Government and Regulations

Navy Vice Admiral Raquel C. Bono has been named director of the Defense Health Agency (DHA), replacing Air Force Lieutenant General Douglas J. Robb, who is retiring. The DHA operation is massive, caring for a TRICARE-eligible population of 9.5 million, including 1.4 million service members on active duty, with more than 1 million inpatient admissions and 95.6 million outpatient visits in 2014.

“We congratulate 2 trailblazers in military medicine—Lt. Gen. Doug Robb and Vice Adm. Raquel ‘Rocky’ Bono,” said Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD. “In the case of Doug Robb, no one has been a more central leader in conceiving, negotiating, shaping and ultimately establishing the Defense Health Agency.”

Related: The Defense Health Agency Stands Up

After leading the agency from initial stand-up to full operational capabilities, Robb will retire. Under Robb’s leadership, DHA joined the previously independent health care operations of the U.S. Army, Navy, and Air Force, with unique cultures, procedures, and technologies. “This is probably the largest military health care transformation that has occurred in decades, if not ever,” Robb told Federal Practitioner.

Related: Lt Gen Douglas J. Robb on Building the Defense Health Agency

Bono was director of the National Capital Region Medical Directorate. Dr. Woodson pointed out how Bono’s history as a surgeon deployed in wartime, a hospital commander, and chief of staff at the former TRICARE Management Activity, among many other accomplishments throughout her career, will help her as she takes on the many tasks DHA faces.

“I look forward to the days ahead,” Bono said at the formal transition ceremony. “I know with the team we have assembled here we can’t go wrong.”

Navy Vice Admiral Raquel C. Bono has been named director of the Defense Health Agency (DHA), replacing Air Force Lieutenant General Douglas J. Robb, who is retiring. The DHA operation is massive, caring for a TRICARE-eligible population of 9.5 million, including 1.4 million service members on active duty, with more than 1 million inpatient admissions and 95.6 million outpatient visits in 2014.

“We congratulate 2 trailblazers in military medicine—Lt. Gen. Doug Robb and Vice Adm. Raquel ‘Rocky’ Bono,” said Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD. “In the case of Doug Robb, no one has been a more central leader in conceiving, negotiating, shaping and ultimately establishing the Defense Health Agency.”

Related: The Defense Health Agency Stands Up

After leading the agency from initial stand-up to full operational capabilities, Robb will retire. Under Robb’s leadership, DHA joined the previously independent health care operations of the U.S. Army, Navy, and Air Force, with unique cultures, procedures, and technologies. “This is probably the largest military health care transformation that has occurred in decades, if not ever,” Robb told Federal Practitioner.

Related: Lt Gen Douglas J. Robb on Building the Defense Health Agency

Bono was director of the National Capital Region Medical Directorate. Dr. Woodson pointed out how Bono’s history as a surgeon deployed in wartime, a hospital commander, and chief of staff at the former TRICARE Management Activity, among many other accomplishments throughout her career, will help her as she takes on the many tasks DHA faces.

“I look forward to the days ahead,” Bono said at the formal transition ceremony. “I know with the team we have assembled here we can’t go wrong.”

Navy Vice Admiral Raquel C. Bono has been named director of the Defense Health Agency (DHA), replacing Air Force Lieutenant General Douglas J. Robb, who is retiring. The DHA operation is massive, caring for a TRICARE-eligible population of 9.5 million, including 1.4 million service members on active duty, with more than 1 million inpatient admissions and 95.6 million outpatient visits in 2014.

“We congratulate 2 trailblazers in military medicine—Lt. Gen. Doug Robb and Vice Adm. Raquel ‘Rocky’ Bono,” said Assistant Secretary of Defense for Health Affairs Jonathan Woodson, MD. “In the case of Doug Robb, no one has been a more central leader in conceiving, negotiating, shaping and ultimately establishing the Defense Health Agency.”

Related: The Defense Health Agency Stands Up

After leading the agency from initial stand-up to full operational capabilities, Robb will retire. Under Robb’s leadership, DHA joined the previously independent health care operations of the U.S. Army, Navy, and Air Force, with unique cultures, procedures, and technologies. “This is probably the largest military health care transformation that has occurred in decades, if not ever,” Robb told Federal Practitioner.

Related: Lt Gen Douglas J. Robb on Building the Defense Health Agency

Bono was director of the National Capital Region Medical Directorate. Dr. Woodson pointed out how Bono’s history as a surgeon deployed in wartime, a hospital commander, and chief of staff at the former TRICARE Management Activity, among many other accomplishments throughout her career, will help her as she takes on the many tasks DHA faces.

“I look forward to the days ahead,” Bono said at the formal transition ceremony. “I know with the team we have assembled here we can’t go wrong.”

Chief of staff and psychiatrist at the Tomah VAMC in Wisconsin, David J. Houlihan, MD, who was placed on administrative leave in January due to allegations of overprescribing narcotic pain killers and retaliatory behavior, was dismissed, effective November 9. Dr. Houlihan’s clinical privileges were also revoked. 

Dr. Houlihan was known to many as the “candy man,” a name dating back as far as 2004, the Tomah VAMC referred to as “candy land,” both according to a 2015 report from the VA Office of Inspector General (OIG).

Unlike other VA officials forced out of their positions during times of controversy, including Tomah’s own director, Col (Ret) Mario V. DeSanctis, USAF, who was removed in September, Dr. Houlihan will not be able to negotiate a settlement, including retirement.

Related: VHA Under Harsh Criticism From OIG, GAO

“The letter communicating [the employee’s] removal specified a future effective date because, by VA policy, Title 38 employees are not subject to immediate termination but are generally entitled to receive notice of the decision to terminate at least five days prior to the effective date of action,” a VA spokesman said.

Although the investigation has come to a head, Dr. Houlihan spent the past 10 months on paid leave, a practice that many veterans’ groups and congressional leaders are trying to eliminate with H.R. 1994—the VA Accountability Act of 2015.

