Roughly a month ago, Bob Macdonald was a relatively unknown name in the veteran community. The former Proctor & Gamble CEO – a man with 33 years of business experience- wasn't well known for his five years of service with the Army or for his graduation from West Point. That all might change within the next few weeks or even days.
After a unanimous vote, the Senate has confirmed that McDonald will serve as the new secretary of the Department of Veterans Affairs.
A clean sweep and high expectations
Just recently, the Senate voted 97-0 to confirm McDonald as the new department head, showing a tremendous amount of confidence from a normally split political body. Now, politicians have put their trust in McDonald to fix the embattled VA health. The organization has been facing high political and media scrutiny after several scandals and systematic problems surrounding the department came to light earlier this year. It will be up to McDonald to solve problems regarding long wait times for veterans seeking health care appointments, a small work force, limited resources and a corrupt network of senior officials and managers.
Many in Congress have high hopes for the former world-class businessman, however.
"If Mr. McDonald is willing to work in a collaborative and open manner with Congress, he will find a constructive partner on this side of the aisle," Senate Minority Leader Mitch McConnell said, according to CBS News. "We know that there is much we can, and should, do to address this crisis together … Because when veterans are denied care, it's a priority deserving of bipartisan attention."
It will be a long road ahead for McDonald despite the support, however. An internal audit conducted by the VA's Veterans Health Administration was made public on the same day of McDonald's appointment, according to USA Today. The news agency reported that the data shows veterans' wait time records had been falsified in 109 clinics and secret lists hiding data manipulation were held in 110 clinics.
The corruption in the VA health department runs deep, but McDonald already has a plan to deal with some of the issues.
A 90-day plan already underway
It didn't take long for the new secretary of the VA to reveal an enthusiastic three-month plan that will take him across the country to different clinics to collect data about regional officials, record keeping systems and provide support to whistleblowers, according to a report by Military Times. McDonald's primary task involves interviewing VA senior leaders and finding the right group of people to lead the failing organization. Currently, there are 10 vacant leadership positions in the VA that require Senate approval for appointments. McDonald will be charged with finding qualified candidates to recommend.
Solving the current wait time crisis is also a major issue for the new VA department head. With 40,000 veterans still waiting for medical appointments, McDonald will have to put a great deal of effort into finding a way to provide timely and effective care for patients. According to Military Times, he plans to install an advisory board of medical officials inside and outside of the VA to collaborate on the best way to provide the most efficient care. McDonald will rely heavily on this board, as he has no prior medical management experience.
Additionally, a request for $17.6 billion in new funds – asked for by acting VA secretary Sloan Gibson – will help the VA hire more medical personnel and lease more medical establishments if passed by Congress. The measure has already received the support of many lawmakers, according to CBS News.
With over 340,000 employees under his management, McDonald will be put to the test in coming months. Suffering from highly publicized scandals, low morale and few resources many have asked why McDonald would want to take the helm.
In response, the former servicemember has said, "there is no higher calling."
A $1 million federal grant awarded to the University of Michigan-Flint will benefit veterans by offering an accelerated nursing program that focuses on past military training, according to The Associated Press. The three-year grant was awarded by The U.S. Department of Health and Human Services' Nurse Education Practice Quality and Retention Program awarded the three-year grant, which will allow veterans to obtain a Bachelor of Science nursing degree. According to MLive Media Group, the program will also ensure that veterans are prepared to take the registered nurse license exam following the receipt of their degrees.
Preparing for the class of 2015
Looking ahead, the University of Michigan-Flint's nursing department is already working on a recruitment program. The school will use the fall semester to recruit and study academic portfolios before initiating the veterans nursing program plan starting at the beginning of 2015.
According to university nursing officials, veterans have already reached out to the school expressing interest in the program. The AP also reported that in the school's program description, the University of Michigan-Flint called the project particularly appealing because the campus is currently in need of more health professionals. Equally beneficial, the school is also in close proximity to counties with particularly high veteran populations. The United States Department of Veterans Affairs reported there are over 660,000 veterans currently living in Michigan.
A program by veterans, for veterans
An article published on the university's news page said the program – called Veterans serving Veterans – will reduce transition and matriculation barriers to allow past servicemembers to obtain a Veteran Bachelor of Science in Nursing degree. The team that designed the program includes a project director, program manager, advisor, administrative assistant, and evaluation consultant – some of which are veterans, according to the school. Namely, the director of the program is veteran, and assistant professor of nursing, Beverly Jones.
