Interview transcript

Terry Gerton You have spent a lot of time on the Hill lately talking to lawmakers about ways the VA could modernize access to care. Tell us both what your message is and what you’re hearing from the lawmakers.

Sean O’Connor Yeah. And maybe before that, Terry, just to touch on why we think this is so important or why personally it’s so important to me. And then thank you again for having us, and [I’m] looking forward to having this conversation today. So just at the start, I’m a third-generation veteran. Both my grandfathers fought and served in World War II, one in the Pacific, one in Europe. My father and my uncles all served during the during the Vietnam era. And I’m a 9/11 vet and served during nine eleven. So since the 1940s, my family has been, you know, leaning on and relying on the VA for all kinds of support and care. So, it’s a mission and it’s an institution that’s very important to me personally and very important to the fabric of our country. So, I think it’s no surprise the VA has struggled, you know, being in the early forefront of EHR … adoption to kind of being a laggard now in kind of EHR modernization. And there’s 9 million vets that really struggle to get access to timely care for some of the services they need as the VA works to modernize. So we’ve been spending a lot of time just talking to some of the leadership on the Hill around the momentum that seems to be building to try to modernize finally and kind of make access to care easier for veterans and and trying to make sure that as community care grows and the VA and veterans have more options to seek care both inside and outside the VA, that we really move the needle on reducing time to care and improving efficiency of care delivery for veterans. So that’s where we’re trying to, you know, spend time talking to the folks in SVAC and the Hill about, and learn about some of the strategies people are trying to implement when it comes to the Dole Act and some of the other things that people are trying to advance when it comes to improving access to care for veterans and really, we’re a small technology company that focuses on healthcare access. And we’re just, you know, trying to support improving access to care for veterans wherever and whenever we can because it’s a really important institution. It’s the largest health system in our country. And it’s probably one of the most outdated when it comes to the complexity of modernizing care for scheduling and finding appointments for veterans. And there’s a lot of things that I think we can do to help the VA as they work to improve some of those services.

Terry Gerton You’ve said that the VA was built for the last century and you’ve just mentioned the Electronic Health Record that the VA spent billions of dollars on and still doesn’t have an operational system. What would you recommend in terms of practice for modernizing some of those administrative functions of the VA?

Sean O’Connor Yeah, it’s complicated. So I’m not suggesting this isn’t complicated. It’s, the VA has gone through four different attempts to try to modernize and it’s still not successful yet in trying to get to the end goal of improving access to care for veterans and having a global view of care. So I think the first thing we’ve been talking to folks about is, today everything works in silos. And it’s tough to leverage the size and sophistication of the VA caregivers when everything’s in silos. And there’s close to 130 different VistA instances, a growing number of Oracle instances. And one of the leaders we talked to at the VA last time we were in D.C. said that the complexity of VA care delivery is beyond human comprehension. There’s how customized each of those VistA instances are. They’re all a unique Snowflake. They don’t talk to each other, they don’t share inventory. One of the VISNs we’re talking to now about a project, there’s roughly 10,000 appointments that go unutilized every month in his hospital because these different EHR instances don’t talk to each other. So one of the first things we’re talking about is, you know, trying to break down those data cells to bring all the supply and all the demand into one queue. And this is what we do for some of the other largest health systems in the country, Kaiser and other folks, where we take this global view of inventory and then you can use, you know, AI and some of these sophisticated navigation tools that have been built in the digital age of healthcare since the pandemic, to start to look at how you load balance that network a little more efficiently, how you share resources, how you improve internal utilization, improve efficiency, and reduce care gaps across boards. So I think until the VA finds a way through either a massive conversion to a centralized EHR or finding ways to work with technology entrepreneurs and vendors that can break down some of these data silos, they’ll continue to have the problem of trying to transition to a large EMR system in Oracle and through that process still have these 130 other systems and up to 24 different scheduling solutions that have been customized across the various VISNs, none of them working together, none of them sharing information across each other. So you have the largest health system in the country, 9 million veterans and their family members that we’re supposed to provide and care for, and none of this stuff talks to each other to share capacity, to share utilization, to share best practices. It’s a very fragmented, siloed and complicated environment. So until we find ways to break down those silos and share, leverage the power of tech and data to kind of level that playing field, it’s going to be very difficult to move anything in a substantial manner, we think.

Terry Gerton I’m speaking with Sean O’Connor. He’s a Navy veteran and co founder and chief strategy officer at DexCare. The VA is not the only federal agency that’s bad at a big bang tech deployment. So when you talk about an agency-wide solution that breaks down silos, anybody who’s been around for a while probably rolls their eyes at us. What would intermediate sorts of technology be that could provide some solution while an agency-wide solution is underway?

Sean O’Connor Yeah, we’ve been a big proponent in working with other really large healthcare systems in the country and doing, you know, scalable, strategically thought-out proof of concepts and smaller fragments first and then learning and scaling and iterating and adopting quickly. So I think one of the things the VA has for it is it does have the VISN network and the ability to kind of do proof of concepts in some of these smaller regional health systems, learn, iterate and adopt and then look to scale from there. We think that’s the best way to do this stuff. That’s how we’ve done it with Kaiser and some of these other really large healthcare systems. You do smaller proof of concepts, you learn the integration points that are important to move the needle. You begin with the end in mind and understanding the success metrics that are going to be important to drive this. And then you learn, iterate and scale quickly from there with bottom-down and top-down support is the only way to kind of move these things. And at the same time, being very conscious of the providers as well. So all of the technology companies we’ve built, we built inside of large healthcare systems. And often cases, technology is only 50% of the problem. Understanding the provider and the change management and the amount of pressure that those folks are under to provide care, and not being disruptive to their workflows and making their lives less efficient. You have to be very thoughtful about that, or none of the stuff is going to go anywhere. You can’t just have tech for tech’s sake. It has to understand the provider world and how the provider interacts. And you have to be very purposeful in how you build these things out to scale from the bottom up over time.

Terry Gerton One of the big points that you’ve emphasized is real time access to care, especially for mental health services and especially in rural communities. Those are two big complicating aspects of the VA’s network. How can the VA think about addressing those kinds of issues? Is it a technology solution? Is it a culture solution? How do they get on to real time care, especially in mental health?

Sean O’Connor I think it’s both. And I think the hard part is it’s probably more culture than technology. But it’s a — I don’t know of a bigger issue for us to kind of rally around as a community to try to improve access care of veterans than this. So when I transitioned from the service in 2004, the VA received roughly $21 billion to support its mission, and 17 men and women took their life every day to suicide: friends, brothers, sisters, husbands, wives. Fast forward to 2024, the VA received $121 billion to support its mission, and that number is still the same. Roughly 17 men and women, brothers, sisters, mothers, daughters took their lives to suicide. We’ve lost more people to suicide in the last 20 years than we did in, you know, during the 9/11 era and supporting the 9/11 kind of ground-on combat. So it’s it’s a crisis that’s not talked about. We haven’t really moved the needle on it despite spending over $100 billion more to support the healthcare delivery mission of the VA. So it’s clearly not just a technology issue, but not having — going back to your first question, Terry — not having the ability to share resources across the network and reduce time to care and make it easier for vets to find and get into the services initially is a problem. I won’t say that’s the biggest problem, but it certainly doesn’t help. So … mental health services in the veteran community is a really complicated issue … It’s not just about having access to cares. You know, a big portion of people that need the care aren’t even enrolled in the VA, and then there’s a homeless population that’s not enrolled in the VA. And how do you how do you outreach and bring those folks in that need the help the most? So it’s a complicated issue, but not being able to have one 24/7-365 on-demand network that shares capacity across mental health services for the VA is an issue as well. And the technology issues are easier to address. We just got to have people that are willing to address them. The cultural issues and the stigmatism around, you know, raising your hand for help is a harder issue to address, but it’s just something we gotta continue to talk about because it’s a travesty that in over 20 years, that number really hasn’t moved, despite putting, you know, literally over $100 billion more at the overall global healthcare issue.