Related: Veterans’ Health and Opioid Safety—Contexts, Risks, and Outreach Implications

The bill, introduced in the U.S. House of Representatives in April, prohibits a demoted VA employee from being placed on administrative leave or any other category of paid leave while an appeal is going on. The bill also streamlines the appeals process, allowing the employee 7 days to appeal the decision and an administrative judge 45 days to make a final decision; thereafter, the original decision becomes final. The VA Accountability Act of 2015 passed the House 256-170 on July 29 and awaits a vote in the U.S. Senate.

Senator Tammy Baldwin (D-WI) said Monday that Dr. Houlihan’s firing and revocation of his license were “long overdue” but show that “change is possible and provides new-found hope that trust can be restored” at VA.

Related: VA Hospital Deficiencies Contributed to Marine’s Death

This past summer, the OIG determined a number of deficiencies in hospital operations at the Tomah VAMC as a result of the investigation of 35-year-old marine Jason Simcakoski’s death. Among the deficiencies were incorrect prescribing practices. Neither of the 2 psychiatrists treating Mr. Simcakoski had obtained informed consent for buprenorphine/naloxone, which was administered with an off-label indication beginning the day prior to his death. One of the 2 psychiatrists was fired as a result of the investigation.

Chief of staff and psychiatrist at the Tomah VAMC in Wisconsin, David J. Houlihan, MD, who was placed on administrative leave in January due to allegations of overprescribing narcotic pain killers and retaliatory behavior, was dismissed, effective November 9. Dr. Houlihan’s clinical privileges were also revoked. 

Dr. Houlihan was known to many as the “candy man,” a name dating back as far as 2004, the Tomah VAMC referred to as “candy land,” both according to a 2015 report from the VA Office of Inspector General (OIG).

Unlike other VA officials forced out of their positions during times of controversy, including Tomah’s own director, Col (Ret) Mario V. DeSanctis, USAF, who was removed in September, Dr. Houlihan will not be able to negotiate a settlement, including retirement.

Related: VHA Under Harsh Criticism From OIG, GAO

“The letter communicating [the employee’s] removal specified a future effective date because, by VA policy, Title 38 employees are not subject to immediate termination but are generally entitled to receive notice of the decision to terminate at least five days prior to the effective date of action,” a VA spokesman said.

Although the investigation has come to a head, Dr. Houlihan spent the past 10 months on paid leave, a practice that many veterans’ groups and congressional leaders are trying to eliminate with H.R. 1994—the VA Accountability Act of 2015.

Related: Veterans’ Health and Opioid Safety—Contexts, Risks, and Outreach Implications

The bill, introduced in the U.S. House of Representatives in April, prohibits a demoted VA employee from being placed on administrative leave or any other category of paid leave while an appeal is going on. The bill also streamlines the appeals process, allowing the employee 7 days to appeal the decision and an administrative judge 45 days to make a final decision; thereafter, the original decision becomes final. The VA Accountability Act of 2015 passed the House 256-170 on July 29 and awaits a vote in the U.S. Senate.

Senator Tammy Baldwin (D-WI) said Monday that Dr. Houlihan’s firing and revocation of his license were “long overdue” but show that “change is possible and provides new-found hope that trust can be restored” at VA.

Related: VA Hospital Deficiencies Contributed to Marine’s Death

This past summer, the OIG determined a number of deficiencies in hospital operations at the Tomah VAMC as a result of the investigation of 35-year-old marine Jason Simcakoski’s death. Among the deficiencies were incorrect prescribing practices. Neither of the 2 psychiatrists treating Mr. Simcakoski had obtained informed consent for buprenorphine/naloxone, which was administered with an off-label indication beginning the day prior to his death. One of the 2 psychiatrists was fired as a result of the investigation.

Chief of staff and psychiatrist at the Tomah VAMC in Wisconsin, David J. Houlihan, MD, who was placed on administrative leave in January due to allegations of overprescribing narcotic pain killers and retaliatory behavior, was dismissed, effective November 9. Dr. Houlihan’s clinical privileges were also revoked. 

Dr. Houlihan was known to many as the “candy man,” a name dating back as far as 2004, the Tomah VAMC referred to as “candy land,” both according to a 2015 report from the VA Office of Inspector General (OIG).

Unlike other VA officials forced out of their positions during times of controversy, including Tomah’s own director, Col (Ret) Mario V. DeSanctis, USAF, who was removed in September, Dr. Houlihan will not be able to negotiate a settlement, including retirement.

Related: VHA Under Harsh Criticism From OIG, GAO

“The letter communicating [the employee’s] removal specified a future effective date because, by VA policy, Title 38 employees are not subject to immediate termination but are generally entitled to receive notice of the decision to terminate at least five days prior to the effective date of action,” a VA spokesman said.

Although the investigation has come to a head, Dr. Houlihan spent the past 10 months on paid leave, a practice that many veterans’ groups and congressional leaders are trying to eliminate with H.R. 1994—the VA Accountability Act of 2015.

Related: Veterans’ Health and Opioid Safety—Contexts, Risks, and Outreach Implications

The bill, introduced in the U.S. House of Representatives in April, prohibits a demoted VA employee from being placed on administrative leave or any other category of paid leave while an appeal is going on. The bill also streamlines the appeals process, allowing the employee 7 days to appeal the decision and an administrative judge 45 days to make a final decision; thereafter, the original decision becomes final. The VA Accountability Act of 2015 passed the House 256-170 on July 29 and awaits a vote in the U.S. Senate.

Senator Tammy Baldwin (D-WI) said Monday that Dr. Houlihan’s firing and revocation of his license were “long overdue” but show that “change is possible and provides new-found hope that trust can be restored” at VA.

Related: VA Hospital Deficiencies Contributed to Marine’s Death

This past summer, the OIG determined a number of deficiencies in hospital operations at the Tomah VAMC as a result of the investigation of 35-year-old marine Jason Simcakoski’s death. Among the deficiencies were incorrect prescribing practices. Neither of the 2 psychiatrists treating Mr. Simcakoski had obtained informed consent for buprenorphine/naloxone, which was administered with an off-label indication beginning the day prior to his death. One of the 2 psychiatrists was fired as a result of the investigation.

Alcohol-related death rates were 520% higher among American Indian/Alaska Native (AI/AN) people in the U.S. from 2007 to 2009 compared with those of all races in 2008. That stunning statistic comes from the latest edition of the Trends in Indian Health report and is only one of many equally alarming findings: Tuberculosis rates were 450% greater; chronic liver disease and cirrhosis, 368% greater; motor vehicle crashes, 207% greater; diabetes mellitus, 177% greater. And the list goes on.