After weeks of disagreement and heated debate, House and Senate lawmakers have made a deal regarding how to help fix the Department of Veterans Affairs' health care system, which has been mired by scandals, long wait times, and whistleblower retaliation for months, according to The Associated Press.
Details of the plan
The agreement – said to include tens of billions of dollars of funding and resources to lease new clinics and hire more medical professionals – will help veterans seek care at VA facilities and at outside agencies to reduce wait times under a strict time schedule. Recently, Sloan Gibson, the acting Secretary of the Department of Veterans Affairs, requested $17.6 billion over the next three years to finance new locations, hire 10,000 more clinicians and upgrade some of the organization's technology. However, lawmakers have not specified the details surrounding the agreement yet. Instead, officials will be holding a press conference to release the full details about funding, hiring goals and other health care information.
Committee chairmen come together
The plan was agreed upon by legislative leaders Sen. Bernie Sanders and Rep. Jeff Miller. The House and Senate approved VA health care bills in mid-June and expected a final bill by July 4, but slow-moving negotiations pushed that deadline back, according to The Associated Press. After talks broke down into verbal clashes, Sanders – the chair of the Senate Veterans committee – and Miller – chairman of the House panel – managed to come together during weekend telephone discussions. Now just days before Congress begins a month-long recess, a plan has been formulated for lawmakers to vote on and approve. After details are released, the plan must go to a conference committee of lawmakers for approval and then to the full House and Senate before reaching President Barack Obama's desk for a signature.
Solving current problems
The Associated Press reported that a recent audit of the VA showed that 10 percent of veterans seeking care at VA hospitals are still waiting 30 days or more for an appointment. Additionally, 46,000 veterans have waited over three months for appointments. At the same time, 7,000 veterans have not received appointments over the decade in which they requested them. Those struggles are due to shortages of doctors, improper timeline goals, and manipulation of patient wait-time data that protected managers' payment bonuses, according to The New York Times.
More than providing funding and leeway for hiring medical staff the plan is said to, "make VA more accountable and to help the department recruit more doctors, nurses and other health care professionals," Miller and Sanders said, as quoted by The Associated Press.
Buying discounted tobacco products will be a thing of the past for military servicemembers, according to The Associated Press. Recently, the Senate Appropriations defense subcommittee slashed the 25 percent discount on tobacco products allowed to soldiers in a defense spending bill that will begin Oct. 1.
Promoting soldiers' health
While financial reasons have been have been cited among the reasons for the change, lawmakers and others mention the inherent health problems associated with tobacco products most frequently.
"I don't know if there's anybody in America who still thinks that tobacco is good for you," Secretary of Defense Chuck Hagel said, according to Stars and Stripes. "The dollars are one thing. But the health of your people — I don't know if you put a price tag on that."
According to the American Lung Association, soldiers that smoke frequently suffer a wide range of health concerns. On its webpage, the group reported that soldiers that smokers are more likely to suffer injuries, perform worse on military fitness evaluations and are more stressed than soldiers who do not smoke, according to reports. Additionally, smoking is one of the main predictors of military training failure.
Reducing smoking in servicemembers
Another noteworthy issue, studies show that members of the military tend to smoke at higher rates than civilians. According to the American Lung Association, 30 percent of all members in the armed forces smoked as of 2008. On top of that, 9.5 percent of military personnel smoked heavily.
The News Tribune reported that military leaders intend to dramatically decrease tobacco use in soldiers by 2020. The AP also reported that some lawmakers are attempting to restrict the use and sale of tobacco. However, Rep. Duncan Hunter had managed to convince members of the House Armed Services Committee in May that the right to smoke should be preserved for soldiers, calling the habit one of the few pleasures for a servicemember.
Many members of the military spend years on the battlefield. In fact, some spend the majority of their lives there. They don't operate aircrafts or military vehicles, aren't equipped with weaponry or much armor, yet they're charged with one of the more dangerous combat jobs overseas: locating explosives. They're the military's combat dogs.
Dedicating their lives to the protection of their human companions and to citizens thousands of miles away, they have been called the guardians of America's freedom. Unfortunately, many of them have been left behind.
Military dogs take the hill
A group of five war dog veterans accompanied by military canine advocates took to Capitol Hill recently to speak with lawmakers. The goal was to pass new legislation mandating that retiring war dogs be brought home to the U.S., preferably with their handlers, instead of being left overseas. According to USA Today, the president of the American Humane Association told reporters that military dogs are often not brought back to the states.