Terry Gerton Well you talked about capacity there and certainly building out the community network of care is a big issue and a big initiative for VA. Are there issues on the community participant side of this so, that community care providers don’t understand the VA as much as the VA doesn’t understand community care providers?

Sean O’Connor We’re going to run out of time on your podcast. Yes, so that’s to me like, you know, obviously selfishly, like, we want to help the VA as a technology company, but the importance of improving access to care for veterans is at the heart of everything that we’re trying to do here. So the beauty of the VA to me — I mention I’m a third-generation veteran, it is a unique community. So when I when I first got out of the military, I moved to Seattle, like, it was a tough transition going from the military to the corporate world. I didn’t know anybody up here. My family and I grew up in Jersey, all my family was on the East Coast. I would literally just go to the Seattle VA and hang out in the lobby and just talk to people that you know had their Vietnam hat on. It’s a community and a culture that you know, should be protected in this institution, in this country. And some of the caregivers, you know, we’re talking about the technology piece here. These are some of the most mission-driven caregivers in the world. Like, they can make more money outside the VA. They choose to work with this community and this provider network for a reason. So there is an understanding of that that I think we need to protect because there is an understanding of someone that’s come back from deployment and has been through some serious high optempo stuff that comes back, and you just get a different conversation with your primary care provider in the VA than somebody outside the VA. So I think there’s that element that we have to protect. But there’s also the element, frankly, that you know, as a veteran, I like the option to have choice to go outside the VA for services that they may not be expert in. So certainly, you know, wound care, PTSD, that stuff, I think should stay in the VA. But maybe, you know, I’m a former athlete and tore my knee up and can get into an ortho appointment outside the VA. I want to have that optionality. And some stuff like that, the history isn’t as important to the veteran for some of those conditions. So, to have the optionality to go out there and do that is important. But what we’re seeing, at least for some of the areas that we work with is the community providers, one, they don’t have a lot of excess capacity to share with the VA. Every health system is stretched to the gill. Like there’s not a ton of health systems raising hands saying, hey, we have providers sitting on their hands. It’s six to eight months to get into an ortho appointment in some of these large health systems as it is. So to have that capacity to share with the VA, one, is difficult. Some of those things I think are bigger deals than others to your point of, you know, should there be a continuum to care in the VA? I’d argue some services is, just do it in the VA and some are easily, you know, sourced out. And then there’s the whole issue of, when they’re sourced out, how do you manage the care gaps for the veteran? How do we close some of those care gaps as those services continue to rise and the disparate records continue to grow across the network?

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The Department of Veterans Affairs is moving toward a more operational approach to cybersecurity.

This means VA is applying a deeper focus on protecting the attack surfaces and closing off threat vectors that put veterans’ data at risk.

Eddie Pool, the acting principal assistant secretary for information and technology and acting principal deputy chief information officer at VA, said the agency is changing its cybersecurity posture to reflect a cyber dominance approach.

“That’s a move away from the traditional and an exclusively compliance based approach to cybersecurity, where we put a lot of our time resources investments in compliance based activities,” Pool said on Ask the CIO. “For example, did someone check the box on a form? Did someone file something in the right place? We’re really moving a lot of our focus over to the risk-based approach to security, pushing things like zero trust architecture, micro segmentation of our networks and really doing things that are more focused on the operational landscape. We are more focused on protecting those attack surfaces and closing off those threat vectors in the cyber space.”

A big part of this move to cyber dominance is applying the concepts that make up a zero trust architecture like micro segmentation and identity and access management.

Pool said as VA modernizes its underlying technology infrastructure, it will “bake in” these zero trust capabilities.

“Over the next several years, you’re going to see that naturally evolve in terms of where we are in the maturity model path. Our approach here is not necessarily to try to map to a model. It’s really to rationalize what are the highest value opportunities that those models bring, and then we prioritize on those activities first,” he said. “We’re not pursuing it in a linear fashion. We are taking parts and pieces and what makes the most sense for the biggest thing for our buck right now, that’s where we’re putting our energy and effort.”

One of those areas that VA is focused on is rationalizing the number of tools and technologies it’s using across the department. Pool said the goal is to get down to a specific set instead of having the “31 flavors” approach.

“We’re going to try to make it where you can have any flavor you want so long as it’s chocolate. We are trying to get that standardized across the department,” he said. “That gives us the opportunity from a sustainment perspective that we can focus the majority of our resources on those enterprise standardized capabilities. From a security perspective, it’s a far less threat landscape to have to worry about having 100 things versus having two or three things.”

The business process reengineering priority

Pool added that redundancy remains a key factor in the security and tool rationalization effort. He said VA will continue to have a diversity of products in its IT investment portfolios.

“Where we are at is we are looking at how do we build that future state architecture, as elegantly and simplistically as possible so that we can manage it more effectively, they can protect it more securely,” he said.

In addition to standardizing on technology and cyber tools and technologies, Pool said VA is bringing the same approach to business processes for enterprisewide services.

He said over the years, VA has built up a laundry list of legacy technology all with different versions and requirements to maintain.

“We’ve done a lot over the years in the Office of Information and Technology to really standardize on our technology platforms. Now it’s time to leverage that, to really bring standard processes to the business,” he said. “What that does is that really does help us continue to put the veteran at the center of everything that we do, and it gives a very predictable, very repeatable process and expectation for veterans across the country, so that you don’t have different experiences based on where you live or where you’re getting your health care and from what part of the organization.”

Part of the standardization effort is that VA will expand its use of automation, particularly in processing of veterans claims.

Pool said the goal is to take more advantage of the agency’s data and use artificial intelligence to accelerate claims processing.

“The richness of the data and the standardization of our data that we’re looking at and how we can eliminate as many steps in these processes as we can, where we have data to make decisions, or we can automate a lot of things that would completely eliminate what would be a paper process that is our focus,” Pool said. “We’re trying to streamline IT to the point that it’s as fast and as efficient, secure and accurate as possible from a VA processing perspective, and in turn, it’s going to bring a decision back to the veteran a lot faster, and a decision that’s ready to go on to the next step in the process.”

Many of these updates already are having an impact on VA’s business processes. The agency said that it set a new record for the number of disability and pension claims processed in a single year, more than 3 million. That beat its record set in 2024 by more than 500,000.

“We’re driving benefit outcomes. We’re driving technology outcomes. From my perspective, everything that we do here, every product, service capability that the department provides the veteran community, it’s all enabled through technology. So technology is the underpinning infrastructure, backbone to make all things happen, or where all things can fail,” Pool said. “First, on the internal side, it’s about making sure that those infrastructure components are modernized. Everything’s hardened. We have a reliable, highly available infrastructure to deliver those services. Then at the application level, at the actual point of delivery, IT is involved in every aspect of every challenge in the department, to again, bring the best technology experts to the table and look at how can we leverage the best technologies to simplify the business processes, whether that’s claims automation, getting veterans their mileage reimbursement earlier or by automating processes to increase the efficacy of the outcomes that we deliver, and just simplify how the veterans consume the services of VA. That’s the only reason why we exist here, is to be that enabling partner to the business to make these things happen.”

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Interview transcript:

 

Elizabeth Curda The disability exam process is an important component in the decisions that VA has to make about a veteran’s claim for disability. So for example, if a veteran was injured during their service in Iraq and they have ongoing hearing problems, but they don’t have medical records to substantiate that, they might be asked to do a medical disability exam to establish that they have that condition and it’s connected to their service.

Terry Gerton How much does the VA spend on this, and do they do it all in house?

Elizabeth Curda It’s a very costly program. It used to be done within the VHA hospital systems, Veterans Health Administration, but in recent years they have shifted most of the work to contractors. And VA spends about $5 billion, that was the expenditure in 2024, and the contractors do over 90% of all the disability exams.

Terry Gerton So as GAO got into this report, what motivated you to start it and what did you find?