The age-adjusted death rates for all causes of death during that 2-year period was 1.2 times the rate for all races in the U.S. The age-specific death rate for AI/ANs more than doubled that of all races in the U.S. for ages 1 though 44 years.

Related: Heart Disease Among American Indians

American Indian/Alaska Native men were most likely to die of heart disease, followed by malignant neoplasms; in women, that was reversed to malignant neoplasms, followed by heart disease. (These are also the 2 most prevalent causes of death for all races in the U.S., the report notes.) When the data were broken down by age, unintentional injuries and chronic liver disease and cirrhosis were the leading causes of AI/AN death for ages 25 to 44 years. Of all AI/AN people who died during 2007 to 2009, 25% were aged < 45 years, compared with 15% of blacks and 7% of whites.

Related: A Multidisciplinary Chronic Pain Management Clinic in an Indian Health Service Facility

In contrast, Alzheimer disease, HIV infection, and major cardiovascular disease were all lower among AI/ANs compared with those of all races. And the age-adjusted rate of deaths due to firearms dropped from 26% in 1979 to 1981 to 12% in 2007 to 2009; however, that rate is still 1.2 times greater than the 10% rate for all races in 2008. Similarly, although the rate of death due to chronic liver disease and cirrhosis declined from 72% in 1979 to 1981 to 43% in 2007 to 2009, that 43% rate is still nearly 5 times higher than the rate in the rest of the U.S. population.

Related: Native Americans Address LGBT Health Issues

The report points out that a variety of programs are tackling the disturbingly high death rates. For instance, the IHS Injury Prevention Program helped reduce unintentional injury deaths between 1973 and 2003 by 58% with initiatives such as the Ride Safe Program, which targets motor vehicle-related injuries to children.

The vital event statistics were derived from various National Center for Health Statistics publications, patient care statistics from IHS reporting systems, and some unpublished data from IHS. To see the entire report, visit http://www.ihs.gov/dps/index.cfm/publications/trends2014.

Alcohol-related death rates were 520% higher among American Indian/Alaska Native (AI/AN) people in the U.S. from 2007 to 2009 compared with those of all races in 2008. That stunning statistic comes from the latest edition of the Trends in Indian Health report and is only one of many equally alarming findings: Tuberculosis rates were 450% greater; chronic liver disease and cirrhosis, 368% greater; motor vehicle crashes, 207% greater; diabetes mellitus, 177% greater. And the list goes on.

The age-adjusted death rates for all causes of death during that 2-year period was 1.2 times the rate for all races in the U.S. The age-specific death rate for AI/ANs more than doubled that of all races in the U.S. for ages 1 though 44 years.

Related: Heart Disease Among American Indians

American Indian/Alaska Native men were most likely to die of heart disease, followed by malignant neoplasms; in women, that was reversed to malignant neoplasms, followed by heart disease. (These are also the 2 most prevalent causes of death for all races in the U.S., the report notes.) When the data were broken down by age, unintentional injuries and chronic liver disease and cirrhosis were the leading causes of AI/AN death for ages 25 to 44 years. Of all AI/AN people who died during 2007 to 2009, 25% were aged < 45 years, compared with 15% of blacks and 7% of whites.

Related: A Multidisciplinary Chronic Pain Management Clinic in an Indian Health Service Facility

In contrast, Alzheimer disease, HIV infection, and major cardiovascular disease were all lower among AI/ANs compared with those of all races. And the age-adjusted rate of deaths due to firearms dropped from 26% in 1979 to 1981 to 12% in 2007 to 2009; however, that rate is still 1.2 times greater than the 10% rate for all races in 2008. Similarly, although the rate of death due to chronic liver disease and cirrhosis declined from 72% in 1979 to 1981 to 43% in 2007 to 2009, that 43% rate is still nearly 5 times higher than the rate in the rest of the U.S. population.

Related: Native Americans Address LGBT Health Issues

The report points out that a variety of programs are tackling the disturbingly high death rates. For instance, the IHS Injury Prevention Program helped reduce unintentional injury deaths between 1973 and 2003 by 58% with initiatives such as the Ride Safe Program, which targets motor vehicle-related injuries to children.

The vital event statistics were derived from various National Center for Health Statistics publications, patient care statistics from IHS reporting systems, and some unpublished data from IHS. To see the entire report, visit http://www.ihs.gov/dps/index.cfm/publications/trends2014.

Alcohol-related death rates were 520% higher among American Indian/Alaska Native (AI/AN) people in the U.S. from 2007 to 2009 compared with those of all races in 2008. That stunning statistic comes from the latest edition of the Trends in Indian Health report and is only one of many equally alarming findings: Tuberculosis rates were 450% greater; chronic liver disease and cirrhosis, 368% greater; motor vehicle crashes, 207% greater; diabetes mellitus, 177% greater. And the list goes on.

The age-adjusted death rates for all causes of death during that 2-year period was 1.2 times the rate for all races in the U.S. The age-specific death rate for AI/ANs more than doubled that of all races in the U.S. for ages 1 though 44 years.

Related: Heart Disease Among American Indians

American Indian/Alaska Native men were most likely to die of heart disease, followed by malignant neoplasms; in women, that was reversed to malignant neoplasms, followed by heart disease. (These are also the 2 most prevalent causes of death for all races in the U.S., the report notes.) When the data were broken down by age, unintentional injuries and chronic liver disease and cirrhosis were the leading causes of AI/AN death for ages 25 to 44 years. Of all AI/AN people who died during 2007 to 2009, 25% were aged < 45 years, compared with 15% of blacks and 7% of whites.

Related: A Multidisciplinary Chronic Pain Management Clinic in an Indian Health Service Facility

In contrast, Alzheimer disease, HIV infection, and major cardiovascular disease were all lower among AI/ANs compared with those of all races. And the age-adjusted rate of deaths due to firearms dropped from 26% in 1979 to 1981 to 12% in 2007 to 2009; however, that rate is still 1.2 times greater than the 10% rate for all races in 2008. Similarly, although the rate of death due to chronic liver disease and cirrhosis declined from 72% in 1979 to 1981 to 43% in 2007 to 2009, that 43% rate is still nearly 5 times higher than the rate in the rest of the U.S. population.