"Military working dogs that are retired overseas will go to a local shelter or another military facility if they're not adopted," said Robin Ganzert, president of the American Humane Association, according to USA Today. "We need to bring them back to the U.S., the country they were raised in and served for. They need to be retired on U.S. soil and reunited with the soldier that they worked with, because that's the person that cares most about the dog. It's a powerful bond they share."
The USA Today report said that over 1,775 war dogs are currently in service. Around 300 to 400 of those dogs retire and are adopted annually. If they are not adopted, they are left in a kennel. Despite a great amount of adoption volunteers, logistics can keep some people from bringing the dogs back home. Namely, future caretakers of the dogs are responsible for the canines' transportation back to the country, and that service can cost thousands of dollars.
According to NPR, Congress passed a law last year saying the military may bring dogs back from war zones to be reunited with their handlers. However, the saying that the military "may" bring the dogs back home does not require them to honor the service. Canine veteran advocates on Capitol Hill want the military to pay for bringing the dogs back stateside, allowing their handlers that served alongside them to adopt them more easily.
A life of service
Military dogs are charged with a service period that can last for years. A dog is only retired if it becomes sick, injured or cannot perform its duties. Where some handlers go on tours that last one or two years, dogs can be kept in service overseas for much longer. Sometimes, they never come back to the U.S.
Last year, John Burnam – a dog handler in Vietnam and the writer of two combat dog books – helped erect the country's first national monument dedicated to service dogs, according to Reuters. Inscribed with "Guardians of America's Freedom, the monument was built with past combat canines in mind. Military officials did not allow combat dogs in Vietnam to return with their handlers.
"They were heroes," Burnam told Reuters, "and they were left to die."
Canine advocates are fighting to bring veteran dogs back home to the states to be reunited with handlers like Marine vet Deano Miller. Miller served with a yellow Labrador named Thor four years ago, according to NPR. During their service, Thor was never on a leash or in a kennel. He never left Miller's side.
When Miller went back to the U.S., Thor was left behind in Afghanistan to finish his service.
"I had to wait 3 1/2 years for him, but I'd wait more if I had to," Miller said, according to NPR.
Now, the veteran dog can rest at home with his partner.
Following the order of Texas Gov. Rick Perry, about 1,000 Texas National Guard soldiers will be dispatched to the Texas-Mexico border. However, these servicemembers will only serve in a listening and observation capacity, according to Military Times. Instead of making regular patrols or apprehending illegal immigrants themselves, the troops intend to watch for individuals who plan to cross the border and alert the Department of Public Safety.
Guarding the border in a different capacity
Although the soldiers will be armed with guns, the weapons are intended to be used only if self defense is necessary. This has been common procedure in similar operations, according to Air Force Maj. Gen. John Nichols.
"They're allowed to defend themselves," he said, according to Military Times. "They will be armed, but it's for personal safety, to defend themselves. We've done Operation Jump Start, Operation River Watch, which were federally funded operations, where in those cases we helped U.S. Customs and Border Protection. We were armed then. The same rules applied."
Instead of walking the border and patrolling, National Guard servicemembers will be stationed at a series of observation posts. Equipped with helicopters with infrared sensors, guardsmen will watch over the border and call DPS if any immigrants are spotted. From that point, it's up to the DPS to interview the people and follow the necessary procedures.
A massive undertaking and an uncertain timeline
Rio Grande Valley Border Patrol and DPS patrol an area that stretches for 320 miles at the edge of the Rio Grande bordering Mexico, according to KVUE – an Austin, Texas, news service. Covering all of that area presents many logistical and resource issues for border patrol forces, according to security officials.
The mission for the National Guard is expected to start within the next two and a half weeks, and around 1,000 troops are expected to be stationed at the border within 45 days. Before going, the troops will be expected to train to a certain extent, learning the to use basic phrases to reduce the language barrier between them and immigrating foreigners.
National Guard servicemembers a normally dispatched for 2 to 3 weeks at a time. However, some say this mission could last over a year, which means soldiers will have to be rotated.
A year-long mission with rotating soldiers means more manpower and money will be necessary for successful completion. The service could cost the state up to $144 million dollars or more, according to KVUE.
President Barack Obama's nominee for secretary of the Department of Veterans Affairs attended a confirmation hearing recently where he promised several organizational and leadership changes to the VA. If elected, McDonald promised changes such as quarterly video conferences with regional VA officials, new review boards to measure the effectiveness of health care delivery, a focused approach on digital record keeping and a publicized invitation to whistleblowers to help spur change in the department, according to Military Times.