Elizabeth Curda Well, we had a request from the chairman of the House VA Committee’s subcommittee on disability and memorial affairs, Chairman Luttrell, to look at the quality of these exams. When you have a contractor performing a function for the government, your toolbox in terms of keeping that contractor accountable — you have to be able to assure you have oversight over the quality of the work that they’re doing, in addition to things like timeliness. And so they wanted to know, what is VA doing to oversee the quality of these exams? We took a comprehensive look at all aspects of their oversight, and we found that overall they had a lot of processes in place for oversight in areas such as preventing errors, detecting errors that occur, and correcting them after the fact. So a lot going on, but we did find some areas for improvement and made recommendations.

Terry Gerton I can imagine that the distribution of contracted providers for this service is nationwide, so that oversight is especially critical in helping to ensure that a veteran in Indiana has a similar experience and quality as a veteran in Texas or California. What were the sorts of challenges that you discovered?

Elizabeth Curda Well, we made five recommendations that cut across three broad areas. And those broad areas were, as we found, breakdowns in some of their procedures for identifying and correcting the most frequent or complex issues with exams. We found issues with financial incentive payments that they make to the contractors. We found errors that resulted in overpayments. And we also saw a gap in an important source of feedback, which is the examiners themselves. VA gets feedback from all different parties: the contracting companies, the veterans, but they didn’t have any way to get direct feedback from examiners who are doing the day-to-day work.

Terry Gerton The part of VA that administers this is the Veterans Benefit Administration, not the health administration portion of VA, is that correct?

Elizabeth Curda Yes.

Terry Gerton And so VBA not only manages these exams but also the full disability determination requirement. They must be stretched pretty thin.

Elizabeth Curda That is correct. We have been reporting for years that they are in our high-risk list for managing their workloads. And that is basically the influx of claims and being able to handle those on a timely basis. So yes, they have been historically stretched pretty thin.

Terry Gerton I’m speaking with Elizabeth Curda. She’s a director in the education workforce and income security team at GAO. So Elizabeth, then tell us more about the recommendations that you made particularly.

Elizabeth Curda We made recommendations over two years. Our initial report on this was last September in a hearing, and we had a recommendation for a process that VBA conducts in which they feed to the contractors on a quarterly basis the most frequent errors. The contractors are required on a quarterly basis to write a report to VA on what they’re going to do to correct those errors. Now we found that VA did not have complete and effective practices for how to review these reports. So the quality review people would get these reports back from the contractors, and then everyone would write a little summary based on sort of what they thought they should be doing. But there wasn’t any procedure for, what should they be looking for in these reports? And the two things that we found that were missing were nobody checks to see if the contractors go back and actually do these actions. So there’s no checking to see if the contractors are fixing things. And there’s no effort to determine if those actions were effective or not. Are they seeing the errors go down? What’s the outcome of all this work? So that was one area.

Terry Gerton It sounds like that might be an opportunity to deploy AI. If you’re getting all of these reports in, maybe an AI reviewer could help streamline those and tell you about trends and where to follow up.

Elizabeth Curda Well that is another topic because that is very complex. And VA is really, I mean, we’ve discussed some of their efforts with AI and it’s really kind of at its very beginnings. But yes, potentially.

Terry Gerton And so what was the second recommendation?

Elizabeth Curda The second area also had to do with oversight of exams and it has to do with what they call “special focus reviews.” And these are three areas where they’re very complex and they tend to have a high error rate. It’s traumatic brain injury, military sexual trauma, and Gulf War illness. So they had a procedure to do these every two years. And they had done one round of the reviews, but they were late — over a year late — doing another round of reviews. And so we recommended that they basically do the second round of reviews on schedule. We subsequently, in the course of our work, learned that their staff have been cut by about 50% of the folks who were doing this particular function. And so they said in response to us that they will be switching to a three-year cycle, which in our view was, it’s better than no years. But we think the two-year cycle would be ultimately better because then you identify things that are working or not working and can take corrective action sooner. They also have begun negotiations on their new contracts for these contractors, which are long term, you know, they were multi-years, and things that they’re finding from these special focus reviews could be built into those contracts. But only if they’re done in a timely manner.

Terry Gerton Did you get any feedback from the providers themselves about how this process was working?

Elizabeth Curda We checked in with the people who do the disability exams, we call them the examiners, and we randomly selected examiners to talk to. And what we found is universally they felt they wanted opportunities to provide feedback about the exam process directly to VBA. Currently the process is, because they work for a contractor, all that feedback would go through the contractor up to VBA. And VBA basically told us, “we get all that feedback, the contractor gives us feedback.” But what we heard from the examiners is, you know, they don’t always feel they’re being listened to, they don’t always have their problems addressed, and they also sometimes get conflicting information if they work for more than one contractor. Different contractors will tell them to do things differently, and they don’t think that both can be right. But they have a hard time resolving these things themselves.

Terry Gerton So better communication, more checking. What else was on the list?

Elizabeth Curda The last area had to do with these financial incentive payments. The way VBA incentivizes good performance is they have these three areas: quality, timeliness, and customer satisfaction. And they measure, for each of the contractors, how well they do in those dimensions. And they feed that into a formula that will produce a bonus payment to contractors that score particularly well and penalties for those that are not meeting basic thresholds. And what we found was the way they calculate these is on a spreadsheet with a lot of manual data entry, and they were doing manual calculations as well. And there wasn’t a procedure in place to double-check the numbers, the data entry. They were doing some checking, but it wasn’t formalized. And so when we reviewed the numbers, we found that VBA had caught some of its errors on its own, but we found some that they hadn’t caught. And it was about $2.3 million worth of errors — bonuses that went out to contractors that did not earn them. And that really just sends … it’s the wrong message. You’re getting paid and you didn’t actually earn it.

Terry Gerton Exactly. How has VBA responded to your findings and recommendations?

Elizabeth Curda VBA agreed, or they use the term agree in principle when they sort of agreed, with all the recommendations. They actually have reported that they’re taking action on all of them, and some I think are very close to being implemented, such as the one on financial incentives. They told us there was a hearing on this last week, and they said that they actually have gotten the money back from the contractor and they are putting in place these new procedures. We just haven’t seen that documentation yet. But you know, when we do we’ll evaluate whether we can close that one or not. But all of them are sort of in the works, you know, in various stages of completion.

Terry Gerton So will you be following up with VBA to check how they’re doing?

Elizabeth Curda Oh, certainly. And we always follow up on our recommendations at least annually, but sometimes more than that, just depending on when they have updates for us.

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Interview transcript

Terry Gerton I want to start with a big picture question because the last few months of downsizing in the federal workforce and the ramifications that has had on contractor workforces have really had a significant impact on military veterans and military spouses. Can you help us understand why those groups are so vulnerable in those particular sectors to downsizing.

Dan Clare Absolutely. I mean, veterans comprise a large percentage of the federal workforce. There is some preference given to disabled veterans, veterans who have certain decorations from their service if they’ve been on campaigns and things like that. And there are federal set-asides as well for government contractors. There’s a lot of disabled veterans, particularly, who are working for the federal government. And those folks, some of them faced a fork in the road — some of them have been furloughed for a long period of time, some of them are looking for different career opportunities now that the government doesn’t seem maybe as steady as it used to be. So we’re hearing from a lot of veterans who [are] just looking at other opportunities, basically. And some of them have been without work for a good while. So we are helping them out. And then on the contracting side, both as employees and as business owners, veterans are disproportionately affected by interruptions in contracts, by government shutdowns, all those sorts of things.

Terry Gerton And the federal government had a special hiring authority for military spouses, correct?

Dan Clare It’s a great question because military spouses are always disadvantaged, they’re always sacrificing for our country alongside their loved one, whether that be a man or woman. And those folks, the portability of their careers is very important to them. So for them, having opportunities in employment, having opportunities to have a business that they can take with them as they go along their journey, those are both very important things for them.

Terry Gerton How is DAV engaged in the veteran employment space? That might not be the first place that folks would expect the Disabled American Veterans Group to be involved.