Related: Native Americans Address LGBT Health Issues

The report points out that a variety of programs are tackling the disturbingly high death rates. For instance, the IHS Injury Prevention Program helped reduce unintentional injury deaths between 1973 and 2003 by 58% with initiatives such as the Ride Safe Program, which targets motor vehicle-related injuries to children.

The vital event statistics were derived from various National Center for Health Statistics publications, patient care statistics from IHS reporting systems, and some unpublished data from IHS. To see the entire report, visit http://www.ihs.gov/dps/index.cfm/publications/trends2014.

Many people like to walk—and it’s often touted as one of the easiest forms of physical activity—but they don’t always have a safe place to do it. That’s why U.S. Surgeon General Vivek H. Murthy says “we need to step it up as a country, ensuring that everyone can choose to walk in their own communities.”

Related: Can Neighborhoods Make People Gain Weight?

Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities addresses the fact that many communities lack safe and convenient places for people to walk or wheelchair roll. That’s unacceptable, Dr. Murthy charges. He points to a 2013 U.S. Department of Transportation study that found 3 of every 10 Americans report that their neighborhood streets have no sidewalks. Moreover, in many communities, violence, or the perception of violence can prove a barrier to walking.

Related: Weight Loss Promotes Nonbariatric Surgery Medical Clearance

Dr. Murthy is challenging civic planners and local leaders to create more areas for walking and wheelchair rolling and to make safe routes for children going to and from school a priority. His call to action includes designing more sidewalks, curb cuts, crosswalks, safe crossings for the visually impaired, and more green spaces. He also calls on city managers, law enforcement, and public health leaders to devise ways to better maintain public spaces, work with residents to promote shared community ownership, improve street lighting, and encourage neighborhood watch programs.

Related: A Call to Action: Intensive Lifestyle Intervention Against Diabesity

“We know that an average of 22 minutes a day of physical activity—such as brisk walking—can significantly reduce the risk of heart disease and diabetes,” Dr. Murthy said. “The key is to get started, because even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”

Visit http://www.surgeongeneral.gov/library/calls/walking-and-walkable-communities/index.html for more information about promoting walkable communities—and for the Surgeon General’s walking playlist on Pandora.

Many people like to walk—and it’s often touted as one of the easiest forms of physical activity—but they don’t always have a safe place to do it. That’s why U.S. Surgeon General Vivek H. Murthy says “we need to step it up as a country, ensuring that everyone can choose to walk in their own communities.”

Related: Can Neighborhoods Make People Gain Weight?

Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities addresses the fact that many communities lack safe and convenient places for people to walk or wheelchair roll. That’s unacceptable, Dr. Murthy charges. He points to a 2013 U.S. Department of Transportation study that found 3 of every 10 Americans report that their neighborhood streets have no sidewalks. Moreover, in many communities, violence, or the perception of violence can prove a barrier to walking.

Related: Weight Loss Promotes Nonbariatric Surgery Medical Clearance

Dr. Murthy is challenging civic planners and local leaders to create more areas for walking and wheelchair rolling and to make safe routes for children going to and from school a priority. His call to action includes designing more sidewalks, curb cuts, crosswalks, safe crossings for the visually impaired, and more green spaces. He also calls on city managers, law enforcement, and public health leaders to devise ways to better maintain public spaces, work with residents to promote shared community ownership, improve street lighting, and encourage neighborhood watch programs.

Related: A Call to Action: Intensive Lifestyle Intervention Against Diabesity

“We know that an average of 22 minutes a day of physical activity—such as brisk walking—can significantly reduce the risk of heart disease and diabetes,” Dr. Murthy said. “The key is to get started, because even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”

Visit http://www.surgeongeneral.gov/library/calls/walking-and-walkable-communities/index.html for more information about promoting walkable communities—and for the Surgeon General’s walking playlist on Pandora.

Many people like to walk—and it’s often touted as one of the easiest forms of physical activity—but they don’t always have a safe place to do it. That’s why U.S. Surgeon General Vivek H. Murthy says “we need to step it up as a country, ensuring that everyone can choose to walk in their own communities.”

Related: Can Neighborhoods Make People Gain Weight?

Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities addresses the fact that many communities lack safe and convenient places for people to walk or wheelchair roll. That’s unacceptable, Dr. Murthy charges. He points to a 2013 U.S. Department of Transportation study that found 3 of every 10 Americans report that their neighborhood streets have no sidewalks. Moreover, in many communities, violence, or the perception of violence can prove a barrier to walking.

Related: Weight Loss Promotes Nonbariatric Surgery Medical Clearance

Dr. Murthy is challenging civic planners and local leaders to create more areas for walking and wheelchair rolling and to make safe routes for children going to and from school a priority. His call to action includes designing more sidewalks, curb cuts, crosswalks, safe crossings for the visually impaired, and more green spaces. He also calls on city managers, law enforcement, and public health leaders to devise ways to better maintain public spaces, work with residents to promote shared community ownership, improve street lighting, and encourage neighborhood watch programs.

Related: A Call to Action: Intensive Lifestyle Intervention Against Diabesity

“We know that an average of 22 minutes a day of physical activity—such as brisk walking—can significantly reduce the risk of heart disease and diabetes,” Dr. Murthy said. “The key is to get started, because even a small first effort can make a big difference in improving the personal health of an individual and the public health of the nation.”

Visit http://www.surgeongeneral.gov/library/calls/walking-and-walkable-communities/index.html for more information about promoting walkable communities—and for the Surgeon General’s walking playlist on Pandora.

The VA is awarding up to $8 million in grants to eligible recipients with experience managing large-scale adaptive sports programs for disabled veterans and service members.

Related: Creative Solutions for Disability Challenges

The awards will go to 89 national, regional, and community programs, including veterans service organizations, municipalities, and other groups. The money can be used for planning, developing, managing, and implementing adaptive sports programs. The VA estimates that approximately 10,000 veterans and service members will benefit.