Inheriting a broken department
Ultimately, McDonald was well received by Senate VA committee officials, who said they would endorse him, The Wall Street Journal reported. However, lawmakers were skeptical about why McDonald would want to take charge of the broken and mismanaged VA.
"You are about to take over a bankrupt corporation," said Sen. Richard Blumenthal, according to the Journal. "The real insolvency is in morale and management."
Senators were blunt about the struggles facing the VA. In the hearing they mentioned problems with data manipulation, whistleblower retaliation, longstanding appointment delays, corruption, insufficient staffing and funds and a flurry of other problems. Many were confused as to why anyone would accept responsibility over an organization fraught with such obstacles.
McDonald, a West Point graduate and veteran himself, called the position a fulfilling responsibility.
"I desperately want this job because I think I can make a difference," McDonald said, according to the Journal. "For me, taking care of veterans is personal. I come from—and deeply care for—military families."
In further remarks, McDonald expressed optimism in changing the VA, and was enthusiastic about his ability to handle the challenge.
"There is a lot of work to do to transform the department and it will not be easy, but it is essential and can be achieved," McDonald said, according to Military Times. "I think I can make a difference … I think this is an opportunity to make a difference in the lives of veterans."
The road ahead
In a greater move for transparency, McDonald suggested sharing his cellphone number with the senators, opening the lines of communication between them. However, the nominee for VA expressed that this would not be a one-way street.
"When I give you my cell phone number, I want yours at the same time," McDonald said, according to the Journal.
Now, after receiving strong support from the senators at the confirmation hearing, McDonald may be voted to head the VA as early as next week. Sen. Bernie Sanders expects a full Senate vote before lawmakers take their summer break Aug. 2, according to Military Times.
Vice President Joe Biden pressed Congress to vote in favor of President Barack Obama's candidate for the role of Department of Veterans Affairs Secretary and discussed the future of U.S. operations in Iraq and Afghanistan this week. However, the vice president made another more optimistic announcement for veterans recently, too. Biden unveiled a White House initiative aimed at decreasing veteran unemployment and resupplying the nation with qualified technology specialists. A new tech jobs training initiative will specialize in veteran-specific training and placement efforts, according to Military Times.
The future of the job market for veterans
At the Veterans of Foreign Wars annual convention, Biden discussed some of the details of the new high-tech training initiative, but told veterans that the fully detailed plan would be made public July 22. This job training effort comes after a month-long review by the vice president regarding how to make high-skill training options available to all U.S. citizens. According to Military Times, the study found a 1.4 million-job void in the technology jobs sector that will be filled by American businesses over the course of five years.
Reducing the amount of outsourced jobs
During the convention, Biden also discussed the training difficulties the U.S. has faced and how it has lured a wave of foreign workers to the nation.
"Ask yourself the rhetorical question: Why do we need to issue 480,000 to 500,000 [immigrant] visas — which I welcome — to come to the United States to fill high-tech jobs that range from $70,000 a year to $168,000 a year in high-tech industries?" Biden said, according to Military Times. "It's because we don't have enough qualified people here at home."
According to the U.S. Bureau of Labor Statistics, veterans have an unemployment rate slightly above the national average. The BLS also reports that some of the youngest veterans – veterans ages 18 to 24 – have the highest rate of unemployment, 24.3 percent, compared to civilians within the same age group, 15.8 percent.
In a recent demo at a Fort Hood training area, the U.S. Army Tank and Automotive Research, Development and Engineering Center unveiled the latest technology in unmanned military vehicles, according to a press release on the group's website.
During the demonstration, two driverless vehicles worked through training ground streets covered with obstacles and oncoming traffic to effectively work with another manned vehicle within a convoy. At the same time, the vehicles followed the rules of the road, avoided pedestrians and managed to change routes several times to showcase the technology's decision-making capabilities and precision. Exhibiting advanced autonomous features, the new technology could present a future method of keeping soldiers out of dangerous locations while completing supply missions and other tasks.
Unmanned vehicles make a debut in the near future
Although the technology is still in testing phases, TARDEC is well on its way to producing independent unmanned vehicles on schedule. The group has set a national date to release a series of driverless vehicles as part of the Autonomous Mobility Appliqué System. That equipment is set to be introduced in 2025, according to Military Times. However, TARDEC Director Paul Rogers believes the driver assist technology could be released for military personnel by next year, and that vehicles could be traveling without soldiers behind the wheel within three years.