Dan Clare You would think, but you know going back a hundred years — DAV has been around for a long time — that was one of the original issues that we faced from World War I veterans coming home. Veterans who are changed as a result of their service — they’re at a disadvantage sometimes when they’re looking for jobs, so … we’ve always advocated for employment opportunities, program services for veterans, but this is a chance for us to connect veterans directly with employers who want to hire them, who recognize the unique skills and talents that they bring. So we’re so proud as an organization to be able to partner with these employers who recognize that value and they’re making it a serious effort to hire and retain veterans.

Terry Gerton What are some of the lessons you’re learning through that involvement about today’s employment market? What are big opportunities? What are employers looking for and how do veterans fit in?

Dan Clare Well, I think one of the things we tell veterans frequently is that you’re in military service and you might have a job specialty or an occupational specialty that doesn’t seem like it translates particularly well to civilian life. Some do. You know, if you’re a firefighter in the military, being a firefighter or a crash rescue guy on the civilian side lines up pretty nice. But we find that there are a lot of soft skills and real talent and job experiences that veterans have that help them out a lot. So we’re talking to all industries right now when we’re talking about our employers. And there are so many different positions that they offer and so many different talents that veterans bring. I mean, people think about maintenance, aircraft maintenance, they think about logistics, but there’s great management opportunities. There’s people who’ve worked with budgets in an operational environment. There’s all kinds of different reasons why veterans are uniquely suited to be resilient as job searchers.

Terry Gerton I’m speaking with Dan Clare. He’s chief communications and outreach officer at the Disabled American Veterans. Dan, DAV is hosting a nationwide virtual job fair next week. Tell us about that.

Dan Clare It’s a virtual career fair. These are awesome events. You’re going to find some great opportunities there. We have AT&T, Department of Energy, Wells Fargo, Border Patrol, Discount Tire. Those are some of the top level companies who we think of, you know, they have names that are pretty recognizable to most of us, but there are a lot of other employers who are gonna be there. And as a veteran or spouse who is looking for a job, you might think, well, I’m not gonna work in the waste management industry because I’m disabled and for me, hiking trash cans isn’t gonna be a career for me. But you have to recognize that all of those companies have different opportunities and different positions within them that might be a perfect fit for a veteran’s experiences so far.

Terry Gerton What helpful hints would you have for veterans and military spouses who are interested in participating? How can they best prepare?

Dan Clare Well, I mean, having a good resume is very important. If you’re going in advance and looking at the job fair, there’s a page there. You can look at the types of positions that are out there and kind of earmark some opportunities specifically. And if you can, you can then tailor a resume a little bit more towards what the requirements are of that position. So those are important things. Veterans know how to dress nice, fortunately. So we have that going for us. You should look great going into it. And then developing a little bit of a pitch for yourself, an elevator pitch, where you say, this is who I am, this is what I’m about professionally, this is the kind of opportunity that I’m looking for, and this is what I hope to do through that opportunity for the company I work for … That’s some of the advice that we’re giving veterans to prepare.

Terry Gerton And not every veteran wants to work for someone else. Many of them want to start their own business. And DAV has a program, the Patriot Boot Camp, to help veterans understand how to start a business. Tell us about that.

Dan Clare It’s an incredible program. It’s cohort based, it’s two and a half days of very intensive training … you’re going be able to talk and interact with people about funding, which is one of the biggest, biggest shortfalls for veterans as entrepreneurs. We’re gonna talk about team building, sales, marketing, branding, and you’re gonna get mentorship. You’re going to get about four hours of mentorship with CEO-level professionals who can help you and they’re driven because they wanna help you avoid making the mistakes that they might have made earlier in their careers. And these people will fly across the country to be there with us. Our next event is Feb. 11 through 13 in Myrtle Beach. And I encourage people to travel for these events because sometimes as an entrepreneur, when you’re closer to home, it’s impossible to avoid some of the details and things that you need to work on for your venture. So Feb. 11th through 13, this is a free opportunity. And we want to get as many veteran entrepreneurs and spouses involved as possible.

Terry Gerton Do you give folks a real taste of the challenges of entrepreneurship? I mean, it’s not the easiest way to move forward.

Dan Clare No, it’s extremely risky. By definition, being an entrepreneur is being a risk-taker, and we recognize that. And we recognize, too, not all these ventures are going to succeed. But the veterans having the experience, getting involved — we find they’re naturally resilient, they’re creative. They’re good at strategy, good at planning. There are just some areas every veteran entrepreneur seems to have where they’re an A+ across the board. And then when it comes to marketing or sales, maybe they’re a D-. So we can address that there. And also they walk away with the community. Each cohort is its own network. And that includes all of the mentors who participate. So we’re really excited. What this does to transform a veteran’s life and make them someone who hires people is extremely exciting for us. And we’re always looking for mentors, always looking for veterans who want to get involved. And it’s extremely meaningful to be involved with.

Terry Gerton What message do you have for employers or business leaders who want to get involved from the hiring side in these activities?

Dan Clare I mean, it’s accessible to you too. Hiring veterans, the people who come to these career fairs, we have them there all the time. Tons of veterans coming through all the times. They tell us that the value is there. The reason why they’re there isn’t — I mean yes, they wanna do the right thing, they’re patriotic, they believe it’s right thing for America to hire veterans — but they’re also making a good deal. They’re finding people who are already trained or trainable. They’re finding people who are disciplined, who show up on time. They find people who’re great team workers and abnormally loyal to companies and institutions that they get involved with. I mean, it makes good business sense for you to hire veterans. If you visit our website, jobs.dav.org, we have an employer resource there where you can kind of validate that decision or make that decision if you want. We have a recognition program called the Patriot Employers Program. That you can access where we’re actually going to help you recruit because you’re going to be able to show veterans with a digital seal that it’s something that you’re focused on. So there are a lot of great ways to get involved. Hiring veterans is good for you and it’s good for our country.

Terry Gerton For veterans and military spouses who might be interested in participating either in the job fair or in the Patriot Boot Camp, where do they go to find out more?

Dan Clare You can find more at jobs.dav.org. There’s all kinds of stuff on there, so check it out. You can hear about success stories, hear about things that are working for other folks, and just visit us … Nov. 25, that virtual career fair could change someone’s life, so we wanna get as many people involved as possible.

The post Two big opportunities are on the horizon for veterans: one to land a job, another to launch a business first appeared on Federal News Network.

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From border security to veteran care, federal agencies are transforming how they serve the public — with AI, cloud platforms and human-centered design leading the way.

Explore how leaders from CBP, DoD, USPS and VA are driving innovation, improving trust and putting people at the center of every mission.

You’ll hear from:

• Barbara Morton, VA
• Janet Pence, CBP
• Bill Tinston, FEHRM Office
• Ken Gonzalez, Verizon

Read the full Federal News Network Executive Briefing and see how tech is powering better experiences for employees and citizens alike.

The post How CBP, DoD, USPS and VA transform services through human-centered design first appeared on Federal News Network.