Related: Microprocessor Knee and Power Foot Combination in a Transfemoral Amputee

Recipients include the Challenged Athletes Foundation (California), which offers a triathlon, surfing, and martial arts; the Professional Association of Therapeutic Horsemanship International (Colorado), which offers therapeutic riding and equine-assisted therapy; and the USRowing Association (New Jersey), which offers adaptive rowing.

Related: Advances in Prosthetics Restore High Levels of Physical Activity

For a full list of organizations that will receive funds, visit http://www.va.gov/adaptivesports/va_grant_program.asp.

The VA is awarding up to $8 million in grants to eligible recipients with experience managing large-scale adaptive sports programs for disabled veterans and service members.

Related: Creative Solutions for Disability Challenges

The awards will go to 89 national, regional, and community programs, including veterans service organizations, municipalities, and other groups. The money can be used for planning, developing, managing, and implementing adaptive sports programs. The VA estimates that approximately 10,000 veterans and service members will benefit.

Related: Microprocessor Knee and Power Foot Combination in a Transfemoral Amputee

Recipients include the Challenged Athletes Foundation (California), which offers a triathlon, surfing, and martial arts; the Professional Association of Therapeutic Horsemanship International (Colorado), which offers therapeutic riding and equine-assisted therapy; and the USRowing Association (New Jersey), which offers adaptive rowing.

Related: Advances in Prosthetics Restore High Levels of Physical Activity

For a full list of organizations that will receive funds, visit http://www.va.gov/adaptivesports/va_grant_program.asp.

The VA is awarding up to $8 million in grants to eligible recipients with experience managing large-scale adaptive sports programs for disabled veterans and service members.

Related: Creative Solutions for Disability Challenges

The awards will go to 89 national, regional, and community programs, including veterans service organizations, municipalities, and other groups. The money can be used for planning, developing, managing, and implementing adaptive sports programs. The VA estimates that approximately 10,000 veterans and service members will benefit.

Related: Microprocessor Knee and Power Foot Combination in a Transfemoral Amputee

Recipients include the Challenged Athletes Foundation (California), which offers a triathlon, surfing, and martial arts; the Professional Association of Therapeutic Horsemanship International (Colorado), which offers therapeutic riding and equine-assisted therapy; and the USRowing Association (New Jersey), which offers adaptive rowing.

Related: Advances in Prosthetics Restore High Levels of Physical Activity

For a full list of organizations that will receive funds, visit http://www.va.gov/adaptivesports/va_grant_program.asp.

“As I have traveled to VA facilities throughout the country,” said Secretary of Veterans Affairs Robert A. McDonald, “I have heard from many veterans about what a vital role their service animals play in their lives.” To make sure veterans and employees have “clear guidance” about what defines a service animal and where they’re allowed, the VA has revised the regulation about animals on VA property.

Related: Health Care Is Coming to a "Crossing"

Only dogs that are individually trained to perform work or tasks on behalf of someone with a disability are considered service animals. Other animals will not be allowed in VA facilities unless for express exceptions, such as animal-assisted therapy or law enforcement purposes. The regulation was revised with input from veterans, advocacy organizations, and other stakeholders.

Related: Fiduciary Services for Veterans With Psychiatric Disabilities

The VA is training frontline employees to ensure that policies at all facilities are consistent with the new regulation.

“As I have traveled to VA facilities throughout the country,” said Secretary of Veterans Affairs Robert A. McDonald, “I have heard from many veterans about what a vital role their service animals play in their lives.” To make sure veterans and employees have “clear guidance” about what defines a service animal and where they’re allowed, the VA has revised the regulation about animals on VA property.

Related: Health Care Is Coming to a "Crossing"

Only dogs that are individually trained to perform work or tasks on behalf of someone with a disability are considered service animals. Other animals will not be allowed in VA facilities unless for express exceptions, such as animal-assisted therapy or law enforcement purposes. The regulation was revised with input from veterans, advocacy organizations, and other stakeholders.

Related: Fiduciary Services for Veterans With Psychiatric Disabilities

The VA is training frontline employees to ensure that policies at all facilities are consistent with the new regulation.

“As I have traveled to VA facilities throughout the country,” said Secretary of Veterans Affairs Robert A. McDonald, “I have heard from many veterans about what a vital role their service animals play in their lives.” To make sure veterans and employees have “clear guidance” about what defines a service animal and where they’re allowed, the VA has revised the regulation about animals on VA property.

Related: Health Care Is Coming to a "Crossing"

Only dogs that are individually trained to perform work or tasks on behalf of someone with a disability are considered service animals. Other animals will not be allowed in VA facilities unless for express exceptions, such as animal-assisted therapy or law enforcement purposes. The regulation was revised with input from veterans, advocacy organizations, and other stakeholders.

Related: Fiduciary Services for Veterans With Psychiatric Disabilities

The VA is training frontline employees to ensure that policies at all facilities are consistent with the new regulation.

A vaccine that will protect against anthrax after exposure is entering initial clinical studies. The project is one of several next-generation anthrax vaccines in development under the HHS Biomedical Advanced Research and Development Authority (BARDA). Each vaccine candidate uses different vaccine technology or is administered differently.

Related: Better Anthrax Vaccine on the Horizon

The latest vaccine, manufactured by Pfenex Inc., has performed well in nonclinical studies. It was shown to be effective after 2 doses administered 28 days apart. The new studies will test safety in a small number of healthy human volunteers. Replicating that finding would mean fewer doses would be needed than the 3 administered over 4 weeks used for postexposure prophylaxis with the current licensed vaccine.

Related: Vaccine Agencies Consolidate for More Effectiveness

Under the agreement with BARDA, Pfenex will also compare the safety and efficacy of a vaccine that incorporates an adjuvant and one that does not. Adjuvants stimulate the immune system with less of the active antigen ingredient, which means fewer doses are needed.

Related: Perceived Attitudes and Staff Roles of Disaster Management at CBOCs

Studies of the company’s manufacturing indicate that millions of doses could be produced using Pfenex’s novel recombinant technology, HHS says. Moreover, that technology could be transferred easily to BARDA’s Centers for Innovation in Advanced Development and Manufacturing to produce even greater quantities.

