trauma (hitting your head on something, or a hard football tackle), my prognosis was that I may have some minor disturbances in my peripheral vision, but that I was now at an extremely low risk for retinal detachment.

Because of the dedication and attention to detail by the staff of the Buffalo VAMC, I was diagnosed and treated before my condition could have been a real problem. Due to their expertise and caring, as well as the support of my coworkers, my vision forecast for the future is, in a word: clear.

So if I had any word of advice for my fellow vets, it’d be this; if you have any medical issues, be it vision related or something completely different –– it may be covered by VA. Should you have any questions, please let us know. We’re always here to help you sort it out!

Stephen Fricano
National Service Officer

Currently, there is no limit on the length of time a veteran can remain in a VA-paid contract nursing home (called either community nursing home care or contract nursing home care). VA will ensure, however, all alternatives to other available resources are addressed, such as home health care and adult day health care, before a contract nursing home is the first resort.

Each VA medical center maintains a list of approved available local nursing homes they conduct contracts with. The purpose of VA contracting with community nursing homes is to meet the needs of veterans requiring long-term care in their own community, while remaining close to their families.

VA nursing home care is for veterans too sick, disabled or elderly to care for their self, but do not require hospital care.

Veterans with a combined service-connected disability rating of 70 percent or more have priority. If space and resources are available, VA can also provide nursing home care to veterans rated below 70 percent and non-service connected veterans––but for a limited amount of time.

Many states operate state veterans homes to provide care to veterans, spouses, and surviving spouses. Most states receive some type of VA funding to cover a portion of the cost of the veteran’s care.

State homes provide hospital care, nursing home care, and domiciliary care. State homes are inspected annually and audited by VA to ensure they meet certain standards.

Since most states have their own eligibility requirements for admission, veterans and advocates will need to contact the individual state home for information.

For more information, please visit http://www.va.gov/geriatrics/Nursing_Home_Eligibility.asp.

Christine Golden
Regional Service Director

While eligibility for routine eye care encompasses all enrolled veterans eligibility for eyeglasses remains somewhat limited like dental care. VA will ensure access to eye care services including preventive health services and routine vision testing for all enrolled veterans and those veterans exempt from enrollment.

Eyeglasses will be provided to the following veterans:

• Those with any compensable service-connected disability.
• Those who are former Prisoners of War (POWs).
• Those who were awarded a Purple Heart.
• Those in receipt of benefits under Title 38 United States Code (U.S.C.) 1151.
• Those in receipt of an increased pension based on being permanently housebound and in need of regular aid and attendance.
• Those with vision impairment resulting from diseases or the existence of another medical condition for which the veteran is receiving care or services from VHA, or which resulted from treatment of that medical condition, e.g., stroke, polytrauma, traumatic brain injury, diabetes, multiple sclerosis, vascular disease, geriatric chronic illnesses, toxicity from drugs, ocular photosensitivity from drugs, cataract surgery, and/or other surgeries performed on the eye, ear, or brain resulting in vision or hearing impairment.
• Those with significant functional or cognitive impairment evidenced by deficiencies in the ability to perform activities of daily living.
• Those who have vision severe enough that it interferes with their ability to participate actively in their own medical treatment and to reduce the impact of dual sensory impairment (combined hearing and vision loss).

For additional information please contact your local Dept. of Veterans Affairs Medical Center or a Veteran’s Service Organization. It is always a good idea to discuss your vision care needs with your primary healthcare provider.

Keith Reimers
National Service Officer

Jonah

U.S. Army veteran Kevin Stone’s early retirement from service after being spinal cord injured left a big hole in his life, that is, until he found a couple of new best friends––his service dogs.

Service dogs are trained to help people living with physical and psychological disabilities such as spinal cord injuries, as well as post-traumatic stress disorder (PTSD) and severe depression. They can perform a variety of tasks, from pulling a wheelchair to fetching dropped items. Service dogs can also help break down barriers between people with disabilities and society, enabling many to access new opportunities that once seemed out of reach.

Stone has owned two service dogs since his injury, Jonah––a blond labrador retriever, and Mambo––a 50/50 hybrid mix of golden retriever and yellow labrador retriever. He credits his first dog Jonah with his initial recovery. “She motivated me to overcome my injury and become who I am today,” Stone said.