© Federal News Network

• The Department of Veterans Affairs said it’s helping a record number of homeless veterans find permanent housing. The VA said it assisted nearly 52,000 formerly homeless veterans with housing in fiscal 2025. That’s more than any previous year tracked by the department. The VA provides subsidies to help some veterans afford rent on houses or apartments. In other cases, it helps reunite homeless veterans with family or friends.
  (VA houses largest number of homeless veterans in seven years - Department of Veterans Affairs)
• A bipartisan push to extend a cybersecurity information sharing law may have a path forward in the Senate. A 10-year extension of the Cybersecurity Information Sharing Act of 2015 could be included in a future spending package. That’s according to Sens. Gary Peters (D-Mich.) and Mike Rounds (R-S.D.), the co-sponsors of the bill. Senate Homeland Security and Governmental Affairs Committee Chairman Rand Paul (R-Ky.) has been blocking their bill. But Peters and Rounds told the audience at the Aspen Institute Cyber Summit on Tuesday that the bill would have plenty of support if it can reach the Senate floor as part of a package. Congress included a short-term extension of the CISA 2015 law in the continuing resolution.
  (Aspen Institute Cyber Summit - Aspen Institute )
• The Army has selected nine installations as potential sites for microreactor power plants under its next-generation Janus nuclear power program. Meanwhile, the Defense Innovation Unit issued a solicitation for commercial advanced nuclear technologies to support the effort. The nine sites the Army identified through comprehensive analysis include Fort Bragg in North Carolina and Redstone Arsenal in Alabama. The Army said the final number and location for these microreactors will be determined as part of the acquisition process, but the service is committed to maximizing the number of sites.
  (Army selects nine installations for next-gen nuclear microreactors - U.S. Army)
• Army Secretary Daniel Driscoll instructed unit leaders to check in on their soldiers daily now through Jan. 15. In a memo to the force, Driscoll mandated every officer and noncommissioned officer to "deliberately" check in on every soldier to see if they need help. “The holidays can be a high-risk period for self-harm. We know it’s a problem, it happens every year, so we’ll address it head-on,” Driscoll said in the memo. The effort is based on initiatives like in the 11th Airborne Division in Alaska, where they “systemically prioritized soldier checks” to combat a high suicide rate.
  (Army secretary tells unit leaders to check in on soldiers daily now through Jan. 15 - Social media platform X)
• The Office of Personnel Management has kicked off another human resources IT modernization effort. OPM is reviewing responses to an RFI and meeting with vendors for how to modernize the USA Hire platform. Agencies use USA Hire to conduct assessments of applicants for jobs. In fiscal 2024, agencies used the program to assess approximately one million applicants for over 20,000 job opportunity announcements. OPM expects agency use to continue to grow, especially from TSA and ICE as they hire more employees. OPM plans to release a draft solicitation in January and a final request for proposals in October to modernize the USA Hire platform.
  (USA Hire added to list of federal HR systems slated for upgrades - Federal News Network)
• The Office of Personnel Management is close to finalizing its effort to strip job protections from tens of thousands of federal employees. OPM’s proposed regulations for the so-called “Schedule Policy/Career” classification have been moved into the “final rule stage,” according to the White House’s regulatory agenda. Those regulations are slated for possible finalization by the end of November. OPM’s final rule will impact career employees in “policy-influencing positions,” making them at-will and easier to fire.
  (Federal union sues OPM, seeking release of ‘Schedule Policy/Career’ records - Federal News Network)
• NASA is moving quickly to consolidate up to a quarter of its suburban Maryland campus. The International Federation of Professional and Technical Engineers said the NASA Goddard Space Flight Center in Greenbelt, Maryland, is embarking on plans to close 13 buildings on its campus. The union said NASA began work closing buildings and labs in late September and that this work continued through the government shutdown. The agency is looking to reduce 25% of the campus’s real estate by 2037.
  (NASA advances plan to shrink Goddard campus by 25% - Federal News Network)
• The General Services Administration continues to lower the price for access to AI tools. First it was $1, then it was 50 cents. Now for a quarter, agencies are able to buy artificial intelligence tools through the GSA schedule contract. Under a new deal signed with the GSA, Perplexity is offering its AI research and drafting capabilities for a mere 25 cents for the next 18 months. GSA said it structured the deal to make the software available directly from Perplexity through the GSA schedule. Previously, agencies could only access Perplexity through a reseller. This is the first OneGov agreement GSA signed that is directly with an original equipment manufacturer, or OEM.
  (GSA cuts cost for AI tool to 25 cents for next 18 months - General Services Administration)
• Agencies are likely to see an uptick in Freedom of Information Act delays and backlogs. That’s because agency FOIA offices were furloughed through the shutdown, but the law requires agencies to count normal working days during the shutdown as part of the FOIA processing time. That’s according to new Justice Department guidance to federal FOIA offices. DOJ said there were 29 days during the shutdown that will count toward FOIA requests and administrative appeals processing.
  (Calculating FOIA response times after 2025 government shutdown - Justice Dept. Office of Information Policy)
• The Trump administration’s cuts to the federal workforce are becoming more apparent across the country. Close to half of respondents in a nonprofit’s recent survey said they or someone they know have been personally affected by the government cuts. Six months ago, less than a third of respondents said the same. The new survey from the Partnership for Public Service also found that the impacts are disproportionately affecting younger adults.
  (The public is noticing the impact of the Trump administration’s cuts - Partnership for Public Service)

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A bipartisan bill that would end the Trump administration’s rollback of collective bargaining rights for most federal employees is guaranteed to get a full House vote, now that a majority of lawmakers support it.

As of Monday, 218 House lawmakers signed onto a discharge petition, forcing the House to vote on the Protect America’s Workforce Act.

The bill, led by Reps. Brian Fitzpatrick (R-Pa.) and Jared Golden (D-Maine) would restore collective bargaining rights for tens of thousands of federal employees, if approved by Congress.

President Donald Trump signed an executive order in March that barred unions from bargaining on behalf of federal employees at many agencies, on the grounds that those agencies work primarily in national security. In August, he signed another executive order that expanded the list of agencies barred from negotiations with federal employee unions.

Lawmakers estimate the executive order impacts about 67% of the federal workforce. The Trump administration’s policy has barred unions from representing employees at the departments of Defense, State, Veterans Affairs, Justice and Energy.

A group of six unions led by the American Federation of Government Employees sued the Trump administration over its rollback of collective bargaining rights, arguing that the administration has taken an overly broad view of agencies that work primarily in national security.

A federal judge blocked the administration from enforcing the executive order in April, but an appeals court stayed that decision this summer and allowed agencies to keep canceling collective bargaining agreements that cover broad swaths of the federal workforce. Since the appeals court’s ruling, several agencies have rescinded their collective bargaining rights with unions.

Reps. Mike Lawler (R-N.Y.) and Nick Lalota (R-N.Y.) contributed the last two signatures for the discharge petition on Monday. Lawler said in a statement that “restoring collective bargaining rights strengthens our federal workforce and helps deliver more effective, accountable service to the American people.”

“Every American deserves the right to have a voice in the workplace, including those who serve their country every single day. Supporting workers and ensuring good government are not opposing ideas. They go hand in hand,” Lawler said.

Everett Kelley, national president of the American Federation of Government Employees, applauded Republican lawmakers for supporting the bill, and called on the House to quickly vote on it.

“Collective bargaining gives employees a fundamental voice in making the government work better for the American people, and we thank Congressman Lawler for recognizing that America functions best when labor and management cooperate toward common goals,” Kelley said.

AFGE’s National VA Council recently filed a lawsuit challenging the VA’s selective enforcement of the administration’s executive order. The complaint states that VA Secretary Doug Collins scrapped collective bargaining agreements with unions opposed to the Trump administration’s federal workforce polices, but spared labor contracts for unions that represent VA police, security guards and firefighters.

Meanwhile, another bipartisan group of lawmakers is also leading a bill that would restore collective bargaining rights for VA employees. Sens. Richard Blumenthal (D-Conn.), Lisa Murkowski (R-Alaska), Chuck Schumer (D-N.Y.), and Rep. Delia Ramirez (D-Ill.) are leading that bill.

The National Treasury Employees Union, as well as the National Weather Service Employees Organization and the Patent Office Professional Association, are also suing the Trump administration over its collective bargaining rollback.  Federal courts in D.C. will hold proceedings in both cases next month.

The post House majority forces vote on bill to restore collective bargaining for most federal employees first appeared on Federal News Network.

© AP Photo/J. Scott Applewhite

Following the longest shutdown in U.S. history, the federal workforce is now trying to get back to at least some sense of normalcy.

While federal employees who have been furloughed for the last 43 days return to work Thursday, the Office of Personnel Management is setting expectations for agencies as they begin to update pay, leave and benefits for those impacted by the lapse in appropriations.