A vaccine that will protect against anthrax after exposure is entering initial clinical studies. The project is one of several next-generation anthrax vaccines in development under the HHS Biomedical Advanced Research and Development Authority (BARDA). Each vaccine candidate uses different vaccine technology or is administered differently.

Related: Better Anthrax Vaccine on the Horizon

The latest vaccine, manufactured by Pfenex Inc., has performed well in nonclinical studies. It was shown to be effective after 2 doses administered 28 days apart. The new studies will test safety in a small number of healthy human volunteers. Replicating that finding would mean fewer doses would be needed than the 3 administered over 4 weeks used for postexposure prophylaxis with the current licensed vaccine.

Related: Vaccine Agencies Consolidate for More Effectiveness

Under the agreement with BARDA, Pfenex will also compare the safety and efficacy of a vaccine that incorporates an adjuvant and one that does not. Adjuvants stimulate the immune system with less of the active antigen ingredient, which means fewer doses are needed.

Related: Perceived Attitudes and Staff Roles of Disaster Management at CBOCs

Studies of the company’s manufacturing indicate that millions of doses could be produced using Pfenex’s novel recombinant technology, HHS says. Moreover, that technology could be transferred easily to BARDA’s Centers for Innovation in Advanced Development and Manufacturing to produce even greater quantities.

A vaccine that will protect against anthrax after exposure is entering initial clinical studies. The project is one of several next-generation anthrax vaccines in development under the HHS Biomedical Advanced Research and Development Authority (BARDA). Each vaccine candidate uses different vaccine technology or is administered differently.

Related: Better Anthrax Vaccine on the Horizon

The latest vaccine, manufactured by Pfenex Inc., has performed well in nonclinical studies. It was shown to be effective after 2 doses administered 28 days apart. The new studies will test safety in a small number of healthy human volunteers. Replicating that finding would mean fewer doses would be needed than the 3 administered over 4 weeks used for postexposure prophylaxis with the current licensed vaccine.

Related: Vaccine Agencies Consolidate for More Effectiveness

Under the agreement with BARDA, Pfenex will also compare the safety and efficacy of a vaccine that incorporates an adjuvant and one that does not. Adjuvants stimulate the immune system with less of the active antigen ingredient, which means fewer doses are needed.

Related: Perceived Attitudes and Staff Roles of Disaster Management at CBOCs

Studies of the company’s manufacturing indicate that millions of doses could be produced using Pfenex’s novel recombinant technology, HHS says. Moreover, that technology could be transferred easily to BARDA’s Centers for Innovation in Advanced Development and Manufacturing to produce even greater quantities.

Ensuring that more children enter school “healthy and ready to learn” is the goal behind new funding from HHS for tribal communities. Through the Administration for Children and Families (ACF), HHS is awarding $600,000 to 6 tribal entities in the Tribal Early Learning Initiative (TELI). Launched by ACF in 2012, TELI supports American Indian tribes in coordinating early learning and development programs.

Related: Taking a New Approach to Tribal Child Welfare

This year’s grants have been awarded to the Confederated Salish and Kootenai Tribes (Montana) for the second time, Cherokee Nation (Oklahoma), Choctaw Nation (Oklahoma), the Confederated Tribes of Siletz Indians (Oregon), the Inter-Tribal Council of Michigan, and Red Cliff Band of Lake Superior Chippewa (Wisconsin).

Related: SAMHSA Awards Funds for Tribal Youth Programs

The ACF has also issued Tribal Early Learning Initiative: Collaborative Success, a report highlighting innovative projects by the first TELI grantees: Choctaw Nation (Oklahoma), Confederated Salish and Kootenai Tribes (Montana), Pueblo of San Felipe (New Mexico), and White Earth Nation (Minnesota).

Each tribe conducted a self-assessment to identify strengths and challenges. Choctaw Nation, for instance, described a “highly experienced, well-qualified, and dedicated staff” but felt challenged by serving families in such a large geographic area and lack of early care and education services for babies and toddlers.

Related: Improving Dental Health in Native Children

The tribes then came up with innovative ways to meet their identified challenges. After finding service gaps, such as no shared data system and weak intraprogram communication, Pueblo of San Felipe developed the “early childhood passport.” The passports, which contain important health and service information for each child and family, help streamline services and data sharing to ensure more timely referrals and continuity of care.

These first 4 projects, ACF says, now serve as models for other tribal early childhood programs.

Ensuring that more children enter school “healthy and ready to learn” is the goal behind new funding from HHS for tribal communities. Through the Administration for Children and Families (ACF), HHS is awarding $600,000 to 6 tribal entities in the Tribal Early Learning Initiative (TELI). Launched by ACF in 2012, TELI supports American Indian tribes in coordinating early learning and development programs.

Related: Taking a New Approach to Tribal Child Welfare

This year’s grants have been awarded to the Confederated Salish and Kootenai Tribes (Montana) for the second time, Cherokee Nation (Oklahoma), Choctaw Nation (Oklahoma), the Confederated Tribes of Siletz Indians (Oregon), the Inter-Tribal Council of Michigan, and Red Cliff Band of Lake Superior Chippewa (Wisconsin).

Related: SAMHSA Awards Funds for Tribal Youth Programs

The ACF has also issued Tribal Early Learning Initiative: Collaborative Success, a report highlighting innovative projects by the first TELI grantees: Choctaw Nation (Oklahoma), Confederated Salish and Kootenai Tribes (Montana), Pueblo of San Felipe (New Mexico), and White Earth Nation (Minnesota).

Each tribe conducted a self-assessment to identify strengths and challenges. Choctaw Nation, for instance, described a “highly experienced, well-qualified, and dedicated staff” but felt challenged by serving families in such a large geographic area and lack of early care and education services for babies and toddlers.

Related: Improving Dental Health in Native Children

The tribes then came up with innovative ways to meet their identified challenges. After finding service gaps, such as no shared data system and weak intraprogram communication, Pueblo of San Felipe developed the “early childhood passport.” The passports, which contain important health and service information for each child and family, help streamline services and data sharing to ensure more timely referrals and continuity of care.

These first 4 projects, ACF says, now serve as models for other tribal early childhood programs.