The technology still needs a lot of work before it can make a debut on the battlefield. According to Military Times, the equipment uses advanced radar and lidar systems to pinpoint oncoming traffic, and obstacles and read the surface of the road and painted lines. Using a pre-programmed system, coordinates can be punched in and a specific route can be followed by the vehicles, or they can be programmed to follow other manned vehicles within a convoy.
In a controlled environment, the systems work very well, but the unmanned vehicles are unready for other areas.
"In a military or unstructured environment, the challenge becomes much more significant," Rogers said, according to Military Times. "We're looking at how to make our systems robust so that they're able to operate in more of these unstructured environments."
Reportedly the vehicles cannot complete more complicated street maneuvers and have not fully passed exercises that require backing up or K-turns, but the technology's developers remain optimistic.
"We are very happy with the results, but the AMAS must undergo more testing before it becomes deployable," Bernard Theisen, TARDEC's lead AMAS engineer, said on the group's website.
Keeping soldiers out of harm's way but still in the field
According to TARDEC officials, the aim of the AMAS is not to replace soldiers. Instead, allowing the vehicles to operate themselves will give soldiers more leeway to work in a defensive capacity in convoys or to complete other tasks while in route to destinations. The system is intended to increase the capability of the vehicles and allow soldiers to retain more situational awareness or operate from a safer distance in particularly dangerous locations. Additionally, taking soldiers out of particular vehicles can help reduce vehicle weight by stripping vehicles of armor, allowing for greater mobility. Ultimately, equipping convoys with unmanned vehicles could drastically improve the performance and effectiveness of soldiers.
A new study, which appears in JAMA Surgery, is showing that a relatively new method of combat care could be saving soldiers' lives. It's called Damage Control Resuscitation. This method of servicemember care is intended to optimize wounded soldier outcomes by reducing blood loss and increasing tissue oxygenation, according to an infographic released by the JR Army Med Corps, and it encompasses an eight-step process after a soldier is wounded in the field:
- Novel hemostatics reduce blood loss and dress wounds
- Battlefield Advanced Trauma Life Support or emergency on-site surgery is provided to buy time to move servicemembers to the next level of care
- Enhanced Medical Emergency Response Teams composed of four-practitioners provide advanced interventions while the soldier is rapidly transported
- The wounded soldier goes through consultant based resuscitation at a nearby hospital or field hospital
- Hemostatic resuscitation – restoring and sustaining normal tissue blood flow – is pursued
- Physicians run bedside diagnostics
- Damage control surgery is performed
- An intensive therapy/treatment unit or Critical Care Air Support Team is dispatched for ongoing treatment or transport
This system brings wounded soldiers from the point of wounding and battlefield care to hospitals. According to Military Times, JAMA Surgery researchers are calling DCR "one of the most important medical breakthroughs of our current conflicts."
A silver lining
Unfortunately, the tremendous improvement in battlefield care has brought surviving soldiers to hospitals, which may have pushed in-hospital deaths of Iraq and Afghanistan soldiers to reach historic heights. To put it into perspective, the amount of servicemember deaths in Iraq and Afghanistan has been very low. However, DCR services provide such speedy evacuations and effective care that critically wounded soldiers make it to hospitals but succumb to their wounds despite the efforts.
Many believe that more soldiers would have died of their wounds without the DCR treatment. In fact, Military Times reports that JAMA Surgery author Nicholas Langan attributes many of the deaths to head injuries, not hemorrhaging or blood loss. Such an assessment suggests that DCR is improving survivability for troops.
Helping enhance in-hospital outcomes
Moving wounded troops to hospitals faster and in better condition increases their chances of survival. Now, researchers must make determining how to improve emergency room outcomes a priority. JAMA Surgery officials think there is a possibility of saving a great deal of patients by giving in-hospital care more attention.
"There appears to be a significant potential for salvage in up to 50 percent of patients who die of wounds at a military treatment facility," Langan wrote in the study, according to Military Times.
Nonetheless, there is wide agreement that DCR efforts have vastly improved wounded soldiers' outcomes since the procedure's adoption in 2006. Of the 57,179 troops wounded in Iraq and Afghanistan only 4.5 percent have died due to their injuries. Of that amount, 80 percent died within 24 hours of arriving to a military treatment facility.
Moreover, many military medical professionals claim that this high attention to combat casualty outcomes could likely improve patient results in future wars. The Pentagon is working to chronicle all combat casualties in the Joint Trauma Registry, and the compiled data could lead to further medical breakthroughs.