In new guidance, OPM said it is “is committed to ensuring that retroactive pay is provided as soon as possible.” Compensation will be provided for both furloughed and excepted federal employees, as the spending agreement that was enacted Wednesday evening reaffirmed. A 2019 law previously called for retroactive compensation for all federal employees impacted by a shutdown.

A senior Trump administration official said the White House “has urged agencies to get employee paychecks out expeditiously and accurately to not leave anyone waiting longer than necessary.”

But the timing of employees receiving their back pay varies, depending on what payroll provider an agency uses, and the different pay schedules across the federal workforce.

Sending out retroactive payments to employees involves working across agency HR offices, federal payroll providers and shared service centers. Agency HR offices, for instance, have to submit timecards for federal employees, which are then processed by the government’s various payroll providers.

According to the senior administration official, employees from the General Services Administration and OPM will be among the first to receive their retroactive paychecks, with an expected deposit date set for Saturday.

Employees at the departments of Veterans Affairs, Energy, and Health and Human Services, as well as civilian employees from the Defense Department, will receive their deposits shortly after that — this Sunday.

On Monday, affected employees from the departments of Education, State, Interior and Transportation, as well as the Environmental Protection Agency, National Science Foundation, Nuclear Regulatory Commission, Social Security Administration and NASA, are all expected to receive their back pay.

Then on Wednesday, employees from the departments of Agriculture, Commerce, Treasury, Labor and Justice, along with the Department of Homeland Security, the Department of Housing and Urban Development and the Small Business Administration, are projected to get their paychecks. The timing of the retroactive payments for feds was first reported by Semafor.

The National Finance Center, a payroll provider housed under the Agriculture Department, confirmed that employees at agencies using NFC’s services should expect a payroll deposit by the middle of next week.

“In order to provide backpay for employees as quickly as possible, the National Finance Center will be expediting pay processing for pay period 22 and backpay for pay periods 19 (October 1-4), 20 (October 5-18), and 21 (October 19-November 1),” USDA wrote in an all-staff email Wednesday evening, obtained by Federal News Network.

Federal News Network has reached out to several other federal payroll providers requesting details on the timeline for processing retroactive payments.

The National Treasury Employees Union urged immediate back pay for all federal employees who have been going without compensation for the last six weeks.

“This is an emergency for federal employees across the country, and they should not have to wait another minute longer for the paychecks they lost during the longest government shutdown in history,” NTEU National President Doreen Greenwald said. “We call on all federal agencies to process the back pay immediately.”

In its new guidance, OPM also noted that to make payments as quickly as possible, payroll providers may need to “make some adjustments.” That could mean, for instance, that the initial retroactive payments employees receive might not reflect the exact calculations of their pay and leave hours.

“Payroll providers will work with agencies to make any necessary adjustments as soon as practicable,” OPM said.

Who receives back pay, and how much?

Furloughed employees will receive their “standard rate of pay” for the hours they would have worked if the government shutdown hadn’t occurred, OPM said in its guidance Wednesday evening.

But there are some exceptions to that. If a furloughed employee, for example, had been scheduled for overtime hours that would have occurred during the shutdown, OPM said they should be paid their premium rate for those hours.

Additionally, OPM said that allowances, differentials and other types of payments, like administratively uncontrollable overtime pay or law enforcement availability pay, should be paid as if the furloughed employee continued to work.

Although most employees impacted by the shutdown are ensured back pay, there are some smaller exceptions carved out where employees may not receive retroactive pay, OPM added.

If a furloughed employee was in a non-pay status before the shutdown began, for instance, then they are not entitled to receive back pay.

Excepted employees who were considered “absent without leave” (AWOL) — or in other words, took unapproved time off — will also not receive back pay for that time.

Guidance on leave, post-shutdown

Although excepted employees are not required to use paid leave for taking time off during the shutdown — and can instead enter a “furlough” period — there may still have been some instances where excepted employees took leave during the funding lapse, OPM wrote in its guidance.

In those cases, excepted employees who were approved to take paid leave during the shutdown will be charged for the hours from their leave bank, OPM said.

Agencies are also expected to begin adjusting leave accrual for furloughed employees. Now that the shutdown is over, furloughed employees should be placed in a “pay status” for the time they would have otherwise spent working during the funding lapse. That means accrual of annual and sick leave will be retroactively adjusted as if the employees were in a pay status, OPM said.

Excepted employees continued to accrue leave during the shutdown, which should be reflected in their leave banks, OPM said.

What happens to RIFs of federal employees?

On top of reaffirming back pay, the spending bill that was enacted Wednesday evening also rescinds the roughly 4,000 reductions in force that have occurred since Oct. 1. Federal employees will be temporarily protected from additional RIFs, at least until the end of January.

Agencies have five days to inform federal employees who received RIF notices in October that those actions are rescinded.

“Agencies should issue those notices and confirm to OPM the rescissions have been issued,” OPM’s guidance states.

At least 670,000 federal employees have been furloughed, and 730,000 employees have been working without pay during the shutdown. Agencies have been putting plans in the works to return all furloughed federal employees to their duties as of Thursday.

OPM also said agencies “may consider” providing flexibility for employees who might not be able to return to work immediately, such as by approving personal leave or adjusting individual work schedules.

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© AP Photo/Mark Schiefelbein

A Senate-passed spending plan to end the longest government shutdown includes bills that would keep the Department of Veterans Affairs funded through the rest of the fiscal year.

The fiscal 2026 spending bill “minibus” passed by the Senate on Monday gives the VA $133 billion in discretionary spending — about a 3% increase compared to last year.

The Senate also approved FY 2026 funding for the Agriculture Department, military construction and the legislative branch.

Lawmakers have included several provisions to ensure the VA doesn’t shed too many employees, as part of its ongoing agency reorganization plans.

The VA previously planned to eliminate 83,000 positions this year. Those plans involved cutting 20,000 clinical staff from the Veterans Health Administration, including nurses and other frontline medical staff.

The department, however, scrapped plans for a department-wide reduction in force, and instead planned to eliminate 30,000 positions by the end of fiscal 2025, largely through attrition.

The spending bill gives the VA 90 days to provide the House and Senate appropriations committees with a staffing model “that will ensure timely, high-quality delivery of healthcare, benefits, and other services.”

“The department is directed to maintain staffing levels to facilitate the department’s own goals,” lawmakers wrote.

On the health care side of VA’s operations, those targets include veterans waiting no longer than 20 days for primary and mental health care appointments, and no more than 28 days for specialty care appointments. The Veterans Benefits Administration must also ensure that it has enough employees to adjudicate benefits claims within 125 days.

The spending bill specifically bars the VA from reducing staffing levels, hours of operation or services at the Veterans Crisis Line or any of its other suicide prevention programs.

Former VCL employees told the Senate VA Committee this summer that hotline employees are often overwhelmed juggling multiple incoming texts and web chats.

Lawmakers wrote that the Veterans Crisis Line “is often the first place a veteran will turn to in a moment of crisis,” and that they are “concerned about the continued functionality, accessibility, and performance of the VCL.”

The VA must also provide the House and Senate appropriations committees with an update on VCL staffing levels and capacity to respond to incoming calls. The report must also include call answer rates, average wait times and referrals to suicide prevention coordinators.

The spending bill also prohibits the VA from terminating any contract over $10 million, unless the VA provides advanced notice to the House and Senate committees, explaining how the department plans to replace the services in the contract targeted for elimination, and whether ending the contract would result in any change in the VA’s staffing levels.

VA gets billions to resume EHR rollout

The Senate-passed spending bill would give the VA $3.4 billion to resume the rollout of its new Electronic Health Record.

The funds will go toward deploying the new EHR to 13 new locations in 2026, as well as “optimization” of the six sites already using the new EHR.

The VA paused its EHR deployment schedule in April 2023, and used the “reset” period to address problems at sites already using the system.

The department currently plans to roll out the new EHR to 27 sites in 2027, but it’s still far away from fully deploying the new system to about 170 VA medical centers across the country.