Ensuring that more children enter school “healthy and ready to learn” is the goal behind new funding from HHS for tribal communities. Through the Administration for Children and Families (ACF), HHS is awarding $600,000 to 6 tribal entities in the Tribal Early Learning Initiative (TELI). Launched by ACF in 2012, TELI supports American Indian tribes in coordinating early learning and development programs.

Related: Taking a New Approach to Tribal Child Welfare

This year’s grants have been awarded to the Confederated Salish and Kootenai Tribes (Montana) for the second time, Cherokee Nation (Oklahoma), Choctaw Nation (Oklahoma), the Confederated Tribes of Siletz Indians (Oregon), the Inter-Tribal Council of Michigan, and Red Cliff Band of Lake Superior Chippewa (Wisconsin).

Related: SAMHSA Awards Funds for Tribal Youth Programs

The ACF has also issued Tribal Early Learning Initiative: Collaborative Success, a report highlighting innovative projects by the first TELI grantees: Choctaw Nation (Oklahoma), Confederated Salish and Kootenai Tribes (Montana), Pueblo of San Felipe (New Mexico), and White Earth Nation (Minnesota).

Each tribe conducted a self-assessment to identify strengths and challenges. Choctaw Nation, for instance, described a “highly experienced, well-qualified, and dedicated staff” but felt challenged by serving families in such a large geographic area and lack of early care and education services for babies and toddlers.

Related: Improving Dental Health in Native Children

The tribes then came up with innovative ways to meet their identified challenges. After finding service gaps, such as no shared data system and weak intraprogram communication, Pueblo of San Felipe developed the “early childhood passport.” The passports, which contain important health and service information for each child and family, help streamline services and data sharing to ensure more timely referrals and continuity of care.

These first 4 projects, ACF says, now serve as models for other tribal early childhood programs.

Diabetes is one of the most common and fastest-growing comorbidities of pregnancy, according to a CDC study. Using Agency for Healthcare Research and Quality (AHRQ) databases for 19 states, the researchers found a 56% increase over 10 years in deliveries involving gestational diabetes mellitus (GDM): from 3.71 per 100 deliveries in 2000 to 5.77 per 100 deliveries in 2010. In that same time span, GDM deliveries increased significantly in all the study states, with relative increases ranging from 36% in Maryland to 88% in Utah.

Related: Does Gestational Diabetes Impact Autism Status?

Overall, the number of GDM deliveries increased by 59%, from 75,212 in 2000 to 119,229 in 2010 in the 19 states studied. In the states where ethnicity statistics were analyzed, the highest relative increase was among Hispanic patients. However, overall, non-Hispanic Asians had the highest prevalence of GDM. (IHS hospitals are not included in the AHRQ state data; the sample of Native Americans’ deliveries in community hospitals was too small to report.) Patients with prepregnancy hypertension were also increasingly likely to have a birth complicated by GDM. The greatest relative increase in GDM deliveries by age was among women aged 15 to 24 years.

Related: Maternal Morbidity: Higher Risk for Minorities

During the study period, the proportion of GDM deliveries with comorbidities also rose significantly: prepregnancy hypertension increased 64%, from 2.5% to 4.1%, and preeclampsia increased 12%, from 9.8% to 11.0%.

Related: Stopping Obesity in Its Infancy

Gestational diabetes mellitus has been associated with many adverse perinatal outcomes, such as larger-than-normal babies, leading to difficult labor and delivery and maternal morbidity. Moreover, GDM puts both mother and child at risk for type 2 DM. The researchers believe the rise in GDM deliveries can be directly linked to the rise in obesity across the U.S. Women who are obese are 4 to 8 times more likely to develop GDM, they note. The researchers advocate not only teaching about diabetes prevention and control, but also breast-feeding, which has been shown to mitigate the risk of type 2 DM, even in women who are obese or who have GDM, and their offspring.

Diabetes is one of the most common and fastest-growing comorbidities of pregnancy, according to a CDC study. Using Agency for Healthcare Research and Quality (AHRQ) databases for 19 states, the researchers found a 56% increase over 10 years in deliveries involving gestational diabetes mellitus (GDM): from 3.71 per 100 deliveries in 2000 to 5.77 per 100 deliveries in 2010. In that same time span, GDM deliveries increased significantly in all the study states, with relative increases ranging from 36% in Maryland to 88% in Utah.

Related: Does Gestational Diabetes Impact Autism Status?

Overall, the number of GDM deliveries increased by 59%, from 75,212 in 2000 to 119,229 in 2010 in the 19 states studied. In the states where ethnicity statistics were analyzed, the highest relative increase was among Hispanic patients. However, overall, non-Hispanic Asians had the highest prevalence of GDM. (IHS hospitals are not included in the AHRQ state data; the sample of Native Americans’ deliveries in community hospitals was too small to report.) Patients with prepregnancy hypertension were also increasingly likely to have a birth complicated by GDM. The greatest relative increase in GDM deliveries by age was among women aged 15 to 24 years.

Related: Maternal Morbidity: Higher Risk for Minorities

During the study period, the proportion of GDM deliveries with comorbidities also rose significantly: prepregnancy hypertension increased 64%, from 2.5% to 4.1%, and preeclampsia increased 12%, from 9.8% to 11.0%.

Related: Stopping Obesity in Its Infancy

Gestational diabetes mellitus has been associated with many adverse perinatal outcomes, such as larger-than-normal babies, leading to difficult labor and delivery and maternal morbidity. Moreover, GDM puts both mother and child at risk for type 2 DM. The researchers believe the rise in GDM deliveries can be directly linked to the rise in obesity across the U.S. Women who are obese are 4 to 8 times more likely to develop GDM, they note. The researchers advocate not only teaching about diabetes prevention and control, but also breast-feeding, which has been shown to mitigate the risk of type 2 DM, even in women who are obese or who have GDM, and their offspring.

Diabetes is one of the most common and fastest-growing comorbidities of pregnancy, according to a CDC study. Using Agency for Healthcare Research and Quality (AHRQ) databases for 19 states, the researchers found a 56% increase over 10 years in deliveries involving gestational diabetes mellitus (GDM): from 3.71 per 100 deliveries in 2000 to 5.77 per 100 deliveries in 2010. In that same time span, GDM deliveries increased significantly in all the study states, with relative increases ranging from 36% in Maryland to 88% in Utah.