Mambo

Jonah’s successor, Mambo has been with Stone for the past 4 years. Along with helping with physical tasks and his mobility issues, Mambo has empowered Stone to rediscover a sense of purpose since leaving the Armed Forces.

“My injury stripped me of the person I was trained to be. Mambo not only brought back my freedom and independence, but also gave me an opportunity to serve my country in new ways,” Stone said.

With his dogs by his side, Stone, a member of AMVETS, replaced his camo and fatigues with a few new uniforms. He has competed as a U.S. Paralympian in Athens in 2004 and Beijing in 2008, winning a bronze medal in archery and raising the American flag on foreign soil. He was also a coach and mentor for the U.S. Paralympic Committee’s Military Program and served his community as a veterans service officer.

Jonah and Mambo have opened many doors for Stone, but his local VA hospital isn’t one of them. Unfortunately, some VA facilities prohibit service dogs from entering. The only dogs fully-protected by law to enter all VA facilities are guide dogs, which are used by people with vision problems. The VA has left it up to each facility’s discretion whether or not to permit access to service dogs.

Stone has experienced firsthand the frustration of being turned away from a VA facility because of his dog. He was recently denied Inpatient Services at Charlie Norwood VA Medical Center in Augusta, Georgia and missed important medical appointments because officials said Mambo presented too many risks to let in. The hospital was mainly concerned with Stone’s ability to care for his dog and the threat of “zoonotic disease transfer”.

“As far as I know, other than microbes and small biologics that could be passed by floating dander or a shed of fur, the only ‘zoonotic disease’ a canine can transfer is the topical ringworm which would have to be transferred from a human host first,” Stone explained.

“Obviously, there are certain areas of VA facilities where dogs should not be allowed, such as burn units or other sensitive sterile areas. But if a veteran is attending a group meeting or appointment, why shouldn’t their service dog be allowed in,” he added.

Thousands of veterans like Stone view service dogs as crucial vehicles to pursuing active lifestyles. For many, they are not a luxury, but a necessity.

“They are motivational prosthetics of freedom. Service dogs are just as important as someone’s wheelchair. Without them, many veterans living with disabilities would be lost.”

There are currently two pieces of legislation that would help protect the rights of veterans who use service dogs, while also ensuring these animals are available to a larger portion of the disabled veteran population.

The first bill, the Veterans Equal Treatment for Service Dogs Act (H.R. 1154), introduced by Congressman John Carter, R-Texas, ensures that all veterans with disabilities who use service dogs are able to access VA facilities. In the Senate, S. 769 would also provide similar protections.

The second bill, the Veterans Dog Training Therapy Act (H.R. 198), introduced by Congressman Michael Grimm, R-N.Y., would create a pilot program to determine whether veterans with post-deployment mental health concerns, such as post-traumatic stress disorder could benefit by participating in the training of service dogs for fellow veterans.

VetsFirst, AMVETS, and other advocacy groups have joined Stone to educate the public and politicians on Capitol Hill about the positive impact that service dogs have on the quality of life of veterans living with disabilities nationwide. Mambo has also become a major player in these efforts.

“My dog has become a politician, and a damned good one,” Stone said.

Kevin with his service dog Mambo

Although there has been widespread support for H.R. 1154, the Veterans Dog Training Therapy Act has received opposition––most notably from the VA Principal Deputy Undersecretary for Health Dr. Robert Jesse. He has stated the bill is “unworkable”, explaining that it would require the evaluation of a large and very detailed list of factors, many of which cannot be measured.

Stone disagrees, stating, “As long as the VA applicant screening process is performed correctly and the dogs are properly trained through accredited training programs there is no reason this bill cannot succeed in helping veterans with PTSD and other mental health issues.”

According to Stone, pairing veterans with properly trained dogs through a VA accredited program would also solve the growing problem of many veterans obtaining “quick fix” service dogs through unaccredited suppliers.

“You can go online, fill out a few forms, and purchase service dog certification IDs, packs, vests, and patches quite easily. There is no accountability. Without proper accreditation from organizations such as Assistance Dogs International Inc. or the International Guide Dog Federation these items mean nothing. Most veterans are learning that the hard way. They are getting stuck with the dogs that are not well-trained that they end up donating or having to pay to get retrained.”