The Defense Department completed its own rollout of the same health record system last year.

Lawmakers are holding onto nearly a third of the EHR modernization funds until July 2026 and will only release the money once the VA has demonstrated that the project is back on track.

Congress will release 30% of the EHR modernization funds to the VA once it has certified that it has seen “at least four consecutive successful site deployments without any incidents of a delay in care or patient harm.”

To receive these funds, the VA must also give Congress an updated lifecycle cost estimate for the new EHR, a facility-by-facility deployment schedule, projected staffing levels and whether sites already using the new EHR are meeting baseline productivity targets.

VA’s EHR deployment plans for fiscal 2026 focus on medical facilities in Michigan, Ohio and Indiana — although go-lives are also planned in Kentucky and Alaska that year.

Lawmakers wrote that they are “encouraged by deployment activities” at some of the 2026 EHR sites. However, they wrote that “Congress remains vigilant of potential usability problems that have led to or contributed to instances of patient harm and reduced employee productivity.”

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Interview transcript:

Terry Gerton Welcome back to this special Veterans Day edition: The best of the Federal Drive with Terry Gerton on Federal News Network. The White House is working to lower the cost of IVF, putting fertility care in the spotlight. But military families often face extra hurdles when trying to start a family, whether it’s deployments, relocations, or the demands of service. New legislation aims to close that gap. To help us understand the medical side of this issue, Federal News Network’s Eric White spoke with Dr. Michael Wittenberger, a reproductive endocrinologist and Navy veteran who spent years treating veterans and their families.

Eric White So obviously, they’re not the only ones that can struggle with infertility, but what is it in particular about military families, where they have even more of an issue getting treatment for it? What are some of the roadblocks of the jobs that they entail that kind of getting in the way? What is what is that you have seen?

Michael Wittenberger The military by its nature is just a different organization completely than what most people are. The military mission takes precedence, and so the military mission often will require that service members are separated from their families. That can be while they are watch-standing, it can be on workups, it can be on deployment. So there’s frequent separations between the partners that are trying to get pregnant. And so using different surveys, there seems to be an increase in the difficulty for military family members in planning and executing a family. And when you look at the prevalence of infertility in the military, it seems like it’s higher than the civilian population. So in addition to these frequent interruptions and the continuity between partners, there’s a number of other things that are inherent to just the military. There’s different jobs that you have, and there’s different expectations for different duty assignment. It’s expected while you’re on sea duty that you don’t try to get pregnant because you’re expected to deploy even though you may be in port and you may not be deployable at that moment. At the time that you’re there, you’re expected not to get pregnant. The other half is okay to get pregnant, but again, there’s other things like access to care. When I retired in 2022, I was one of three active-duty reproductive endocrinologists and infertility specialists in the entire Navy. That’s serving, you know, the approximately 500,000 active-duty Navy and Marines on both coasts and around the world. So you can imagine when there’s just a couple or three specialists that there’s going to be bottlenecks in care. And a lot of times the sailors, the marines, the service members are going to located remotely so there’s not going to a local catchment where they can be seen and taken care of. So another barrier to care is really just a delay in diagnosis for many of them for getting the care, they’ll be out in an area they can’t access care, so they have to wait to come back to a military training facility that actually has a reproductive endocrinologist to try to get access to care. So, you know, a lot of different barriers potentially to care for the military family.

Eric White I guess we can start with your interaction with these patients. Was that a frustration that you heard a lot in treating service members, you know, “it took me two months to get this appointment”? Did some of them seek help outside of their respective military branch?

Michael Wittenberger I would say that’s always been a concern of people trying to access care, is that the delay to get in and see a specialist is hard or that they need to go out and see fertility specialist in the civilian world. The problem with that is that in both cases, TRICARE, they completely covered the diagnostics of trying to diagnose you with infertility, but the treatment options are very limited with TRICARE for active duty. They consist basically of any treatment option that uses coitus as a form of conception. So that means anything with artificial insemination, IVF, fertility preservation in many cases is not covered by TRICARE. So yes, the military members try to access care on the outside. And they find out that they have to cover the bill, and so that’s a huge financial burden for them. Even within the military, there’s a thought that if they can get care at the military treatment facility with a reproductive endocrinologist as active duty, that it’ll be covered. Well, that’s only partially true. So TRICARE has an exception to the lack of coverage that allows them to, for graduate medical education purposes, provide some additional care, like artificial insemination and the monitoring for IVF, the medications for IVF. So it does slightly reduce the cost of IVF, but since there’s no embryology team in any of the military services, there’s still a lot of expenses that the patient needs to contract with the civilian embryology lab or IVF center to actually cover.

Eric White And so let’s finish up here with some of the solutions that have been proposed and other ones that you think could be implemented. There’s legislation in the House from Rep. Sarah Jacobs that is aiming to increase access for military families to this treatment. What do you know about that? And what else could be done to make this an easier process for those that are looking to serve their country, but also want to fulfill their familial wishes?

Michael Wittenberger Sarah Jacobs is a fellow San Diegan, so it’s good to see that she’s really pressing for this. My understanding of the legislation is that it’s been reintroduced in April of this year. It was previously passed through the House, and I think Tammy Duckworth introduced it into the Senate, and both of those were passed and put into last year’s NDAA, the National Defense Authorization Act. And then it was scrubbed at the last minute. And so now they’re reintroducing…and my understanding is that this includes basically standard-of-care treatment for active-duty TRICARE recipients and their dependents, which just means that there’s IVF included in this, there’s artificial insemination included in this. And I think it’s three cycles of IVF, unlimited embryo transfers; it doesn’t matter if you’re single or you’re partnered, it’s inclusive there. Now, the great travesty, I think, here is when you look at what’s currently available to our warfighters that are out there sacrificing their lives potentially to build a country for their families, that maybe they end up sacrificing their families. But as soon as they exit…active duty, if they separate, if they retire, now they’re in the VA system and there’s a huge discrepancy at what’s provided by the VA versus what’s providing for active-duty members. So the VA, if you have a fertility-related diagnosis, if you’re currently experiencing infertility in the active-duty forces and you separate and you have fertility-related diagnosis, now you’re eligible for up to six cycles of IVF. Even if you don’t have a fertility-related diagnosis, you’re automatically eligible for artificial insemination. So, you know, the bottom line really is that if you’re active duty and your priority is to start a family and you have a fertility-related diagnosis, it may actually benefit you to leave active duty and go into the VA system to get that care covered without the financial burdens that it causes.

The post Military families face unique barriers to fertility care, and new legislation aims to close the gap first appeared on Federal News Network.

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An IT glitch at the Department of Veterans Affairs is delaying the payment of education benefits for thousands of veterans’ surviving children and spouses.

The VA, through its Survivors’ and Dependents’ Educational Assistance program, part of the GI Bill, pays education benefits for the children and spouses of veterans or service members who have died, been captured or are missing, or are totally disabled from a service-connected disability. The payments help eligible students pay for school or cover expenses while training for a job. Full-time students enrolled in this program receive nearly $1,600 each month from the VA.

The VA, in its latest contingency plans, said education benefits would be unaffected by a government shutdown, and would continue to be paid out on time. But the department has furloughed the IT staff who are able to fix this issue, and the department’s GI Bill hotline is also closed during the shutdown.

VA Press Secretary Pete Kasperowicz said in a statement that some VA education benefits payments are behind schedule “due to the combined effects” of recently moving to a new claims processing system, a high volume of fall enrollments and the government shutdown.

“VA had planned additional systems enhancements to speed up the process and automate a large batch of these claims, but the Democrats’ government shutdown prevents the department from doing so,” Kasperowicz said.

Kasperowicz said any student dealing with delayed payments will be paid in full as soon as possible. The VA expects it will take until late November or early December to fully resolve the issue.

So far this month, the VA’s average processing time for these claims is about 49 days.