Related: Does Gestational Diabetes Impact Autism Status?

Overall, the number of GDM deliveries increased by 59%, from 75,212 in 2000 to 119,229 in 2010 in the 19 states studied. In the states where ethnicity statistics were analyzed, the highest relative increase was among Hispanic patients. However, overall, non-Hispanic Asians had the highest prevalence of GDM. (IHS hospitals are not included in the AHRQ state data; the sample of Native Americans’ deliveries in community hospitals was too small to report.) Patients with prepregnancy hypertension were also increasingly likely to have a birth complicated by GDM. The greatest relative increase in GDM deliveries by age was among women aged 15 to 24 years.

Related: Maternal Morbidity: Higher Risk for Minorities

During the study period, the proportion of GDM deliveries with comorbidities also rose significantly: prepregnancy hypertension increased 64%, from 2.5% to 4.1%, and preeclampsia increased 12%, from 9.8% to 11.0%.

Related: Stopping Obesity in Its Infancy

Gestational diabetes mellitus has been associated with many adverse perinatal outcomes, such as larger-than-normal babies, leading to difficult labor and delivery and maternal morbidity. Moreover, GDM puts both mother and child at risk for type 2 DM. The researchers believe the rise in GDM deliveries can be directly linked to the rise in obesity across the U.S. Women who are obese are 4 to 8 times more likely to develop GDM, they note. The researchers advocate not only teaching about diabetes prevention and control, but also breast-feeding, which has been shown to mitigate the risk of type 2 DM, even in women who are obese or who have GDM, and their offspring.

Friday, October 16, Under Secretary for Benefits Allison A. Hickey became the third top official to resign at the VA since the wait-time scandal broke in 2014. Ms. Hickey was responsible for overseeing the arm of the VA that determines the type of benefits that veterans receive and their eligibility, as well as the disability claims backlog project.

Related: VA Falling Behind on Backlog According to the OIG

Ms. Hickey’s resignation was announced by Secretary of Veterans Affairs Robert A. McDonald in a statement. The VA went on to say, “The Department has not yet made any determination regarding individual wrongdoing in connection with the (Inspector General) report, nor has the Department of Justice notified the Department of any determination regarding criminal wrongdoing. As a result, no adverse action has been taken against Under Secretary Hickey or any other VBA employee.”

Related: VHA Under Harsh Criticism From OIG, GAO

Apart from the scandal during the summer of 2014 that seemingly led to the resignations of VA’s then Under Secretary for Health Dr. Robert Petzel and then Secretary Eric K. Shinseki, a recent report in late September from the VA Office of Inspector General found that about 2 dozen senior executives were promoted or moved to different positions within the department, and many were awarded salary increases, including the payment of $300,000 to a senior executive in Ms. Hickey’s department during a time when pay increases of this kind were frozen.  

Related: Michael Missal Nominated to Fill VA Inspector General Vacancy

A hearing was scheduled for October 21 by the House Committee on Veterans’ Affairs on the inappropriate use of position and misuse of the relocation program and incentives. Ms. Hickey was scheduled to appear at the hearing as a witness.

Friday, October 16, Under Secretary for Benefits Allison A. Hickey became the third top official to resign at the VA since the wait-time scandal broke in 2014. Ms. Hickey was responsible for overseeing the arm of the VA that determines the type of benefits that veterans receive and their eligibility, as well as the disability claims backlog project.

Related: VA Falling Behind on Backlog According to the OIG

Ms. Hickey’s resignation was announced by Secretary of Veterans Affairs Robert A. McDonald in a statement. The VA went on to say, “The Department has not yet made any determination regarding individual wrongdoing in connection with the (Inspector General) report, nor has the Department of Justice notified the Department of any determination regarding criminal wrongdoing. As a result, no adverse action has been taken against Under Secretary Hickey or any other VBA employee.”

Related: VHA Under Harsh Criticism From OIG, GAO

Apart from the scandal during the summer of 2014 that seemingly led to the resignations of VA’s then Under Secretary for Health Dr. Robert Petzel and then Secretary Eric K. Shinseki, a recent report in late September from the VA Office of Inspector General found that about 2 dozen senior executives were promoted or moved to different positions within the department, and many were awarded salary increases, including the payment of $300,000 to a senior executive in Ms. Hickey’s department during a time when pay increases of this kind were frozen.  

Related: Michael Missal Nominated to Fill VA Inspector General Vacancy

A hearing was scheduled for October 21 by the House Committee on Veterans’ Affairs on the inappropriate use of position and misuse of the relocation program and incentives. Ms. Hickey was scheduled to appear at the hearing as a witness.

Friday, October 16, Under Secretary for Benefits Allison A. Hickey became the third top official to resign at the VA since the wait-time scandal broke in 2014. Ms. Hickey was responsible for overseeing the arm of the VA that determines the type of benefits that veterans receive and their eligibility, as well as the disability claims backlog project.

Related: VA Falling Behind on Backlog According to the OIG

Ms. Hickey’s resignation was announced by Secretary of Veterans Affairs Robert A. McDonald in a statement. The VA went on to say, “The Department has not yet made any determination regarding individual wrongdoing in connection with the (Inspector General) report, nor has the Department of Justice notified the Department of any determination regarding criminal wrongdoing. As a result, no adverse action has been taken against Under Secretary Hickey or any other VBA employee.”

Related: VHA Under Harsh Criticism From OIG, GAO

Apart from the scandal during the summer of 2014 that seemingly led to the resignations of VA’s then Under Secretary for Health Dr. Robert Petzel and then Secretary Eric K. Shinseki, a recent report in late September from the VA Office of Inspector General found that about 2 dozen senior executives were promoted or moved to different positions within the department, and many were awarded salary increases, including the payment of $300,000 to a senior executive in Ms. Hickey’s department during a time when pay increases of this kind were frozen.  

Related: Michael Missal Nominated to Fill VA Inspector General Vacancy

A hearing was scheduled for October 21 by the House Committee on Veterans’ Affairs on the inappropriate use of position and misuse of the relocation program and incentives. Ms. Hickey was scheduled to appear at the hearing as a witness.