Related articles: Service Dogs-A Veteran’s Best Friend

Tom Scott
Staff Editor, VetsFirst

The proposed legislation––titled the “Charles August Long (CAL) Undiagnosed Diseases Research and Collaboration Network Act of 2011”(H.R. 2671)––will provide the medical community the ability to instantly share data on undiagnosed illnesses with each other so that they can work together to develop effective treatments and ultimately cures for illnesses that are currently a mystery.

Heather Ansley, VetsFirst’s director of Veterans Policy, discussed how the CAL Network could be particularly useful to the Department of Veterans Affairs (VA) during a recent press conference in Washington, DC that introduced the bill.

“We are excited about the opportunities for collaboration between physicians, researchers, and government agencies that will be created through this legislation,” Ansley said.

“Although VA maintains registries for exposure to certain substances and environments, the CAL Network will allow VA to benefit from the experiences of and facilitate collaboration with the larger health and research communities,” she added.

The legislation would also help veterans who do not obtain health care through VA but develop undiagnosed diseases more easily connect to the illnesses of other veterans who use VA health care. Specifically, the CAL Network will ensure that VA is able to see patterns among not only the veterans they serve but those present in veterans who seek private care.

This bill will provide the commonsense networking tools for our medical community to better share information on undiagnosed illnesses,” said Congressman John Carter, who sponsored the legislation in response to thousands of families across the country struggling to care for loved ones with undiagnosed diseases.

Other sponsors include Congressmen David Dreier (R-CA); Michael Burgess (R-TX); and Dennis Kucinich (D-OH).

“After studying this issue for some time, I was surprised to learn that there is not a more effective approach for physicians to identify and talk with other doctors who are treating patients with similar undiagnosed illnesses. The establishment of the CAL Network will put in place a forum for physicians to search for similar cases and facilitate cross-disease research of undiagnosed diseases. Ultimately, the faster a problem can be identified, the easier it will become to improve the care of the patient,” Dreier explained in a press release.

The Cal Network Act is named for Charles August Long ‘Cal’ of Cedar Park, Texas, who passed away in December 2006 at the age of 5 due to an undiagnosed illness.

Press conference attendees included Heather Long (the bill is named for her son); James Alton, an undiagnosed disease patient and his parents, Greg Alton and Caroline Loewy of Atherton, California; and AMVETS National Acting Legislative Director Christina Roof.

Cal Network press conference attendees. From left to right: Congressman Dreier, Heather Long, Greg Alton, Caroline Loewy, James Alton, Emily Long, Congressman Carter, Heather Ansley (VetsFirst), Christina Roof (AMVETS)

Overall, VetsFirst is pleased with the President’s budget request of approximately $132 billion which demonstrates his commitment to ensure that the VA has the resources it needs to provide health care and compensation benefits to our nation’s veterans.

The President’s request includes approximately $62 billion in discretionary spending, which mainly funds medical care for veterans. The Independent Budget, which is supported by VetsFirst and other veterans service organizations to guide policymakers in developing an adequate health care budget, calls for $65.3 billion in discretionary spending.

VetsFirst is concerned, for example, that the limited amount of funding requested by the VA for major constructions projects ($589.6 million) may not be sufficient to ensure access to VA health care services for all veterans with disabilities. Specifically, the Independent Budget recommends $2.2 billion for major constructions projects.

In addition to the request for fiscal 2012, the President requested $41.4 billion in advance appropriations for medical services for fiscal 2013. The lack of a budget for fiscal 2011 has demonstrated the importance of having an assured level of funding for health care beyond the current fiscal year to ensure that veteran’s health care will not be disrupted.

The VA’s priorities for fiscal 2012 include eliminating veteran homelessness, expanding access to benefits and services, and reducing the disability claims backlog. Although not listed as a priority by the VA during its briefing, the budget request also includes $208 million to fund the implementation of new caregiver benefits under the Caregivers and Veterans Omnibus Health Services Act of 2010, which was strongly supported by VetsFirst.

As the budget process moves forward, VetsFirst will continue to advocate for the level of funding needed to support the programs and services that our veterans with disabilities and their families deserve.

Heather Ansley
Director of Veterans Policy

This week, the U.S. House of Representatives will likely consider the fiscal year 2011 Veterans Affairs (VA) funding legislation (H.R. 5822).

The House Committee on Appropriations’ legislation would provide the VA with $56.8 billion in discretionary funding (mainly for health care for veterans), which is on par with the $56.9 billion provided for by the Senate Committee on Appropriations. Under both the House and Senate bills, the VA would receive approximately $64 billion in mandatory funding (mainly for disability compensation and pensions for veterans).