Ashlynne Haycock-Lohmann, director of government and legislative affairs at the Tragedy Assistance Program for Survivors (TAPS), told reporters on Monday that the VA had updated the IT systems that handle these education benefits payments this summer. The VA in September reported a glitch to Congress that impacted education benefits for about 900 individuals.

Lohmann, however, said the department underestimated the impact of the glitch. In reality, she said it may have delayed payments for up to 75,000 student beneficiaries.

“VA never put anything out on out to schools. They never let the schools know that there was a problem. They never let students know that there was a problem. They told Congress it was a minor glitch. They have never taken accountability for what has happened here,” Lohmann said.

Jonathan Mackey, a senior at Southeastern Louisiana University, said he only received a partial payment of $839 last week, about $500 short of his usual monthly payment. He said the partial payment has made it harder to cover living expenses this month. Mackey, whose late father served in the Iowa National Guard, said VA’s “lack of community and accountability” has been a major source of frustration.

“Calls to the VA education have been unanswered, and we weren’t informed about the processing delays before the shutdown,” he said. “While we’re told by the schools that we’ll receive back pay eventually, we don’t know when that eventually is. And that doesn’t really help us pay the bills or feed ourselves in the meantime.”

Kaanan Mackey-Fugler, Mackey’s mother and a surviving spouse who forfeited her survivor benefits when she remarried, said this is now the third semester she’s had to step in and cover living expenses for at least one of her adult children, while they wait for reimbursement from the VA.

“Before the shutdown, we were told that our benefits wouldn’t be affected. Yet, here we are. Students and families across the country are desperate, and they’re anxious about how they’re covering bills month to month while our system’s still stalled out,” Fulger said.

Lawmakers have reached a deal to end the government shutdown, which should make it out of Congress and onto President Donald Trump’s desk later this week. But Will Hubbard, the vice president for veterans and military policy at Veterans Education Success, called on the VA to immediately reopen the GI Bill hotline and bring back furloughed IT staff to expedite claims processing.

“While there’s a deal in the works with the shutdown coming to a conclusion, every single day counts,” Hubbard said. “You have to understand that if a student is missing their payment, they’re wondering what’s going to happen the next day – not in three days, not in five days.”

In a recent survey of over 2,400 students, the National Association of Veterans Program Administrators (NAVPA) found that more than 1,000 reported payment disruptions, and that 740 of them attributed those delays directly to the shutdown. NAVPA President Camden Ege said students have been told to reach out to their schools if there is a problem with their VA education benefits, but said schools “don’t have those answers.”

“While the immediate cause stems from a technical glitch in VA systems, the government shutdown has made matters worse,” Ege said.

Joe Wescott, national legislative liaison for the National Association of State Approving Agencies, said that the VA should have alerted schools to its IT problems before the shutdown.

“The beginning of the fall term, this is not a good time to roll out an IT fix, about which there is uncertainty – not at all,” Wescott said.

The post VA IT glitch delays education benefits for thousands of students first appeared on Federal News Network.

© Getty Images/Kiyoshi Tanno

One of the worst nights of Susan Barron’s career came a few years ago, when the artist was in Manhattan to unveil her mixed-media art series, Depicting The Invisible. Military veteran portraits adorned with paint and text comprised the collection, which Barron designed to highlight veteran struggles with post-traumatic stress disorder (PTSD).

Just before the show, Barron’s phone rang. On the other end of the line was the mother of one of her photographic subjects. “She said he had succumbed to PTSD and taken his own life,” Barron says. “It was a gut punch.”

Nearly three million service members have deployed in support of the Global War on Terror since 2001. Of those who served in Iraq or Afghanistan, between 11 and 20 percent now suffer from PTSD. These glaring statistics have left an interminable trail of suicide victims in their wake—individuals, like Barron’s friend, who quietly endure the invisible wounds of combat, personal loss or sexual assault.

22 veterans per day. The suicide statistic has circulated extensively since such data first reached the public sphere. In 2020, the Department of Veterans Affairs reported 6,146 military vets died by suicide, an astonishing 17 per day. And while that number amounted to the lowest total since 2006, any semblance of empathy would suggest it stands at 6,146 too many.

It was learning about this epidemic that inspired Barron to create “Depicting The Invisible,” an exhibit that, since its launch, has occupied the hallowed halls of the National Veterans Memorial and Museum in Columbus, OH, and the Army and Navy Club in Washington, DC. among others.

“I’m really grateful these very brave men and women shared their stories with me,” Barron says. “I wanted to shine a light on this epidemic of PTSD and suicide and help break down the stigma around issues of mental health. Every one of us needs to do whatever we can to help. As an artist, this is what I felt I could do.”

Barron’s photo series was shot using a classical black-and-white style that she says, “was intentionally in direct contrast to the brutality of their stories.”

“They’re heroic. They’re elegant,” Barron says.

The works also proved to be conversation starters, eventually becoming the subject of an NPR podcast and an award-winning short documentary of the same name.

“This project has had so many hands lift it up, and throughout all of it, I’ve been contacted by people I don’t even know telling me what a huge difference it made in their life or in their spouse’s life,” Barron says. “Sons, mothers, grandmothers—so many family members have been thankful for destigmatizing this, for honoring this as a wound of war and not a mental illness.”

Shattering stigmas has also opened the door to a more expansive network of PTSD treatment options for veterans, cannabis principal among them.

Ryan Cauley may not be one of Barron’s subjects, but his story, like the myriad of veterans enduring the trials of neurological trauma, is remarkably similar. Originally from Pendleton, Indiana, Cauley joined the Army in 2004 and served as a cavalry scout until 2007 with the service’s 1st Squadron, 32nd Cavalry Regiment, 101st Airborne Division.

Life after the service proved difficult. Post-traumatic stress impacted Cauley’s ability to connect. Depression and anxiety became a viciously cyclical norm. His attitude and behavior soured, and in turn, his marriage and personal relationships eroded.

Months of anger management and cognitive behavioral therapy helped Cauley understand how to manage the condition, but it wasn’t until his 2016 foray into medical cannabis—and subsequent launch of the cannabis and PTSD advocacy company Combat Cultivators—that he’d experience a real transformation.

“I had to convince my wife about using cannabis, but almost instantly, she was able to see the change in my attitude,” Cauley says. “I was able to give more love and be more compassionate. I could focus on tasks and not be consumed by negative thoughts.”

Noticeable attitude changes eventually manifested a genuine interest in the industry, and in 2018, Cauley set out to complete his first grow. “I was such a baby,” he says, smiling at the memory. “I wanted to grow my own cannabis, because, at the time, prices were more expensive than they are now. Today, we grow our own because it’s better than anything in the dispensaries.”

Cauley’s infantile curiosity soon blossomed into a profession. He became a lead grower at a company in Michigan, learning the ins and outs of large-scale growth, environmental control and cloning. He even recruited his best friend from the Army, Carlos Ozuna, to work in the same role. Together, the duo launched the Combat Cultivators Instagram account to be a vehicle of contacting other veteran cannabis advocates struggling with PTSD.

And while the friends have since left the company, Cauley credits the knowledge the two accumulated there for the duo’s success with Combat Cultivators. More than that, however, has been the remarkable difference cannabis has made in Cauley’s personal life. “It’s given me so much of my life back,” he says. “That sense of doing something for a reason. It also gave Carlos and I the opportunity to work together again.”

The number of ways veterans are learning to confront PTSD is ever-expanding. For Barron and Cauley, using their respective platforms has injected life into a conversation about mental health that remained dormant for far too long.

The dreaded phone call Barron received that day in Manhattan is one that many of today’s veterans and military family members have endured ad nauseam. Every story is unique, but the excruciating pain of loss is undeniably similar. Preventing that from happening to anyone else, Barron says, is a calling we should all gravitate toward.

“That day was a personal low for me, but it ignited an even stronger drive to get these stories out there,” Barron says. “We all just really need to do more.”

This story was originally published in issue 47 of the print edition of Cannabis Now.

The post The Healing Art: Military Veteran Portraits Highlight PTSD & Cannabis appeared first on Cannabis Now.