VetsFirst is pleased to report that both the House and Senate bills also include $50.6 billion in advance appropriations for VA health care. VetsFirst, along with other veterans service organizations, supported advance appropriations to ensure that the VAs will be able to meet the needs of veterans from all eras.

Earlier this year, the President submitted his FY 2011 budget which included $125 billion for the VA. The President’s request included $60.3 billion for discretionary spending and $64.7 billion in mandatory funding.

As the appropriations legislation moves through Congress, VetsFirst will continue to advocate for Congress to provide the funding needed to ensure that our nation’s veterans receive the services and benefits they have earned through their service to our nation.

VetsFirst believes that veterans with disabilities must have access to needed health care services through the VA health care system. Specifically, veterans must be able to receive accessible physical and appropriate mental health services, including long-term services and supports (long-term care). In order to adequately perform these services, Congress must ensure that the VA has the appropriate staffing and resource levels to provide these benefits to veterans of all eras and genders.

Despite efforts to link veterans to the VA health care system, a substantial number of veterans are accessing health care through community-based, non-VA, providers and services. VetsFirst believes that the VA must fully recognize the importance of veterans being able to receive a wide variety of services in their communities and develop robust partnerships to ensure that these services will be available to veterans when and where they need them. At the same time, however, the VA must find better ways to reach out to veterans to make them aware of the assistance available. Partnering with non-VA providers that also serve veterans with disabilities would help individuals to learn about the VA and receive all of the services that they are eligible for as people with disabilities.

Better access to health care will ensure that veterans are able to maintain their health and functioning, thereby reducing the need for long-term services and supports. When long-term services and supports are required due to disability or age, most people want to live in and be a part of their communities. Evolving the VA’s system of long-term care to one that is more focused on community supports, funded by the VA, will ensure that veterans are receiving services and supports in the least restrictive setting appropriate to their needs.

Lastly, VetsFirst believes that streamlining the transition from soldier to veteran is an important step in making VA health care services accessible. Although the care of servicemembers and veterans is divided between the DOD and VA, it is the responsibility of these agencies to ensure that individuals’ needs are seamlessly met. The DOD and VA must diligently work toward the development and implementation of an electronic records system for medical information and service-related documentation sharing that will help veterans in filing for VA benefits and receiving proper VA health care.

VetsFirst will continue to fight for access to health care and other services and benefits that are critical for veterans with disabilities.

In future posts, we will explore additional VetsFirst public policy priorities.

The equipment was used during endoscopic procedures, including colonoscopies, at three VA medical centers: Murfreesboro, TN, between April 2003 and to December 2008, Augusta, GA. between January and November 2008, and Miami, FL. between May 2004 and March 2009. The equipment was improperly sterilized after use.

So far, the VA has sent letters to 10,555 veterans who are at risk for infection as the result of these procedures. The letters advise them of the danger and invite veterans to undergo additional testing to determine if they have, in fact, been infected.

More than 3,000 veterans have been tested to date and the results are rather alarming. Twenty-two veterans have tested positive for Hepatitis B (5), Hepatitis C (11) and the Human Immunodeficiency Virus (HIV) (6).

The results do not necessarily prove that these infections were actually caused by diagnostic testing at the affected VA facilities, but they do raise the disturbing possibility. In response, the VA, in addition to notifying potentially exposed veterans about the danger, is offering testing, treatment and counseling services. The VA is following up on notification letters that have been returned as undeliverable, as well as reaching out to homeless veterans with no known address.

Although VA officials have described the situation as “unacceptable” and are “extremely concerned about this matter”, the fact remains that in two VA medical centers, veterans were potentially exposed to contaminated invasive equipment for as long as five years! This is not merely unacceptable, it is unconscionable.

VA Secretary Eric Shinseki and newly-confirmed Deputy Secretary Scott Gould need to get on top of this issue immediately to safeguard veterans’ health. Otherwise, their credibility and promises of VA health care reform will be seriously compromised. This is what VetsFirst means by demanding meaningful accountability on the part of the VA. It is not about pointing fingers, but fixing problems – quickly and permanently.

If you are, or know of, a veteran that may have been potentially exposed to contaminated VA medical equipment, please call 1-877-575-7256 for additional information.